Cascade of Provider-Initiated Human Immunodeficiency Virus Testing and Counselling at Specific Life Events (Pregnancy, Sexually Transmitted Infections, Marriage) in Côte d'Ivoire

• Published in: Sexually transmitted diseases Vol. 47; no. 1; pp. 54 - 61
• Main Authors: Inghels, Maxime, Kouassi, Arsène Kra, Niangoran, Serge, Bekelynck, Anne, Carillon, Séverine, Sika, Lazare, Danel, Christine, Kone, Mariatou, du Loû, Annabel Desgrées, Larmarange, Joseph
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 01-01-2020; Lippincott Williams & Wilkins Ovid Technologies
• Subjects: Acceptance tests; Adolescent; Adult; Consultation; Cote d'Ivoire; Counseling; Cross-Sectional Studies; Female; Health care; Health services; HIV; HIV Infections - diagnosis; Human immunodeficiency virus; Humans; Immune system; Infections; Life Change Events; Life events; Male; Marriage; Mass Screening - statistics & numerical data; Medical personnel; Medical tests; Men; Middle Aged; National guidelines; Practice Patterns, Physicians' - statistics & numerical data; Pregnancy; Sexual Partners; Sexually transmitted diseases; Sexually Transmitted Diseases - diagnosis; STD; Surveys and Questionnaires; Telephone surveys; Tests; Viruses; Young Adult; Cote d'Ivoire; Ivory Coast
• ISSN: 0148-5717; 1537-4521
• DOI: 10.1097/OLQ.0000000000001084

Despite the implementation of Provider Initiated Testing and Counselling (PITC) in 2009, PITC coverage remains low in Cote d'Ivoire. The purpose of this study is to determine whether an human immunodeficiency virus (HIV) test was offered and performed at specific life events where PITC is recommended by national guidelines.
In 2017, a cross-sectional telephone survey was conducted among a representative sample of 3,867 adults from the general population in Côte d'Ivoire. The occurrences of the following events over the past 5 years were documented: pregnancy (event A) or partner's pregnancy (event B) of the last child, sexually transmitted infection (event C) and marriage (event D). For each of these events, participants were asked (i) if they consulted a health care professional, (ii) if they were offered an HIV test during that consultation and (iii) if they accepted it.
Consulting a health care provider was reported by 94.9%, 58.3%, 70.3% and 19.1% of those who reported events A, B, C and D respectively. In case of medical consultations following events A, B, C and D, respectively 70.1%, 33.1%, 28.1%, and 78.8% of individuals were offered an HIV test. The testing acceptance was high regardless of the event. Overall, testing coverage was 63.7%, 16.9%, 13.4% and 14.5% for events A, B, C and D respectively.
Increasing HIV testing coverage in Côte d'Ivoire requires (i) facilitating attendance to health services in case of sexually transmitted infections, marriage and pregnancy-for men-and (ii) strengthening routine testing offer on these occasions.