Abstract

Bringing health facilities to the people: HIV voluntary counseling and testing (VCT) in a public square

J. Carreazo, C. Anton, R. Ayarza, S. Moran, B. Brown

Via Libre, Lima, Peru

Issues: In Peru, many health care facilities offer HIV testing, but very few people get tested. Socio-cultural barriers are the main reason for low attendance. Initiatives to make VCT facilities available to people outside traditional heath care settings are needed.
Description: Twenty module units were used to provide free VCT services with rapid HIV tests in a public square in Lima. We utilized television, radio, press and billboards to promote this activity, and brought in musicians and games to attract participants. The team consisted of 28 health care providers and 53 volunteers.
We tested 757 people (66.1% men, 33.9% women). Sexual orientation included: heterosexual (84.8%), homosexual (7.6%) and bisexual (7.6%). Of all participants, 62.7% had never been tested for HIV, 49.8% didn't know the location of VCT facilities, and 36.9% engaged in HIV risk activities during the last year but didn't recognize them as such.
Furthermore, 68.4% didn't use a condom during their last sexual intercourse and 12.4% had unprotected sex with both stable and occasional partner(s) during the last year. Reported reasons for not using condoms included: trusting their partner (36.0%), not liking condoms (24.9%), partner objection (18.5%), non-availability of condoms (8.8%) and alcohol use (4.3%). Overall, 1.1% tested positive for HIV and received emotional support and health education information.
Lessons learned: By providing innovative, free and confidential VCT services in a public square, we reached 475 people who had never received HIV testing. Using mass media promotion and providing entertainment spaces on site were key strategies for success of this public health campaign.
Next steps: Local government units should be given assistance to replicate this HIV testing strategy. Efforts to assess the feasibility of providing additional rapid STI testing, as part of this model, are needed.