The role for government health centers in provision of same-day voluntary HIV counseling and testing in Kenya

J Acquir Immune Defic Syndr. 2005 Nov 1;40(3):329-35. doi: 10.1097/01.qai.0000166376.23846.38.


Objective: To explore the role of primary health centers in provision of voluntary counseling and testing (VCT) in Kenya.

Design and setting: Prospective service evaluation at 3 (1 urban and 2 rural) government health centers.

Subjects: Consecutive adult clients.

Main outcome measures: Uptake of services, user characteristics, quality of service.

Results: Counseling services received 2315 new clients over 26 months. The last quarter averaged 101 clients per clinic. More than 80% of clients lived locally. Overall 93% opted to test, 91% receiving results, 82% on the same day. Most clients tested HIV negative (81%). Youth and men were well represented. Few couples (10%) attended. Seventeen percent of women were pregnant. Self-referral was common and illness was an uncommon reason for testing (<20%). Thirty-one percent of clients were referred from VCT to other health center services. Counseling was perceived as high quality by users and providers. Validation of the test algorithm showed a sensitivity of 98.0% and specificity of 98.7%.

Conclusion: Government health centers in Kenya can be appropriate providers of VCT. This pilot helped initiate a new strategy of health center-based VCT in Kenya and this has facilitated rapid expansion and more equitable provision for Kenyans.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Community Health Centers / statistics & numerical data*
  • Counseling / statistics & numerical data*
  • Family Characteristics
  • Female
  • Government Agencies / statistics & numerical data*
  • HIV Antibodies / blood
  • HIV Infections / diagnosis
  • HIV Infections / epidemiology
  • HIV Infections / prevention & control*
  • HIV Seronegativity
  • Humans
  • Kenya / epidemiology
  • Male
  • Pregnant Women
  • Primary Health Care / statistics & numerical data*
  • Quality of Health Care*
  • Self Care
  • Sensitivity and Specificity
  • Seroepidemiologic Studies


  • HIV Antibodies