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Uptake and Outcomes Associated with Implementation of a Community-Based Voluntary HIV Counseling and Testing Program in Antigua and Barbuda

Objective: To evaluate the implementation of community-based voluntary HIV counseling and testing (CBVCT) in the Eastern Caribbean. Methods: A total of 9782 unique HIV testing events performed through a national program of CBVCT in Antigua and Barbuda (2009-2012) were analyzed. The authors describe testers’ demographic characteristics and assess demographic (education, housing, marital status, nationality, and age) and sexual exposure (partner gender, transactional sex, and multiple partners) factors associated with testing HIV-positivity and with condom use. Results: Older men and men having sex with women and women with higher education, of Antiguan nationality, and having sex with men were less likely to test positive for HIV. Younger, educated, and unmarried men and women with multiple partners were more likely to report using condoms. Conclusion: The CBVCT model can be successfully implemented in Eastern Caribbean. Demographic differences persist in HIV testing, risk behavior, and infection among vulnerable populations and should be considered in HIV prevention intervention design.