Voluntary and Testing Services<br />Bernadette Hamilton-Saunders<br />Bahamas<br />
Overview of the Bahamas<br />Archipelago nation of approximately 700 islands, of which 40 are populated.<br />The islands cover an area of about 100,000 square miles, located in the Caribbean, southeast of Florida and northeast of Cuba<br />Population: 330,000 persons, 85% black, 12% white, 3% Asian and Hispanic<br />Nassau is the capital located on New Providence <br />
As at Dec 2004<br />Total HIV infected persons alive 6601<br />Total AIDS cases alive 1529<br />PLWHA with CD4 <350 2505<br />PLWHA on HAART 1600<br />HIV+ Pregnant Women 105<br />MTCT rate < 2%<br />PLWHA on Rx 1638<br />
VCT Services Provided<br />PMTCT Program – ANC are –pretest counseled, positive referred to the HIV/AIDS Centre for post-test counseling MW – post-test counseled mainly by staff of the HIV/AIDS Centre<br />Inpatient Care – IDW and other hospital wards: staff from the HIV AIDS Centre called in to counseled HIV+ clients<br />Home care services: to promote privacy, decrease stigma targeted towards the individual<br />
Use and Demand of VCT Services<br />PMTCT – Pregnant women and their partners<br />All Blood Donors Screened<br />Contact tracing/screening<br />Walk-ins <br />
VCT – usually offered by midwives at the ANC, Maternity Ward, Infectious Disease Clinic and Comprehensive Clinic.<br />100% acceptance among pregnant women and prisoners<br />App 85-90% acceptance among contacts<br />Return rate for results highest among pregnant women and contacts, lowest among prisoners especially after discharge from prison<br />Type of test – Abbott Murex and Abbott Determine rapid test<br />
Barriers to VCT <br />Persons prefer not to know their status<br />Level of stigma and discrimination in the society <br />Confidential issues in the community, health care system<br />Waiting time for test results<br />Availability, accessibility of VCT services (limited)<br />Limited amount of trained VCT Counselors<br />
Challenges Confronting VCT Services in the Bahamas<br />Acceleration of access to VCT – training of HCP to decrease patient counselor ratio<br />Overcrowded clinics – impacts privacy<br />Lack of stand alone VCT centres<br />Level of social support interventions is compromised due to insufficient personnel to provide these services<br />Lack of computerized system causing delay in receipts of clients results<br />
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