Patterns of self-reported behaviour change associated with receiving voluntary counselling and testing in a longitudinal study from Manicaland, Zimbabwe

Abstract

Voluntary counselling and testing (VCT) is promoted as a potential HIV prevention measure. We describe trends in uptake of VCT for HIV, and patterns of subsequent behaviour change associated with receiving VCT in a population-based open cohort in Manicaland, Zimbabwe. The relationship between receipt of VCT and subsequent reported behaviour was analysed using generalized linear models with random effects. At the third survey, 8.6% of participants (1,079/12,533), had previously received VCT. Women who received VCT, both those positive and negative, reduced their reported number of new partners. Among those testing positive, this risk reduction was enhanced with time since testing. Among men, no behavioural risk reduction associated with VCT was observed. Significant increases in consistent condom use, with regular or non-regular partners, following VCT, were not observed. This study suggests that, among women, particularly those who are infected, behavioural risk reduction does occur following VCT.

Fig. 1

Previous uptake of testing and results collection reported by individuals at each survey round (N = 17,874). In earlier study rounds (1998–2000 and 2001–2003) those who reported to have tested may include those who were tested for medical purposes but did not receive their results

Fig. 2

Relative change in the number of new partners in the last year, following VCT. The results in the above figure are based on comparing those who received VCT to those who did not receive VCT. Thus, this figure illustrates the additional reduction in mean number of new partners in the last year associated with receiving VCT. The 0% indicates no change. Results are adjusted for age (5 year categories), calendar year and marital status. The relative change is calculated as: Exp(Coef.) − 1

Fig. 3

The effect of VCT on behaviour in relation to time since testing. The results are based on comparing those who received VCT to those who did not receive VCT. Thus, these figures illustrate the additional change in behaviour associated with receiving VCT. Results are adjusted for age (5 years categories) and sex. a Bar/beer hall attendance. b New sexual partner in the past year. c Sexual partner in the past month. d Multiple concurrent partners