World AIDS Conference 2008 Mexico City
WAC Abstract STI Sikoro
Published as poster abstract in “CD accompanying WAC brochure”
August 2008
Abstract title: Increased HIV and STI testing in Bamako, Mali using a push/pull intervention
Abstract number: CDC0368
This number will be your abstract’s reference number on the CD-ROM.
Increased HIV and STI Testing in Bamako, Mali using a Push/Pull Intervention
Karamoko Tounkara, Youssouf Kone, Ben Aboubacar, Flabou Bougadougo, Ousmane Koita, Anne S. De Groot
GAIA Mali, ASACOMSI, Millennium Villages Project, University of Bamako, GAIA Vaccine Foundation (USA),
Background: We developed a street-outreach peer education program that uses a mnemonic based on the five fingers of the hand to teach illiterate residents of a peri-urban slum in Mali about sexually transmitted diseases, HIV testing, HIV treatment and prevention. Here we report the impact of peer education intervention on the uptake of sexually transmitted infection testing and HIV testing at the local infirmary-style community clinic (the ASACOMSI).
Methods: Beginning in February 2007, 11 peer educators provided HIV education and distributed condoms in street-based outreach sessions. Initial projections were that the Hêré Bolo program would reach 440 people per month or approximately 5,000 individuals in its the first year. At the same time, HIV testing was provided at the local infirmary at no cost.
Results: STI and HIV testing information was collected from clinic records. The program was formally initiated in February 2007. The 11 peer educators made 7242 contacts with community members from 2/2007 to 11/2007. During this period, 7941 condoms were distributed. STI testing requests at the ASACOMSI increased by 81% over the same period in 2006; and HIV testing requests increased four fold over the course of the year. From January-June the rate of HIV testing requests was 7/mo.; from June to September, the rate of testing was 27/mo.
Conclusions: Community-based clinics serve as a portal of entry to the HIV care system. We used a push/pull model to increase HIV testing: increasing demand through peer education and reducing the barrier to testing by making HIV tests free. This combined intervention increased the rate of HIV testing four-fold over a period of two years. In the next phase of the program we will make testing for STI’s free to all comers and provide free treatment for STIs. This intervention is easily adaptable to other settings in Sub Saharan Africa.