National Institute of Medical Research, Mwanza, Tanzania.
Trop Med Int Health. 2012 Aug;17(8):e15-25. doi: 10.1111/j.1365-3156.2011.02877.x.
To describe trends in voluntary counselling and testing (VCT) use and to assess whether high-risk and infected individuals are receiving counselling and learning their HIV status in rural Tanzania.
During two rounds of linked serological surveys (2003-2004 and 2006-2007) with anonymous HIV testing among adults, VCT was offered to all participants. The crude and adjusted odds ratios for completing VCT in each survey were calculated to compare uptake by demographic, behavioural and clinical characteristics, stratified by sex. Repeat testing patterns were also investigated.
The proportion of participants completing VCT increased from 10% in 2003-2004 to 17% in 2006-2007, and among HIV-infected persons from 14% to 25%. A higher proportion of men than women completed VCT in both rounds, but the difference declined over time. Socio-demographic and behavioural factors associated with VCT completion were similar across rounds, including higher adjusted odds of VCT with increasing numbers of sexual partners in the past 12 months. The proportion having ever-completed VCT reached 26% among 2006-2007 attendees, with repeat testing rates highest among those aged 35-44 years. Among 3923 participants attending both rounds, VCT completion in 2006-2007 was 17% among 3702 who were HIV negative in both rounds, 19% among 124 who were HIV infected in both rounds and 22% among 96 who seroconverted between rounds.
VCT services are attracting HIV-infected and high-risk individuals. However, 2 years after the introduction of antiretroviral therapy, the overall uptake remains low. Intensive mobilisation efforts are needed to achieve regular and universal VCT use.
描述坦桑尼亚农村地区自愿咨询检测（VCT）使用的趋势，并评估高危和感染人群是否接受咨询并了解其 HIV 状况。
在两轮成年人匿名 HIV 检测的血清学调查（2003-2004 年和 2006-2007 年）中，向所有参与者提供 VCT。计算每个调查中完成 VCT 的粗比数比和调整后的比值比，以比较按性别分层的人口统计学、行为和临床特征的吸收率。还调查了重复检测模式。
在 2003-2004 年至 2006-2007 年期间，完成 VCT 的参与者比例从 10%增加到 17%，HIV 感染者从 14%增加到 25%。两轮中男性完成 VCT 的比例均高于女性，但这种差异随着时间的推移而缩小。与 VCT 完成相关的社会人口统计学和行为因素在两轮中相似，包括过去 12 个月中性伴侣数量增加，VCT 完成的调整后比值比更高。在 2006-2007 年参加者中，有过 VCT 经历的比例达到 26%，其中年龄在 35-44 岁的重复检测率最高。在参加两轮调查的 3923 名参与者中，2006-2007 年两轮均为 HIV 阴性的 3702 名参与者中，有 17%完成了 VCT；两轮均为 HIV 感染的 124 名参与者中，有 19%完成了 VCT；两轮之间发生血清转换的 96 名参与者中，有 22%完成了 VCT。
VCT 服务正在吸引 HIV 感染者和高危人群。然而，在抗逆转录病毒治疗推出两年后，总体吸收率仍然较低。需要加强动员努力，以实现定期和普遍的 VCT 使用。
