艾滋病与临床研究杂志

Barriers to VCT for Vulnerable and Non-Vulnerable population at Risk of HIV

Abstract

Bang-on Thepthien and Supattra Srivanichakorn

This study had the objective to study obstacles to HIV VCT for vulnerable and non-vulnerable populations at risk of HIV. Data were collected in a cross-sectional survey conducted during May to July, 2013 in eight, purposively-selected provinces which are part of the 31 priority provinces of the NAP for 2012-16. Selection of the vulnerable population was conducted using time-location sampling and quota sampling, yielding a sample of 751 persons. Representatives of the non-vulnerable population were selected using probability proportional to size and cluster sampling, yielding 1,937 cases. This study found that, among those who ever had been tested for HIV before, the deterrents to intention to seek VCT in the coming year include lack of perceived self-risk for HIV, lack of knowledge of right to subsidized VCT, negative attitude toward VCT, and disrespectful service providers. Among those who had never had an HIV test, deterrents include lack of risk behavior, lack of being urged to go for testing, lack of information on VCT, and negative attitude. Thus, in order to increase coverage of VCT for populations vulnerable for HIV there should be interventions to increase accurate self-risk assessment, increased information about VCT and the right to subsidized services, and deployment of peer motivators to encourage testing for those with risk. MSM had lower coverage of VCT than other vulnerable groups. From this study, it is clear that negative attitude toward VCT affects VCT-seeking behavior. Thus, interventions are needed to modify attitudes toward VCT so people see the benefit of knowing one’s serostatus, and enable those newly-infected to receive early treatment. Increasing coverage of VCT for the non-vulnerable population should not be that difficult. However there may be a need for a re-design of prevention interventions so they are more closely linked with treatment to ensure optimal initiation of treatment of the infected.