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Characteristics of HIV voluntary counseling and testing clients before and during care and treatment scale-up in Moshi, Tanzania.

Publication ,  Journal Article
Shorter, MM; Ostermann, J; Crump, JA; Tribble, AC; Itemba, DK; Mgonja, A; Mtalo, A; Bartlett, JA; Shao, JF; Schimana, W; Thielman, NM
Published in: J Acquir Immune Defic Syndr
December 2009

OBJECTIVES: We evaluated changes in characteristics of clients presenting for voluntary counseling and testing (VCT) before and during care and treatment center (CTC) scale-up activities in Moshi, Tanzania, between November 2003 and December 2007. METHODS: Consecutive clients were surveyed after pretest counseling, and rapid HIV antibody testing was performed. Trend tests were used to assess changes in seroprevalence and client characteristics over time. Multivariable logistic regression models were used to estimate the contribution of changes in sociodemographic and behavioral risk characteristics, and symptoms, to changes in seroprevalence before and during CTC scale-up. RESULTS: Data from 4391 first-time VCT clients were analyzed. HIV seroprevalence decreased from 26.2% to 18.9% after the availability of free antiretroviral therapy and expansion of CTCs beyond regional and referral hospitals. Seroprevalence decreased by 27 % for females (P = 0.0002) and 34% for males (P = 0.0125). Declines in seropositivity coincided with decreases in symptoms among males and females (P < 0.0001) and a more favorable distribution of sociodemographic risks among females (P = 0.002). No changes in behavioral risk characteristics were observed. CONCLUSIONS: Concurrent with the scale-up of CTCs, HIV seroprevalence and rates of symptoms declined sharply at an established freestanding VCT site in Moshi, Tanzania. If more HIV-infected persons access VCT at sites where antiretrovirals are offered, freestanding VCT sites may become a less cost-effective means for HIV case finding.

Duke Scholars

Published In

J Acquir Immune Defic Syndr

DOI

EISSN

1944-7884

Publication Date

December 2009

Volume

52

Issue

5

Start / End Page

648 / 654

Location

United States

Related Subject Headings

  • Virology
  • Tanzania
  • Risk-Taking
  • Male
  • Humans
  • Health Services Accessibility
  • HIV Seroprevalence
  • HIV Infections
  • Female
  • Developing Countries
 

Citation

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Shorter, M. M., Ostermann, J., Crump, J. A., Tribble, A. C., Itemba, D. K., Mgonja, A., … Thielman, N. M. (2009). Characteristics of HIV voluntary counseling and testing clients before and during care and treatment scale-up in Moshi, Tanzania. J Acquir Immune Defic Syndr, 52(5), 648–654. https://doi.org/10.1097/QAI.0b013e3181b31a6a
Shorter, Meghan M., Jan Ostermann, John A. Crump, Alison C. Tribble, Dafrosa K. Itemba, Anna Mgonja, Antipas Mtalo, et al. “Characteristics of HIV voluntary counseling and testing clients before and during care and treatment scale-up in Moshi, Tanzania.J Acquir Immune Defic Syndr 52, no. 5 (December 2009): 648–54. https://doi.org/10.1097/QAI.0b013e3181b31a6a.
Shorter MM, Ostermann J, Crump JA, Tribble AC, Itemba DK, Mgonja A, et al. Characteristics of HIV voluntary counseling and testing clients before and during care and treatment scale-up in Moshi, Tanzania. J Acquir Immune Defic Syndr. 2009 Dec;52(5):648–54.
Shorter, Meghan M., et al. “Characteristics of HIV voluntary counseling and testing clients before and during care and treatment scale-up in Moshi, Tanzania.J Acquir Immune Defic Syndr, vol. 52, no. 5, Dec. 2009, pp. 648–54. Pubmed, doi:10.1097/QAI.0b013e3181b31a6a.
Shorter MM, Ostermann J, Crump JA, Tribble AC, Itemba DK, Mgonja A, Mtalo A, Bartlett JA, Shao JF, Schimana W, Thielman NM. Characteristics of HIV voluntary counseling and testing clients before and during care and treatment scale-up in Moshi, Tanzania. J Acquir Immune Defic Syndr. 2009 Dec;52(5):648–654.

Published In

J Acquir Immune Defic Syndr

DOI

EISSN

1944-7884

Publication Date

December 2009

Volume

52

Issue

5

Start / End Page

648 / 654

Location

United States

Related Subject Headings

  • Virology
  • Tanzania
  • Risk-Taking
  • Male
  • Humans
  • Health Services Accessibility
  • HIV Seroprevalence
  • HIV Infections
  • Female
  • Developing Countries