Technological profile assessment of voluntary HIV counseling and testing centers in Brazil.
OBJECTIVE
To characterize and analyze technological profiles of voluntary HIV counseling and testing centers in Brazil.


METHODS
A structured self-completion questionnaire with 78 questions was used. This questionnaire was answered by 320 (83.6%) of the 383 Brazilian centers, in 2006. Responses that characterized the services' technological profile were analyzed using K-means clustering technique. Associations between the profiles described and the municipal contexts were analyzed using the chi-square and residue analysis for proportions, and ANOVA and Bonferroni for means.


RESULTS
Centers showed significant deficiencies to guarantee adequate services. A total of four technological profiles were identified. The 'care' profile (21.6%) predominated among the services instituted before 1993, in areas with high AIDS incidence and in large cities. The 'prevention' profile (30.0%), prevalent between 1994 and 1998, was the type that best complies with the Ministry of Health's norms, with better readiness and productivity indicators. The 'care and prevention' profile (26.9%), included in the AIDS services, predominated between 1999 and 2002, and developed the most comprehensive set of activities, including STD treatment. The 'testing' profile (21.6%) was the most precarious, found where the epidemic is most recent and with a lower number of people tested.


CONCLUSIONS
Counseling and testing centers constitute a set of heterogeneous services. In addition, service implementation guidelines have not been completely incorporated in Brazil, thus having and influence on low resolution and productivity indicators and also the inadequate development of prevention activities.
Grangeiro
Alexandre
A
Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil. ale.grangeiro@gmail.com
Escuder
Maria Mercedes
MM
Wolffenbüttel
Karina
K
Pupo
Ligia Rivero
LR
Nemes
Maria Ines Battistella
MI
Monteiro
Paulo Henrique Nico
PH
D000704:Analysis of Variance; D001938:Brazil; D016009:Chi-Square Distribution; D003151:Community Health Centers / Q000458:organization & administration; D003376:Counseling; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D005791:Patient Care / Q000706:statistics & numerical data; D013673:Technology Assessment, Biomedical / Q000706:statistics & numerical data*; D000078329:Workforce