Availability of antiretroviral therapy is associated with increased uptake of HIV testing services

Voluntary counselling and testing (VCT) is an important tool in HIV prevention efforts and in the identification of HIV-infected individuals for care and treatment services. But despite the central role of VCT in the response to HIV/AIDS, less than 20% of South Africans have been tested for HIV. Although there are substantial barriers to seeking VCT, including quality of services and AIDS-related stigma, improving VCT rates remains a critical part of the response to the HIV/AIDS epidemic. Recently there has been particular interest in the potential influence of access to antiretroviral therapy (ART) on demand for HIV testing services. It has been suggested that the availability of effective treatment for HIV/AIDS may help motivate individuals to find out their HIV status. However, this possibility remains largely hypothetical and there have been few studies investigating this question. In light of the importance of VCT as an entry point to HIV prevention interventions and treatment services, the possible impact of ART availability on VCT uptake has major implications for the public health response to HIV/AIDS in South Africa. We investigated whether the availability of ART was associated with HIV testing among individuals attending the site B day hospital in Khayelitsha near Cape Town, the setting for a well-publicised antiretroviral pilot