Document Type : Original Article


Iranian Research Center for HIV /AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran


Background and aims: Behavioral counseling centers are the main health organizations which
are responsible for providing treatment and care for the patients living with HIV (PLWH). HIVpositive
patients receive services through a unique counseling process called voluntary counseling
and confidential testing (VCCT). Although there are reports regarding VCCT evaluation from other
countries, not such an evaluation was found in Iran until this study, to the best of our knowledge. The
study was performed to fulfill this necessity.
Methods: Using consecutive method sampling, 314 subjects were sampled from the patients referred
to Behavioral Counseling Center of Imam Khomeini hospital, Tehran, Iran. A combination of process
and output evaluation of VCCT was performed in the biggest Behavioral Counseling Center of Iran at
Imam Khomeini hospital, Tehran, Iran. Data were analyzed using descriptive statistics (percentages
and averages).
Results: Participants’ response rate was 95.54%. Two shortcomings were found in the counseling
process. Cronbach alpha reliability coefficient for this scale was 0.899, which was a desirable
reliability for the questionnaire. As the main finding of the study, 48.33% of patients were not using
antiretroviral medications regularly. An average number of patients (2.88) had HIV related stigma and
fear of disclosure. In a quantitative study before testing in the study, it has been found that HIV patients
did not have adequate information about their disease.
Conclusion: Defects in the consultation process for the patients with HIV infection in the hospital were
concluded. The quantity of consulting services for patients was in low level; therefore it is essential to
improve consulting services for health promotion of the HIV patients.


