The role of voluntary counselling and testing in modifying risky sexual behaviour for HIV infection : cross-sectional study from the ‘Wellness Clinic’ of a District Hospital in rural Limpopo, South Africa
Thesis (MMed)--Stellenbosch University, 2016.
ENGLISH ABSTRACT: Background: Voluntary HIV counselling and testing (VCT) is considered one of the key strategies in the prevention and control of HIV/AIDS in South Africa. However its role in modifying risky sexual behaviour among patients tested as HIV-negative (primary prevention) is controversial. Objective: This study was intended to demonstrate the likelihood of VCT reducing risky sexual practices among patients testing sero-negative for HIV infection. Methods: This is a quantitative cross-sectional survey that took place over a period of 3½ months in a district hospital in rural South Africa. A self-administered questionnaire was completed by 54 patients who had VCT and tested sero-negative for HIV infection during the previous 12 months (Study Group). The same questionnaire was filled in by 61 patients who had never received VCT before (Control Group). Both groups consisted of women and men aged 18 years or older. Socio-demographic information, sexual behaviour, willingness to disclose the HIV sero-status with the sexual partner, and readiness to have VCT were asked in the survey. To compare differences between two independent proportions the Pearson Chi-square test was used. Significant results were regarded as a p-value of less than 0, 05, which was taken as an indication of association between VCT and the variable being measured. Results: The median age of our sample was 29 years (Interquartile Range 24-40), with most of the respondents (38 %) between the ages of 26 and 35 years. More than 90 % of patients in both groups reported being sexually active. Sexual intercourse with more than one partner was significantly lower in the Study group (p=0,003). Those who had never received VCT before had a higher (although not significant) incidence of episodes of unprotected sexual intercourse and symptoms of sexually transmitted infections (STIs) (81, 9 % and 42, 6 % respectively) when compared to the study group (77, 7 % and 35, 1 %). Most of the participants in both groups did not consider the disclosing of their sero-status an issue of concern for their sexual partner(s). Readiness to receive VCT was significantly higher in the study group (p=0, 02). Conclusions: In this study, people who tested sero-negative for HIV through VCT showed a significant decrease in the number of sexual partners as compared to the control group who did not undergo VCT. The VCT group had less unprotected sexual intercourse and less symptoms of STIs than the control group.