Client-provider interactions in provider-initiated and voluntary HIV counseling and testing services in Uganda
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Date
2013
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Health Services Research
Abstract
Provider-initiated HIV testing and counselling (PITC) is based on information-giving while voluntary
counselling and testing (VCT) includes individualised client-centered counseling. It is not known if the providerclient
experiences, perceptions and client satisfaction with the information provided differs in the two approaches.
Methods: In 2008, we conducted structured interviews with 627 individuals in Uganda; 301 tested through PITC
and 326 through voluntary counselling and testing (VCT). We compared client experiences and perceptions based
on the essential elements of consent, confidentiality, counseling, and referral for follow-up care. We conducted
multivariate analysis for predictors of reporting information or counselling as sufficient.
Results: In VCT, 96.6% (282) said they were asked for consent compared to 91.3% (198) in PITC (P = 0.01). About the
information provided, 92.0% (286) in VCT found it sufficient compared to 78.7% (221) in PITC (P = <0.01). In VCT
79.9% (246) thought their results were kept confidential compared to 71.7% (200) in PITC (P = 0.02). Eighty percent
(64) of HIV infected VCT clients said they were referred for follow-up care versus 87.3% (48) in PITC (p = 0.2).
Predictors of perceived adequacy of information in PITC included an opportunity to ask questions (adj.RR 1.76,
CI 1.41, 2.18) and expecting the test results received (adj.RR 1.18, CI 1.06, 1.33). For VCT significant factors included
being given an opportunity to ask questions (adj.RR 1.62, CI 1.00, 2.60) and 3+ prior times tested, (adj.RR 1.05,
CI 1.00, 1.09).
Description
Keywords
Provider-initiated HIV testing, HIV counselling
Citation
Wanyenze, R. K., Kyaddondo, D., Kinsman, J., Makumbi, F., Colebunders, R., & Hardon, A. (2013). Client-provider interactions in provider-initiated and voluntary HIV counseling and testing services in Uganda. BMC Health Services Research, 13(1), 1-8.