Mobile HIV testing program removes barriers to testing in Sub-Saharan Africa

A voluntary counseling and testing (VCT) program using a mobile van to travel to marketplaces in townships and villages overcomes the structural barriers to HIV testing in Sub-Saharan Africa, according to UCSF researchers.

“Mobile VCT eliminates the cost and inconvenience of having to travel to urban centers for HIV testing, while the presence of the mobile van with outreach workers in busy marketplaces creates familiarity with the testing process and reduces the stigma associated with this process, a significant psychological barrier to testing,” said study lead author, Gertrude Khumalo-Sakutukwa, MSW, M Med Sc, an academic specialist at the UCSF AIDS Policy Research Center.

Khumalo-Sakutukwa presented the findings at the XV International AIDS Conference in Bangkok, Thailand on July 14.

A mobile testing van traveled to six marketplaces in villages and townships in Epworth and Seke, Zimbabwe on a rotating basis offering free VCT using rapid HIV tests and same-day results. Researchers had identified the cost of paying for an HIV test and the cost and inconvenience of traveling to the city as the significant structural barriers to testing.

The major psychological barriers identified by the researchers included social stigma associated with being seen going into an HIV testing site, assumption that testers have HIV or AIDS, and fear of learning that one did indeed have HIV. Researchers addressed these concerns by creating a community advisory board (CAB) before testing started and having CAB members engage the community, creating awareness and generating discussions about HIV and testing. The rotating presence of the mobile VCT van in crowded marketplaces became the talk of the community, leading to increased familiarity and diminished stigma.

“Two elements of mobile VCT should be noted. One is the acceptance of rapid tests, and participants liked getting their results the same day and had no doubts that the results were theirs because the blood samples were not sent away for a week. Second, it is important to provide post-test support services including post-test clubs that include both negative and positive test-takers and linkages to medical, psychosocial, and spiritual services for those who test positive,” said study co-author, Stephen F. Morin, PhD, director, UCSF AIDS Policy Research Center.