V is for Voluntary: Uptake of HIV Testing and Counseling in Mombasa District, Kenya

Voluntary counseling and testing (VCT) is a crucial HIV intervention strategy, promoting safe behavior, providing personalized support, and serving as an entry point for care and treatment. Experts agree that knowledge of HIV status should ideally be universal; however, as VCT is a voluntary service, certain challenges arise in promoting its uptake. Though Kenya has made remarkable headway in expanding its VCT provision, setting a leading example for the world, 80% of adult citizens still have never been tested. This project investigates the factors controlling the uptake of VCT in Mombasa district and seeks ways to reach more people with testing and counseling services. The first section identifies common barriers that keep individuals from seeking VCT services, including psychological, socio-cultural and physical barriers. The second section explores the wide variety of VCT programs existing in Mombasa district, and how they have contributed to recent increases in uptake. The third section is a case study of the 2007 HIV Testing Week, shedding light on the challenges and possibilities of targeting great numbers of people with VCT. Finally, the last section explores the acceptability and future prospects of alternative strategies to VCT, which are being considered to universalize HIV testing. This study finds that the issues of stigma, poverty, and human rights must continuously be considered in any efforts to expand uptake of HIV counseling and testing services. In order to uphold the efficacy of the VCT intervention, the quality and integrity of services must be prioritized above target numbers of clients