Barcelona 2013
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| Abstract #480 - E-Posters English | ||||
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Session: 50.79: E-Posters English (Poster) on Sunday in Chaired by Authors: Presenting Author: Dr Michele Breveglieri - Verona Health Authority 20 - Veneto Region, Italy |
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| Additional Authors: Dr. Jordi Casabona, Sra Cristina Sanclemente, Dra. Anna Esteve, Dra. Victoria Gonzalez, Grupo HIVITS TS, | ||||
| Aim: HIV-Cobatest survey aimed to understand how the concept of Community Based Voluntary Counseling and Testing (CBVCT) is translated into practice in Europe. | ||||
| Method / Issue: The study was a quantitative cross-sectional survey in EU/EFTA countries. Two targets were foreseen: HIV/AIDS National Focal Points and CBVCTs. Data from the CBVCT sample are presented. CBVCT was defined as ?any program or service that offers HIV counseling and testing on a voluntary basis outside formal health facilities and that has been designed to target specific groups of the population most at risk and is clearly adapted for and accessible to those communities. These services should ensure the active participation of the community with the involvement of community representatives either in planning or implementing HIV testing interventions and strategies?. Correspondence analysis was performed. | ||||
| Results / Comments: CBVCTs are implemented in at least 23 European Countries. Data from 55 CBVCTs were collected from 22 countries. In terms of community involvement and strategy, the CB approach was found to be very different between and within countries. Differences were found regarding who is allowed to perform post-test counselling: in only 8 countries (36%) peer educators were involved in post-test counselling. The most reported setting is NGO (73%), followed by outdoor setting (42%) and venue setting (40%). Only 31% reported health care setting. 73% of CBVCTs report using rapid blood HIV tests through finger prick. Oral fluid rapid test was only reported by two services. Only 45% reported they perform confirmatory test directly on site. 91% of CBVCTs report a NGO management, three by public bodies and only in one case NGO and public body shares responsibility. Half of the CBVCTs reported a public/private co-funding and one third reported a public/governmental funding. With correspondence analysis three main forms of CBVCT were identified: one with a strong community involvement, peer-driven, implemented in venue or NGO settings, managed by the community and usually targeting MSM; one characterized by a bigger role played by professionals such as psycho-social workers, but where an NGO is present as a key ?community representative? and where work and settings are organized in order to meet the needs of the target, mainly IDUs, SWs and migrants; one characterized by the central role of the health care setting, and ?community-based? is interpreted mainly in the sense of a target orientation characterized by some kind of needs assessment and outdoor activity. There is also a fourth form that is less clearly identifiable as ?community-based?, characterized by a full medicalization of the procedure. | ||||
| Discussion: The HIV-COBATEST CBVCT definition has been highly accepted. Data suggest important differences among CBVCTs. Efforts should be done to facilitate the development of common regulations, strategies and procedures to implement and evaluate CBVCTs to ensure comparability across countries. Regulations that may be obstacles for CB testing should be reviewed. Common legal frameworks for non-health professionals performing rapid tests should be developed and minimum pre-test information packages agreed. It is necessary to provide guidance to CBVCTs on the use of comparable indicators to monitor and evaluate their activities. | ||||
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