| Popis: |
Background: HIV testing and counseling are entry points to HIV-related care and prevention services, and provide opportunities for people to reduce their risk of acquiring or transmitting HIV. Very little has been done to assess the quality of VCT services in Addis Ababa. Objective: A cross sectional, facility based study was conducted in February 2006 to assess the quality of VCT services in Addis Ababa. Methodology: It used structured questionnaires adopted from standardized UNAIDS materials. The study involved 41 different VCT sites, 65 VCT counselors and 403 VCT clients for exit interview. Six clients per counselor for exit interview were selected systematically. Descriptive statistics were computed for most of the variables. A non parametric comparison was made for time variables among the three service provider sites. SPSS version 11.0 was used to enter, clean, and analyze the data. Results: Only 27 (69.2%) VCT sites provide follow up counseling for HIV positive individuals besides Pre- and Post-test counseling services. Twenty two VCT sites have a separate counseling room with adequate space. Out of 65 counselors, 61 (93.8%) were nurses and only 20 (30.8%) were self motivated to be one. In-service training was given for only 11(16.6%) counselors and only 24 (36.9%) attend counselors' support group. Over 83% of the clients came self referred and 177 (43.9%) clients chose the specific VCT site because it was close to home. The median waiting time to see a counselor was longer in government sites and waiting time to get test results was longer in private VCT sites. Over 79% of the clients were generally satisfied by the service. Conclusions: Majority of the VCT sites in Addis Ababa fulfilled the minimum requirements recommended by the WHO. There seemed to be lack of ongoing counseling training and support for counselors. There was a high satisfaction viii rate by the clients. However, counseling session durations were found to be less than the recommended. Recommendations: The regional government should take measures to enhance quality VCT services within the already available sites and establish more free standing sites. A strong counselors' support group should be formed and be able to enroll as many members as possible. Further studies should apply direct observation of counseling sessions. |
