South Africa : Who Goes to the Public Sector for Voluntary HIV/AIDS Counseling and Testing?

Thiede, Michael ; Palmer, Natasha ; Mbatsha, Mbatsha

World Bank, Washington, DC

关键词: AGE GROUPS;    AIDS CARE;    ANTENATAL CARE;    ANXIETY;    COMMUNITIES;   

RP-ID  :  30477

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

This is a study of how well publicvoluntary counseling and testing (VCT) programs for HIV/AIDSreach poor people in township areas of Cape Town, SouthAfrica. The study covered three public clinics, where laycounselors from local nongovernmental organizations providedcounseling. A clinic nurse was responsible for testing andnotifying patients of the results. Waiting room interviewsof 540 patients included questions about the patients'possessions and housing conditions designed to assesseconomic status. This information was compared withcomparable information for people in South Africa as awhole, and in South Africa's urban areas, collectedthrough a large-scale household Demographic and HealthSurvey. The principal finding was a much higher use of VCTservices by lower- than higher-income patients. Almost 75percent of VCT patients came from the poorest 40 percent ofSouth Africa's urban population, fewer than 10 percentof patients belonging to the urban population's highest40 percent. VCT patients were also poorer on average thanpatients attending the clinics for other reasons. The studyalso included focus group discussions with residents of thetownships where the clinics were located, designed todetermine what factors influence use of the clinics for VCT.These suggest that an important reason for the predominanceof poor people among clinic patients was the poor reputationof the services provided by the clinics. This led better-offpeople to seek care from other, more expensive available sources.