www.ias2011.org
Reaching Out To Men In Soweto Through A Community-Based VCT Approach
G. Robertson1, S. Mhlongo1, M. Van der Watt1, G. Gray1
1 University of the Witwatersrand, Perinatal HIV Research Unit, Johannesburg, South Africa
www.ias2011.org
Background
• Historically, relatively few men volunteered for HIV Counseling and Testing (VCT) in Soweto, South Africa.
• An indication of the situation:– Between March 2003 and October 2006, Project Accept surveyed
14,818 participants in 48 communities across 5 sites in 4 countries on prior VCT uptake.
– compared to non-testers …• Testers in Zimbabwe were as likely to be men or
women; • Testers in Vulindlela, SA were twice as likely to be
women; Testers in Tanzania were 2.5 times as likely to be women; Testers in Thailand were almost 3 times as likely to be women; and,
• Testers in Soweto, SA, were nearly 5 times as likely to be women.
www.ias2011.org
Background• Project Accept is a community-randomized controlled
trial with an intervention which includes community mobilization, community-based voluntary counseling and testing (CBVCT), and post-test support services.
www.ias2011.org
Methods• Project Accept offered CBVCT in 4 Soweto communities.• Administrative and HIV serology data, from July 2006 to December
2010, were analyzed to assess uptake and HIV rates.
www.ias2011.org
Results
• 20,304 participants were offered VCT• 20, 100 (99.0%) agreed to be tested for HIV along with pre-test and
post-test counseling.• The median age was 28 years.
www.ias2011.org
Results
• Of those tested, 10,177 (50%) were women and 10,127 (50%) were men.
0
200
400
600
800
1000
Jul 06 Nov 06 Mar 07 Sep 07 Jan 08 May 08 Oct 08 Feb 09 Aug 09 Dec 09 Apr 10 Sep 10
Month (2006-2010)
VCT
upta
ke
MaleFemale
www.ias2011.org
Results• 33% (n=6,605) of all participants reported never having
taken an HIV test before.• Of these, 59% were men.
0
100
200
300
Jul 06 Nov06
Mar 07 Sep07
Jan 08 May08
Oct 08 Feb09
Aug09
Dec09
Apr 10 Sep10
Month (2006-2010)
VC
T up
take
by
first
tim
e te
ster
s
MaleFemale
www.ias2011.org
Results• Of all participants tested, 1830 (9%) were sero-positive
for HIV.• More women (n=1,117, 11%) tested positive than men
(n=713, 7%); (p<0.0001).
0
5
10
15
20
25
30
35
40
<18 18-25 26-35 36-50 >50
Age group (years)
Ove
rall
HIV
pr
eval
ence
200
6-20
10
(%) Male
Female
www.ias2011.org
Results
• In all women who had never tested, 35% tested HIV sero-positive
• In all men who had never tested, 52% tested HIV sero-positive (p<0.0001)
0
5
10
15
20
25
30
35
40
45
<18 18-25 26-35 36-50 >50
Age group (years)
HIV
pre
vale
nce
in fi
rst t
ime
test
ers
(%)
MaleFemale
www.ias2011.org
Results
• HIV prevalence by year
0
2
4
6
8
10
12
14
2006 2007 2008 2009 2010
Year
HIV
pre
vale
nce
(%)
MaleFemale
www.ias2011.org
Conclusion
It appears that men are less likely than women to access standard VCT.
Unlike previously observed trends, the Project Accept community-based approach shows similar VCT uptake between women and men in Soweto.
The high prevalence of HIV among first-time testers, particularly men, indicates that the community-based approach seems effective in reaching previously unreachable men.
www.ias2011.org
Acknowledgements
• NIMH
• HPTN
• Project Accept Team– Perinatal HIV Research Unit, Soweto
• Professor Thomas Coates (Study PI)
