Perceptions of staff and
policy-makers of voluntary testing and counseling in Guyana
C. Trout1, S. Sayana2, J. Chang2, S. Singh3, D. Success-Hall3, O. Alleyne4, H. Bailey5, H. Khanlou2
1Boston University School of Public Health, Boston, United States, 2AIDS Healthcare Foundation, Los Angeles, United States, 3Ministry of Health, HIV-AIDS, Georgetown, Guyana, 4Management Sciences for Health, Georgetown, Guyana, 5AIDS Healthcare Foundation, Georgetown, Guyana
Background: Guyana has an HIV prevalence rate of 1.8%. In preparation for a four-year USAID-funded technical assistance project to the Guyanese government, the Guyana HIV/AIDS Reduction and Prevention Project-II (GHARP-II) and AIDS Healthcare Foundation conducted a needs assessment. This included formal interviews with key stakeholders eliciting their perceptions regarding the national Voluntary Counseling and Testing (VCT) programs.
Methods: A semi-structured qualitative interview tool was used during July to September of 2009 to elicit feedback from 20 key stakeholders in 6 of Guyana's 10 administrative regions regarding challenges and successes of Guyana's VCT program. Nine interviews were individual and 5 were held with groups of 2-3 people. Interviewees included national and regional policymakers as well as site-level staff. Open-ended responses were grouped by theme, tabulated and ranked in order of importance.
Results: According to the key stakeholders interviewed, Guyana's VCT programs have made great progress since its inception in 1998. Stakeholders felt that increased numbers of tested, increased demand in the population, and good referrals were the most important successes, in that order. Strengths of the VCT programs included, with order of importance, linkages to medical treatment, national political will, and a strong education component. Areas of prioritized improvement were increased services in the interior regions and improvement of provider-initiated counseling and testing (PICT), a national priority. Two key weaknesses identified were monitoring, supervision and reaching Guyanese Most-At-Risk Populations (MARP), such as Men who have Sex with Men, and Commercial Sex Workers with HIV testing due to stigma, discrimination, lack of disclosure, and insufficient targeting of the service.
Conclusions: Guyana's VCT programs for HIV are mature and supported by strong political will and motivated staff and leadership. Focus should now be on improving PICT, better geographic coverage, and better targeting MARP.
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