Acceptance of and barriers to voluntary HIV counselling and testing among adults in Guizhou province, China.
OBJECTIVE
To find and compare the levels of acceptance of and barriers to voluntary counselling and testing (VCT) among adults in two different counties of Guizhou province, China, one in which the China CARES project was operating and the other in which it was not.


METHODS
A longitudinal design with two-stage cluster sampling was employed.


METHODS
A total of 1012 participants were recruited in the two counties. All participants were interviewed, then given a coupon for free VCT after the interview. Participants were paid for returning the coupon within 2 months, whether tested or not. The uptake of VCT was measured within 2 months after the interview.


RESULTS
The study found that the levels of HIV/AIDS knowledge and acceptability of VCT among the adults in both counties were low. Although 459 participants (43.5%) expressed an intent to use the VCT services, only 193 (16.5%) actually visited the VCT facilities, and only 42 (3.7%) actually took an HIV test within 2 months after the interview. The use of VCT was related to occupation, age, transportation difficulties, health status, ethnicity, and high-risk behaviors. The main barriers to HIV testing included perceiving oneself as low risk, fear of unsolicited disclosure, and fear of stigma and discrimination that would result from taking the test.


CONCLUSIONS
Education about HIV/AIDS and VCT needs to be improved, and levels of stigma and discrimination reduced, in order to enhance the uptake of VCT services, an essential step for the initiation of treatment.
Ma
Wei
W
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China. wei_ma01@sohu.com
Detels
Roger
R
Feng
Yuji
Y
Wu
Zunyou
Z
Shen
Limei
L
Li
Yu
Y
Li
Zezhen
Z
Chen
Fang
F
Wang
Aimin
A
Liu
Taiming
T
D015492:AIDS Serodiagnosis / Q000523:psychology* / Q000706:statistics & numerical data; D000328:Adult; D001294:Attitude to Health; D002681:China / Q000453:epidemiology; D003376:Counseling / Q000706:statistics & numerical data; D005239:Fear; D005260:Female; D005500:Follow-Up Studies; D006078:Government Programs / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D009042:Motivation; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D011287:Prejudice; D015397:Program Evaluation; D012494:Sampling Studies; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D016312:Treatment Refusal