Voluntary Counselling and Testing and Behavior Change Communication

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Voluntary Counselling and Testing and Behavior
Change Communication

• Dr. Gwendolyn T. Morgan
• Population Services International Nairobi, Kenya

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History of VCT Promotional Campaigns

• 2001- aimed to increase general awareness of VCT
  and service centers
• 2002 - targeted to youth to promote VCT as the
  key tool that helps individuals control and
  manage their serostatus in order to achieve
  future goals and dreams
• 2003 - encourage young Kenyan couples to visit
  VCT centers to know each others HIV status as a
  normal, indisputable element of dating, getting
  married or starting a family

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Care and Treatment Emphasis in BCC

• Access to care and treatment can help prevention
  by providing hope to persons affected by AIDS
• Greater incentive to seek HIV testing (and
  therefore risk reduction counseling) when
  effective HIV treatment is available and greater
  disincentive when it is not, especially where
  high stigma of HIV exists
• Communities devastated by AIDS may view HIV
  infection as inevitable and self care and
  prevention take low priority
• Thus current VCT mass media campaign strategy
  focuses on importance of HIV testing as a
  lifestyle strategy for those who may feel
  perfectly healthy, as well as promote the message
  of positive living and treatment options for
  people who test HIV

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2004 Campaign Goal and Objectives

• Fourth VCT mass media campaign currently airing
• Communications goal increasing uptake of
  national VCT services in Kenya.
• Communications objectives
• To increase the general understanding that while
  most people test negative, there is hope and
  treatment available for people who test positive.
• To reduce the fear associated with testing among
  non-users

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2004 Campaign Target and Approach

• Target Audience male family decision-makers and
  established couples aged 18-35
• Branding and approach
• Onyesha Mapenzi Yako
• Continues to focus on the importance of HIV
  testing as a lifestyle strategy for those who may
  feel perfectly healthy as with previous
  campaigns.
• First VCT mass media campaign developed under the
  national communications strategy that also seeks
  to promote the message of positive living and
  treatment options for people who test HIV.
• While message is hopeful and positive, campaign
  look and feel is less aspirational (i.e.,
  upmarket) than previous campaigns

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2004 PSI Tracking Survey - Methods

• National survey conducted by PSI in September
  2004 as a campaign baseline
• Random sample, urban/peri-urban household
  baseline survey in Kenyas 13 largest towns and
  cities sample size 2,334 males and females
  aged 15-35
• Survey included questions on motivations for HIV
  testing, as well as ART and its potential effect
  on peoples willingness to be tested.

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2004 PSI Tracking Survey - Results

• Nearly 90 of males and females aged 15-35 are
  aware of confidential HIV testing
• 32 have ever been tested 23 of the total
  sample has ever received a voluntary test
• Among those who have never been tested (n1589),
  70 expressed interest in taking a test in the
  future

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Reasons for getting tested, N2334
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Reasons for NOT getting tested, N2334
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When a person should get tested, N2334
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Where a person should get tested, N2334
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With whom respondent was voluntarily tested, n546
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HIV Testing and ART availability

• Among those who have never been tested (n1589),
  67 were interested in testing, regardless of
  whether or not ART is available.
• An additional 26 were set on not getting tested,
  even after the possibility of access to ARVs was
  mentioned.
• Only 7 (104 out of 1589 never tested
  respondents) said that access to ARVs would
  actually change their mind and make them more
  interested in going for HIV testing.

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Conclusions

• Without any communications efforts (at baseline),
  hypothetical availability of ART is not likely to
  be a big motivator for HIV testing among
  previously uninterested or undecided people who
  have never received an HIV test.
• Will the current ART and VCT promotional
  campaigns change this view?
• Future research around the ART campaign as well
  as a follow-up survey for the VCT campaign should
  yield additional information and insights on the
  use of care messages to encourage VCT uptake.