1.Uzochukwu B, Uguru N, Ezeoke U, Onwujekwe O, Sibeudu T. Voluntary counseling and testing (VCT) for HIV/AIDS: a study of the knowledge, awareness and willingness to pay for VCT among students in tertiary institutions in Enugu State Nigeria. Health Policy. 2011;99(3):277-84. doi: 10.1016/j. healthpol.2010.11.007. 
2.Mkhabela MP, Mavundla TR, Sukati NA. Experiences of nurses working in Voluntary Counseling and Testing Services in Swaziland. J Assoc Nurses AIDS Care. 2008;19(6):470-9. doi: 10.1016/j.jana.2008.07.003. 
3.Hussain T, Arif M, Kulshreshtha KK, Yadav VS. HIV infection among clients attending an Integrated Counseling & Testing Centre (ICTC) at Agra, India: Trend over a period of 10 years between 1999 and 2008. HIV & AIDS Review. 2011;10(4):105- 8. doi: 10.1016/j.hivar.2011.09.001. 
4.Ulasi CI, Preko PO, Baidoo JA, Bayard B, Ehiri JE, Jolly CM, et al. HIV/AIDS-related stigma in Kumasi, Ghana. Health Place. 2009;15(1):255-62. doi: 10.1016/j.healthplace.2008.05.006. 
5.Gaudine A, Gien L, Thuan TT, Dung do V. Perspectives of HIV-related stigma in a community in Vietnam: a qualitative study. Int J Nurs Stud. 2010;47(1):38-48. doi: 10.1016/j. ijnurstu.2009.06.004. 
6.Mkhabela MP, Mavundla TR, Sukati NA. Experiences of nurses working in Voluntary Counseling and Testing Services in Swaziland. J Assoc Nurses AIDS Care. 2008;19(6):470-9. doi: 10.1016/j.jana.2008.07.003. 
7.Mugisha E, van Rensburg GH, Potgieter E. Factors influencing utilization of voluntary counseling and testing service in Kasenyi fishing community in Uganda. J Assoc Nurses AIDS Care. 2010;21(6):503-11. doi: 10.1016/j.jana.2010.02.005. 
8.UNAIDS. Voluntary counseling and testing (VCT). Geneva: UNAIDS Technical Update; 2000. 
9.Matovu JK, Makumbi FE. Expanding access to voluntary HIV counselling and testing in sub-Saharan Africa: alternative approaches for improving uptake, 2001-2007. Trop Med Int Health. 2007;12(11):1315-22. doi: 10.1111/j.1365- 3156.2007.01923.x. 
10.Hutchinson PL, Mahlalela X. Utilization of voluntary counseling and testing services in the Eastern Cape, South Africa. AIDS Care. 2006;18(5):446-55. doi: 10.1080/09540120500213511. 
11.Baggaley R.The impact of voluntary counseling and testing: a global review of the benefits and challenges. In: UNAIDS best practice collection. Geneva: UNAIDS: 2001. 
12.Maman S, Mbwambo J, Hogan NM, Kilonzo GP, Sweat M. Women’s barriers to HIV-1 testing and disclosure: challenges for HIV-1 voluntary counselling and testing. AIDS Care. 2001;13(5):595-603. doi: 10.1080/09540120120063223. 
13.World Health Organization. Increasing access to HIV testing and counseling: report of WHO Consultation, 19-21 November 2002. Geneva: WHO; 2003. 14. 
14.Bwambale FM, Ssali SN, Byaruhanga S, Kalyango JN, Karamagi CA. Voluntary HIV counselling and testing among men in rural western Uganda: implications for HIV prevention. BMC Public Health. 2008;8:263. doi: 10.1186/1471-2458-8- 263. 
15.Fylkesnes K, Siziya S. A randomized trial on acceptability of voluntary HIV counselling and testing. Trop Med Int Health. 2004;9(5):566-72. doi: 10.1111/j.1365-3156.2004.01231.x. 
16.Programa Nacional de DST e AIDS, Ministério da Saúde. Pesquisa de conhecimento, atitudes e práticas na população brasileira de 15 a 54 anos, 2004. Brasília: Ministério da Saúde; 2005. 
17.Souza Junior PR, Szwarcwald CL, Barbosa Junior A, Carvalho MF, Castilho EA. [HIV infection during pregnancy: the Sentinel Surveillance Project, Brazil, 2002]. Rev Saude Publica. 2004;38(6):764-72. doi: /S0034-89102004000600003. 
18.Lohn LG. Açao educativa em saude: estudo de caso em Centro de Testagem e Aconselhamento. Florianopolis: Universidade Federal de Santa Catarina; 2005. 
19.Menezes Succi RC. Mother-to-child transmission of HIV in Brazil during the years 2000 and 2001: results of a multicentric study. Cad Saude Publica. 2007;23 Suppl 3:S379-89. doi: 10.1590/S0102-311X2007001500006 
20.Segurado AC, Miranda SD, Latorre MD. Evaluation of the care of women living with HIV/AIDS in Sao Paulo, Brazil. AIDS Patient Care STDS. 2003;17(2):85-93. doi: 10.1089/108729103321150818. 
21.Fisher M. Late diagnosis of HIV infection: major consequences and missed opportunities. Curr Opin Infect Dis. 2008;21(1):1- 3. doi: 10.1097/QCO.0b013e3282f2d8fb. 
22.Souza PR, Jr., Szwarcwald CL, Castilho EA. Delay in introducing antiretroviral therapy in patients infected by HIV in Brazil, 2003-2006. Clinics (Sao Paulo). 2007;62(5):579-84. doi: 10.1590/S1807-59322007000500008 
23.Fraser C, Hollingsworth TD, Chapman R, de Wolf F, Hanage WP. Variation in HIV-1 set-point viral load: epidemiological analysis and an evolutionary hypothesis. Proc Natl Acad Sci U S A. 2007;104(44):17441-6. doi: 10.1073/pnas.0708559104. 
24.Alvarez do Barrio M, Gonzalez Diez R, Hernandez Sanchez JM, Oyonarte Gomez S. Residual risk of transfusiontransmitted viral infections in Spain, 1997-2002, and impact of nucleic acid testing. Euro Surveill. 2005;10(2):20-2. doi: 10.2807/esm.10.02.00521-en. 
25.Bassichetto KC, Mesquita F, Zacaro C, Santos EA, Oliveira SM, Veras MASM, et al. Perfil epidemiologico dos usuarios de um Centro de Testagem e Aconselhamento para DST/HIV da Rede Municipal de Sao Paulo, com sorologia positiva para o HIV. Rev Bras Epidemiol. 2004;7(3):302-10. doi: 10.1590/S1415- 790X2004000300008. 
26.Pechansky F, Kessler F, Von Diemen L, Inciardi JA, Surratt H. [Substance use, risk situations, and HIV seroprevalence among individuals seeking free HIV testing in Porto Alegre, Brazil]. Rev Panam Salud Publica. 2005;18(4-5):249-55. Almeida MR, Labronici LM. [The silent itinerary of people with HIV told through oral history]. Cien Saude Colet. 2007;12(1):263-74. doi: 10.1590/S1413- 81232007000100030. 
28.World Health Organization/Joint United Nations.Programme on HIV/AIDS. Policy statement on HIV testing. http://www. .ics/hivtestingpolicy_en_pdf.pdf (accessed on 15/Aug/2007). 
29.Ferreira AD, Caiaffa WT, Bastos FI, Mingoti SA. Injecting drug users who are (un)aware of their HIV serostatus: findings from the multi-center study AjUDE-Brasil II. Cad Saude Publica. 2006;22(4):815-26. doi: /S0102-311x2006000400020. 
30.Franca-Junior I, Lopes F, Paiva V, Venturi G. Acesso ao teste anti-HIV no Brasil 2003: a pesquisa MS/ Ibope. http://www. (accessed on 05/ Oct/2007). 
31.Ministerio da Saude. Evaluation of the effectiveness of preventive measures aimed at sex workers, in three Brazilian.