title: A mobile school-based HCT service - is it youth friendly?
abstract: Despite an increase in HIV Counselling and Testing (HCT), few young people have been tested. It has been suggested that they do not test because formal health services (where HCT is provided) are often not youth friendly. The World Health Organisation describes a youth-friendly health service (YFHS) as one which is accessible, equitable, acceptable, appropriate, and effective. A mobile school-based model has been implemented by a non-governmental organisation in Cape Town in an attempt to make HCT more youth friendly and accessible to young people. The objective of this study was to explore whether this mobile school-based HCT service is youth friendly.
  
  
  
  The study was descriptive, using three qualitative data collection methods: observation of the HCT site at two secondary schools; interviews with six service providers; and direct observation of 21 HCT counselling sessions.
  
  
  
  The mobile school-based HCT service fulfilled some of the criteria for being a YFHS. The service was equitable in that all students, irrespective of race, gender, age, or socio-economic status, were free to use the service. It was accessible in terms of location and cost, but students were not well informed to make decisions about using the service. The service was acceptable in that confidentiality was guaranteed and the service providers were friendly and non-judgemental, but it was not considered acceptable in that there was limited privacy. The service was appropriate in that HCT is recommended as an intervention for decreasing the transmission of HIV, based on evidence and expert opinion; however, in this case, HCT was provided as a stand-alone service rather than part of a full package of services. Moreover, studies have suggested that young people want to know their HIV status. The service was ineffective in that it identified students who are HIV positive; however, these students were not assisted to access care.
  
  
  
  Providing HCT in the school setting may make HCT more accessible for students, but it needs to be provided in an equitable, accessible, acceptable, and effective way.
authors: a PhD student, School of Public Health , University of the Western Cape , Cape Town , South Africa.
authors: Estelle
authors: E
authors: Lawrence
authors: b PhD, Associate Professor at School of Public Health , University of the Western Cape , Cape Town , South Africa.
authors: Patricia
authors: P
authors: Struthers
authors: c PhD, Professor at Department of Special Education , Ghent University , Ghent , Belgium.
authors: Geert
authors: G
authors: Van Hove
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003219:Confidentiality; D037001:Directive Counseling; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control*; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D008952:Mobile Health Units; D019370:Observation; D010342:Patient Acceptance of Health Care; D018907:Privacy; D017064:Process Assessment, Health Care; D015397:Program Evaluation; D036301:Qualitative Research; D012017:Referral and Consultation; D012574:Schools; D013019:South Africa
keywords: Aide Psychosociale et Test de Dépistage VIH (ADV); HIV Counselling and Testing; HIV/AIDS; VIH/SIDA; adapté aux besoins des jeunes; jeunes; school; students; youth; youth friendly; école; étudiants