title: Heterogeneity of community-based voluntary, counselling and testing services for HIV in Europe: the HIV-COBATEST survey.
abstract: This study reports the first EU-wide survey of community-based voluntary counselling and testing services (CBVCTs), with the following aims: to assess the current availability of CBVCTs and how the concept of CBVCT is understood; to describe CBVCT modalities and strategies; and to measure the use of rapid tests within CBVCTs. A cross-sectional survey was conducted in two different key informant groups: HIV/AIDS National Focal Points (NFPs) and CBVCTs from the EU and European Free Trade Association (EFTA) countries. A definition of CBVCTs was reached. Descriptive and correspondence analyses were performed. The COBATEST survey was answered by NFPs from 25 of the 32 EU/EFTA countries (response rate of 78.1%), and by 55 CBVCTs in 22 different countries. CBVCTs were functioning in nearly all the responding countries, but only 56% explicitly included them in their national strategic plans. In those that had CBVCTs, the NFPs often lacked reliable information on CBVCTs. In general, CBVCTs in Europe are focused mainly on men who have sex with men, are primarily peer-driven and highly communitarised, whereas CBVCTs targeting other at-risk populations are more medicalised. In addition, the oral test is under-used and in general test performance is highly medicalised. Results show that there is a wide heterogeneity of CBVCTs in Europe, which is varied and highly medicalised. The data provided in this study in conjunction with other deliverables produced by the COBATEST project should contribute to the development of standardised indicators to enable comparisons over time and eventually improve the effectiveness of CBVCTs across Europe.
authors.affiliation: 1 Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain.
authors.forename: Juliana
authors.initials: J
authors.lastname: Reyes-Urueña
authors.affiliation: 2 Service for International Social and Health Relations, Verona Local Health Authority n. 20 of the Veneto Region, Italy.|3 Arcigay Italian LGBT Association, Bologna, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Breveglieri
authors.affiliation: 2 Service for International Social and Health Relations, Verona Local Health Authority n. 20 of the Veneto Region, Italy.|4 HIV & STI Department, Centre for Infectious Disease Surveillance and Control, Public Health England, London, England.
authors.forename: Martina
authors.initials: M
authors.lastname: Furegato
authors.affiliation: 1 Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain.|5 CIBER Epidemiologia y Salud Pública (CIBERESP), Spain.|6 Sciences Research Institute of the "Germans Trias i Pujol" Foundation (IGTP), Badalona, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Fernàndez-López
authors.affiliation: 1 Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain.|5 CIBER Epidemiologia y Salud Pública (CIBERESP), Spain.|6 Sciences Research Institute of the "Germans Trias i Pujol" Foundation (IGTP), Badalona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Agusti
authors.affiliation: 1 Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT), Agencia de Salut Publica de Catalunya (ASPC), Generalitat de Catalunya, Badalona, Spain.|5 CIBER Epidemiologia y Salud Pública (CIBERESP), Spain.|6 Sciences Research Institute of the "Germans Trias i Pujol" Foundation (IGTP), Badalona, Spain.|7 Department of Paediatrics, Obstetrics and Gynaecology, and Preventive Medicine, Universidad Autonoma de Barcelona, Bellaterra Cerdanyola, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Casabona
mesh_terms: D000328:Adult; D003153:Community Health Services / Q000458:organization & administration*; D055812:Community-Based Participatory Research; D003376:Counseling; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control / Q000523:psychology / Q000628:therapy; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000458:organization & administration / Q000706:statistics & numerical data*; D008875:Middle Aged; D014838:Volunteers; D055815:Young Adult
keywords: Europe; HIV infections; community health services; counselling; diagnosis; early diagnosis; prevention and control; therapy