Abstract
SETTING
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).
OBJECTIVES
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.
DESIGN
Cross-sectional study using client records, 2009–2012.
RESULTS
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).
CONCLUSION
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.
