Voluntary counseling and testing (VCT) services and their contribution to access to HIV diagnosis in Brazil.
The Voluntary Counseling and Testing (VCT) Network was implemented in Brazil in the 1980s to promote anonymous and confidential access to HIV diagnosis. As a function of the population and dimensions of the local epidemic, the study assessed the network's coverage, using data from a self-applied questionnaire and data from the Information Technology Department of the Unified National Health System (SUS), UNDP, and National STD/AIDS Program. The Student t test was used for comparison of means and the chi-square test for proportions. Brazil has 383 VCT centers, covering 48.9% of the population and 69.2% of the AIDS cases. The network has been implemented predominantly in regions where the epidemic shows a relevant presence, but 85.3% of the cities with high HIV incidence lack VCT centers; absence of VCT was associated with more limited health infrastructure and worse social indicators. A slowdown in expansion of the network was observed, with VCT Centers implemented on average 16 years after the first AIDS case in the given municipality. The number of HIV tests performed under the SUS is 2.3 times higher in cities with VCT centers. The network's scope is limited, thus minimizing the contribution by these services to the supply of HIV diagnosis in Brazil.
Grangeiro
Alexandre
A
Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil. ale.grangeiro@gmail.com
Escuder
Maria Mercedes
MM
Veras
Maria Amélia
MA
Barreira
Draurio
D
Ferraz
Dulce
D
Kayano
Jorge
J
D015492:AIDS Serodiagnosis / Q000706:statistics & numerical data*; D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology; D001938:Brazil / Q000453:epidemiology; D016009:Chi-Square Distribution; D003376:Counseling / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000175:diagnosis*; D006284:Health Plan Implementation; D006293:Health Promotion; D006297:Health Services Accessibility / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D009111:Local Government; D009313:National Health Programs / Q000592:standards / Q000706:statistics & numerical data*; D035141:Voluntary Programs / Q000706:statistics & numerical data*