Two free-standing urban human immunodeficiency virus (HIV)
testing and counselling (HCT) centres in Bhutan offering services to the
general population and targeting the most at-risk populations (MARPs).
To assess the trend in testing for HIV, hepatitis B and
syphilis in both the general population and MARPs, and to determine if
sociodemographic and risk behaviour characteristics are associated with HIV,
hepatitis B and syphilis seropositivity.
Cross-sectional study using client records, 2009 – 2012.
Of 7894 clients, 3009 (38%) were from the general
population, while 4885 (62%) were from MARPs. Over the 4-year period, testing
declined progressively among the general population, while it increased or
remained static for MARPs. Of 4885 MARPs, seropositivity was respectively 0.7%,
1.3% and 1.2% for HIV, hepatitis B and syphilis. Female sex workers (FSWs)
(relative risk [RR] 4.4, P = 0.03) and partners of person
living with HIV (RR 25.9, P < 0.001) had a higher risk of
being HIV-positive. FSWs had also a greater risk of being syphilis-positive (RR
9.1, P < 0.001).
The increase in uptake of HCT services by MARPs is a welcome
finding; however, the relatively static trends call for the introduction of
community outreach approaches. The critical gateway being provided to MARPs is
an ‘opportunity’ for the expansion of the current service package.
Below: Trends in total registered clients at two urban HIV counselling and testing sites in Bhutan, 2009–2012. MARP = most at-risk population; HIV = human immunodeficiency virus.
TABLE 2
A) Socio–demographic and risk group/behaviour characteristics associated with HIV positivity among most at–risk populations with recorded HIV test results (n = 4883) at two urban stand–alone counselling and testing centres, Bhutan, 2009–2012
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By: L. Khandu,
1 R. Zachariah,2 R. Van den Bergh,3 D. Wangchuk,4 N. Tshering,1 D. Wangmo,5 R. Ananthakrishnan,6 T. Dorji,7 and S. Satyanarayana81 National HIV/AIDS & STIs Control Programme, Department of Public Health, Ministry of Health, Royal Government of Bhutan, Thimphu, Bhutan
2 Operational Research Unit (LuxOR), Operational Centre Brussels, Médecins Sans Frontières, Luxembourg, Luxembourg
3 LuxOR, Operational Centre Brussels, Médecins Sans Frontières, Brussels, Belgium
4 Department of Public Health, Ministry of Health, Royal Government of Bhutan, Thimphu
5 National HIV/AIDS Consultant (Pvt), PIE Solution, Thimphu, Bhutan
6 REACH, Chennai, India
7 Communicable Disease Division, Department of Public Health, Ministry of Health, Royal Government of Bhutan, Thimphu, Bhutan
8 International Union Against Tuberculosis and Lung Disease, South-East Regional Office, New Delhi, India
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