Evaluation of a Comprehensive Training Intervention for Couples Voluntary HIV Counseling and Testing Providers in Zambia Open Access

Deen, Amanda (2015)

Permanent URL: https://etd.library.emory.edu/concern/etds/6t053g15k?locale=en


Background: Since 2007, couples' voluntary HIV counseling and testing (CVCT) has been expanded and implemented in government clinics in urban and rural Zambia. Recently, CVCT services have been integrated with couples' family planning counseling (CFPC) with a focus on providing long-acting reversible contraception (LARC) to couples who wish to delay fertility.

Methods: Data were analyzed from 305 trainees in government clinics in five districts between 2013 and 2014. Certifying nurses and laypersons to insert LARC methods involves passing both a didactic training consisting of multiple-choice and true/false questions regarding the benefits of family planning and HIV integration, knowledge of the intrauterine device (IUD), hormonal implants and a practical training. Covariates of interest were described by whether the trainee passed the didactic test and by whether the trainee passed the practicum using counts and percentages (means and SDs) for categorical (continuous) variables. Logistic regression identified covariates significantly associated with passing the didactic test.

Results: Ninety percent of trainees (n=275) passed the didactic test. In multivariate models, higher pretest scores and receiving training in 2014 versus 2013 were significant (p<0.05) predictors of passing. Of those that passed the didactic test, 60% (n=164) passed the practicum. In univariate analyses, having a higher education and receiving training in Lusaka versus the Copperbelt were significantly (p<0.05) associated with passing the practicum.

Conclusions: Understanding the factors associated with successful completion of CFPC didactic and practical trainings can help to target potential trainees (for example, those with more than a secondary education) and to evaluate the success of training programs (we saw changes in the training program implemented in 2014 lead to more training success). This training model could be used by others to facilitate the integration of family planning services and HIV prevention services to address unmet need for family planning and prevention of mother-to-child transmission of HIV.

Table of Contents

Chapter 1: INTRODUCTION. 1

Context. 1

Problem Statement. 2

Purpose. 2

Definition of Terms. 4


HIV/AIDS in Zambia. 4

Couples' HIV Voluntary Counseling and Testing (CVCT). 5

Integration of family planning and HIV services. 6

Chapter 3: MANUSCRIPT. 10

Background. 14

Methods. 20

Analysis. 21

Results. 23

Chapter 4: DISCUSSION. 25

Conclusions. 27

Chapter 5: REFERENCES. 29

Chapter 6. TABLES. 34


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