Botswana's Tebelopele voluntary HIV counseling and testing network: use and client risk factors for HIV infection, 2000-2004.
BACKGROUND
: HIV services, including voluntary counseling and testing (VCT) and antiretroviral (ARV) therapy, expanded rapidly in Botswana from 2000 through 2004.


METHODS
: Client data from Botswana's Tebelopele VCT network were analyzed to describe clients, factors associated with HIV infection, and trends in VCT use.


RESULTS
: Tebelopele provided free, anonymous, same-day HIV tests for 117,234 clients from 2000 through 2004. Before ARV therapy was available, 8.3% of clients sought a test because of illness, and 26.3% were HIV-positive. After ARV therapy became available, 20.1% of clients sought a test because of illness, and 38.8% were HIV-positive. Most VCT clients (82.7%) were unmarried; 89.8% reported no or 1 sexual partner in the last 3 months; and 50.2% of unmarried clients reported always using condoms in the last 3 months. In multivariate analysis, higher educational level, marriage, and always using condoms were associated with a lower risk of HIV. Having only 1 recent sexual partner was associated with less condom use and a higher risk of being HIV-positive for men.


CONCLUSIONS
: VCT has been well accepted in Botswana. Analysis of this data set supports efforts to promote 100% condom use and to emphasize that partner reduction must be combined with condom use and HIV testing to protect against HIV.
Creek
Tracy L
TL
Centers for Disease Control and Prevention, Atlanta, GA, USA. tgc0@cdc.gov
Alwano
Mary Grace
MG
Molosiwa
Ronald R
RR
Roels
Thierry H
TH
Kenyon
Tom A
TA
Mwasalla
Vida
V
Lloyd
Ethleen S
ES
Mokomane
Modisaotsile
M
Hastings
Philip A
PA
Taylor
Allan W
AW
Kilmarx
Peter H
PH
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001902:Botswana / Q000453:epidemiology; D017280:Condoms / Q000706:statistics & numerical data*; D003376:Counseling; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012747:Sexual Partners / Q000523:psychology; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000517:prevention & control*; D035141:Voluntary Programs / Q000706:statistics & numerical data*