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Acceptance of and barriers to voluntary HIV counselling and testing among adults in Guizhou province, China

Ma, Weia; Detels, Rogerb; Feng, Yujib; Wu, Zunyoua,b; Shen, Limeic; Li, Yuc; Li, Zezhend; Chen, Fange; Wang, Aimine; Liu, Taimingd

doi: 10.1097/01.aids.0000304708.64294.3f
Original papers

Objectives: To find and compare the levels of acceptance of and barriers to voluntary counselling and testing (VCT) among adults in two different counties of Guizhou province, China, one in which the China CARES project was operating and the other in which it was not.

Design: A longitudinal design with two-stage cluster sampling was employed.

Methods: A total of 1012 participants were recruited in the two counties. All participants were interviewed, then given a coupon for free VCT after the interview. Participants were paid for returning the coupon within 2 months, whether tested or not. The uptake of VCT was measured within 2 months after the interview.

Results: The study found that the levels of HIV/AIDS knowledge and acceptability of VCT among the adults in both counties were low. Although 459 participants (43.5%) expressed an intent to use the VCT services, only 193 (16.5%) actually visited the VCT facilities, and only 42 (3.7%) actually took an HIV test within 2 months after the interview. The use of VCT was related to occupation, age, transportation difficulties, health status, ethnicity, and high-risk behaviors. The main barriers to HIV testing included perceiving oneself as low risk, fear of unsolicited disclosure, and fear of stigma and discrimination that would result from taking the test.

Conclusion: Education about HIV/AIDS and VCT needs to be improved, and levels of stigma and discrimination reduced, in order to enhance the uptake of VCT services, an essential step for the initiation of treatment.

From the aNational Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China

bDepartment of Epidemiology, University of California, Los Angeles, School of Public Health, Los Angeles, California, USA

cGuizhou Provincial Center for Disease Control and Prevention, Guiyang, China

dWeng'an County Center for Disease Control and Prevention, Weng'an, China

eZhijin County Center for Disease Control and Prevention, Zhijin, China.

Correspondence to Roger Detels, MD, MS, Department of Epidemiology, UCLA School of Public Health, Box 951772, Los Angeles, CA 90095-1772, USA. Tel: +1 310/206 2837; fax: +1 310/206 6039; e-mail: detels@ucla.edu

Requests for reprints to Wei Ma, MD, PhD, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, China. Tel: +86 10 63039082; e-mail: wei_ma01@sohu.com

© 2007 Lippincott Williams & Wilkins, Inc.