The 2010 UNAIDS report on the global AIDS epidemic states that based on the 2009 data, 33.3 million people are living with HIV worldwide and Sub-Saharan Africa makes up 68% of the global total with 22.5 million people living with HIV.1 In an effort to address this epidemic, voluntary counseling and testing (VCT) programs have been implemented in many of rural and remote areas. VCT serves as the gateway to HIV prevention, treatment, care and support by allowing people to learn their HIV status. According to World Health Organization (WHO), knowledge of one’s HIV status benefits the individuals, community, and population through awareness and education.2 Therefore, there have been great efforts to expand VCT services since inception over 20 years ago. Unfortunately, global participation remains low, especially in the remote areas.3 Studies show that there are various reasons why people do not participate. Some of the main reasons are stigma, lack of awareness, lack of access, cost of the test, and test-related fears.4 Several VCT models have been implemented to address these concerns but research suggests that further work needs to be done. Organic Health Response (OHR) has piloted an innovative Cyber-VCT Program in Mfangano Island by using technology to attract residents to participate. The Cyber-VCT Program uses access to solar-powered internet as an incentive to attract people to do HIV testing. The people who participate become part of the Post-Test Club and have free access to the labs in the Cyber-VCT facility called Ekialo Kiona Center (EKC). The facility has confidential VCT rooms, solar-powered computer lab with satellite Internet, radio studio, seminar rooms, and an “Global report: UNAIDS report on the global AIDS epidemic 2010” (UNAIDS, 2010: http://www.unaids.org/globalreport/documents/20101123_GlobalReport_full_en.pdf). 2 World Health Organization, “Scaling-up HIV testing and counselling services: a toolkit for programme managers.” (WHO Press, 2005: http://www.who.int/hiv/pub/vct/counsellingtestingtoolkit.pdf) 3 Information from World Health Organization on HIV testing and counselling accessed May 4, 2011: http://www.who.int/hiv/topics/vct/en/ 4 Joseph K.B. Matovu and Frederick E. Makumbi, “Expanding access to voluntary HIV counselling and testing in sub-Saharan Africa: alternative approaches for improving uptake, 2001–2007,” Tropical Medicine and International Health, 12:2 (November 2007), pp. 1315-1322. Page 1 of 6 1
open-air amphitheater. The program provides access to the only internet / library facility on the island and according to OHR, needs assessment and ethnographic research have shown that residents are enthusiastic about having access to technology, which suggest the potential for program effectiveness.5 There is a bi-annual membership renewal process where residents need to do individualized VCT session with a counselor from the International Medical Corps. This renewal process will provide the structure for more longitudinal effects. The ultimate goal of Cyber-VCT Program is to encourage voluntary counseling and testing, facilitate the process of referrals to Ministry of Health and FACES treatment programs, connect those who are HIV positive with locally formed psycho-social support, and improve dissemination of HIV education. It is more comprehensive and effective than community stand-alone VCT centers, mobile VCT, Routine offer of VCT or better known as provider-initiated HIV testing and counseling (PITC), and home-based VCT. These other VCT models have increased uptake but they have limitations that the Cyber-VCT program helps address. Stand-alone VCT centers values client initiation – people have to travel and access the services on their own but the stigma associated with it is a huge barrier that limits people from utilizing the services at the centers. The mobile VCT...
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