The voluntary HIV counselling and testing service in Kenema District, Sierra Leone, 2004-2006: a descriptive study

The study examines data on the population that obtained HIV VCT in Kenema District, Sierra Leone, from 2004 to 2006, using descriptive statistics and exploring potential HIV risk factors using bivariate and multivariable logistic regression. Analysis was performed separately for two subpopulations: those accessing VCT routinely as part of antenatal care and those specifically seeking VCT.During this period, 2230 people accessed VCT: 1213 through antenatal testing and 1017 specifically seeking VCT. The HIV prevalence was 0.6% in women presenting for antenatal care, 12.6% in women specifically accessing VCT, and 6.7% in men specifically accessing VCT. In both bivariate and multivariable analyses, being female was statistically significantly associated with testing positive in people specifically seeking VCT.These data from the VCT service in Kenema will be used to improve the accessibility of HIV testing. Questions raised by the analysis will be used to enhance data collection and to inform further research on risk factors.Sierra Leone is a country in West Africa with a population of 5.9 million, 2.7 million of whom are aged 15-49 [1]. Subsequent to a civil war that ended in 2001, health indicators for Sierra Leone reveal poor average health, with a life expectancy at birth of 40 years, an infant mortality rate of 159 per 1000 live births, an under-5 mortality rate of 269 per 1000 live births, and a maternal mortality ratio of 2100 per 100,000 [1].While the HIV/AIDS epidemic is profoundly affecting many parts of sub-Saharan Africa including countries in West Africa, relatively little is known about the epidemiology of HIV/AIDS in Sierra Leone. A national population-based seroprevalence study in 2005 revealed a prevalence of 1.53% [2], with no significant difference in prevalence between women and men. Of those who tested positive for HIV, 91% were HIV-1 positive, 4.5% were HIV-2 positive, and 4.5% were positive for both HIV-1 and HIV-2. The World Health Organization's