The Rakai Project counselling programme experience.

During the initial survey (April 1999-January 2000) of an ongoing Community HIV Epidemiological Research (CHER) study, adults aged 15-49 years in 56 study communities were enrolled into the study. Knowledge, Attitude, Behaviour, Practice questionnaires were administered and blood was obtained from 77.6%. HIV testing was performed using two different enzyme immunosorbent assays with Western blot confirmation of discordant results and first time positives. All those who gave blood had free and unlimited access to voluntary counselling and testing (VCT), and were free to participate as individuals or couples. HIV results were provided in people's homes by trained and certified project resident counsellors. Ninety per cent of those who were bled requested their HIV results, while 64.6% of those who requested their HIV results received them. The proportion of people receiving HIV results has almost doubled in the last 6 years (1994-2000) from about 35% in 1994/1995 to 65% in 1999/2000. These data indicate high proportions of acceptance and receipt of VCT in this rural population-based cohort, suggesting that home delivery of VCT could offer a unique opportunity for people in the rural areas to access counselling and testing services, given adequate resources.