Utilization of HIV Testing and Counseling in Ghana: Implications for Universal Coverage

Alfred E. Yawson, Phyllis Dako-Gyeke, Stephen Ayisi Addo, Bernard T. Dornoo, Nii Akwei Addo


HIV testing and counselling (HTC)  is a gateway to all systems of AIDS-related care. This study examined national programme data to highlight gaps in HTC service utilization, regional differences and differential use of various HTC programs in Ghana in the period, 2007-2010. Analysis showed HTC increased rapidly across the country, however the increase was not uniform across the 10 regions.  Also huge differential use of current HTC programs (Diagnostic Centre(DCs), Know Your Status campaigns(KYS) and PMTCT Centres) emphasized differential preferences of various testing programmes. Testing through KYS was substantially higher than testing done at DCs. However, HIV positive test rates at DCs were comparatively higher across the  regions than those of KYS. KYS thus attracts and conducts huge numbers of HIV tests, yet it captures relatively low HIV positives. A well structured and more targeted expansion of facility-based HTC services to capture most vulnerable population groups is needed. (Afr J Reprod Health 2014; 18[1]: 145-155).


Keywords: HIV testing and counseling, HIV testing programs, regional differences, National AID/STI Control Program, Ghana  



Le dépistage et le conseil (DC) à l’égard du VIH est une passerelle vers tous les systèmes de soins liés au sida. Cette étude a examiné les données des programmes nationaux de mettre en évidence des lacunes dans l'utilisation des services de DC, les différences régionales et de l'utilisation différentielle des divers programmes DC au Ghana dans la période 2007-2010. L'analyse a montré que le DC a augmenté rapidement à travers le pays, mais l'augmentation n'est pas uniforme dans les 10 régions. En plus,  l’utilisation différentielle énorme  des programmes actuels de DC  (Centre de diagnostic (CD), les campagnes « Connaissez votre statut  immunologique » (CVS) et des Centres de la (PTME) ont souligné les préférences différentielles de divers programmes de dépistage. Le dépistage à travers le CVS était sensiblement plus élevé que les dépistages effectués aux CDs. Toutefois, les taux de dépistages positifs pour le VIH dans les pays en développement ont été relativement plus élevés à travers  les régions que celles de CVS. Le CVS attire donc et effectue un très grand nombre de dépistage du VIH, mais il capte la séropositivité relativement faible. Il faut une expansion bien structurée et plus ciblée des services de DC dans des établissements de santé pour capturer les groupes de population les plus vulnérables. (Afr J Reprod Health 2014; 18[1]: 145-155).


Mots-clés: dépistage du VIH et de conseil, programmes de dépistage du VIH,  différences régionales, programme national de

contrôle du SIDA / IST, Ghana

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Koku EF: Stigma, sexual risk and desire for HIV test in Ghana. Sexual Health. Sexual Health 2011, 8:110119.

Bwambale FM, Ssali SN, Byaruhanga S, Kalyango JN, Karamagi C: Voluntary HIV counseling and testing among men in rural western Uganda: Implications for HIV prevention. . BMC Public Health 2008, 8:24582463.

Levi J: Ensuring timely access to care for people with HIV infection: a public health imperative. Am J Public Health 2002, 92(3):339-340.

Valdiserri RO, Holtgrave DR, West GR: Promoting early HIV diagnosis and entry into care. AIDS 1999, 13:2317-2330.

Snow RC, Madalane M, Poulsen M: Are men testing? Sex differentials in HIV testing in Mpumalanga Province, South Africa. AIDS Care 2010, 22(9):1060-1065.

Marks G, Crepez N, Janssen RS: Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA. AIDS 2006, 20(10):1447-1450.

Matovu JKB, Makumbi FE: Expanding access to voluntary HIV counseling and testing in sub-Saharan Africa: alternative approaches for improving uptake, 2001-2007. Tropical Medicine and International Health 2005, 12(11):1315-1322.

Ndiaye B, Salleron J, Vincent A, Bataille P, Bonnevie F, Choisy P, Cochonat K, Fontier C, Guerroumi H, Vandercam B et al: Factors associated with presentation to care with advanced HIV disease in Brussels and Northern France: 1997-2007. BMC Infect Dis 2011, 11:11.

Mitchell S, Cockcroft A, Lamothe G, Andersson N: Equity in HIV testing: evidence from a cross-sectional study in ten Southern African countries. bmc international Health and Human Rights 2010, 10:23.

Murphy RL: Antiretroviral therapy for advanced naive HIV-infected patients: current status and comparison of two different management strategies. J Acquir Immune Defic Syndr 2007, 46 Suppl 1:S1-2.

Granich R, Crowley S, Vitoria M, Smyth C, Khan KG, Benneth R: Highly active antiretroviral treatment as prevention of HIV transmission: review of scientific evidence and update. Current Opinion in HIV and AIDS 2010, 5:298-304.

Holmes CN, Preko PO, Bolds R, Baidoo J, Jolly PE: Acceptance of voluntary counseling, testing and treatment for HIV among pregnant women in Kumasi, Ghana. Ghana Med J 2008, 42(1):8-15.

Egger M, May M, Chene G, Phillips AN, Ledergerber B, Dabis F: Prognosis of HIV-1-infected patients starting highly active antiretroviral therapy: a collaborative analysis of prospective studies. The Lancet 2002, 360:679-686.

Castilla J, Del Romero J, Hernando V, Marincovich B, Garcia S, Rodriguez C: Effectiveness of highly active antiretroviral therapy in reducing heterosexual transmission of HIV. J Acquir Immune Defic Syndr 2005, 40(1):96-101.

Gupta P, Mellors J, Kingsley L, Riddler S, Singh MK: High viral load in semen of human immunodeficiency virus type 1-infected men at all stages of disease and its reduction by therapy with protease and nonnucleoside reverse transcriptase inhibitors. Journal of Virology 1997, 71:6271-6275.

GHS: 2007 HIV Sentinel Survey Report. In. AccraGhana: National AIDS/STI Control Program; 2008.

GHS: 2010 Annual Report. In. Accra-Ghana: National AIDS/STI Control Program 2011; 2011.

GHS: 2009 HIV Sentinel Survey Report. In. AccraGhana: National AIDS/STI Control Program; 2010.

GHS: 2008 Annual Report. In. Accra-Ghana: National AIDS/STI Program; 2009.

GHS: 2009 Annual Report. In. Accra-Ghana: National AIDS/STI Control Program; 2010.

Peltzer K, Matseke G, Mzolo T, Majaja M: Determinants of knowledge of HIV status in South Africa: results from a population-based HIV survey. BMC Public Health 2009, 9:174.

Cockcroft A, Andersson N, Milne D, Mokoena T, Masisi M: Community views about routine HIV testing and antiretroviral treatment in Botswana: signs of progress from a cross sectional study. bmc international Health and Human Rights 2007, 7(5).

Shisana O, Rehle T, Simbayi L, Parker W, Zuma K, Bhana A: South African National HIV Prevalence, HIV Incidence, Behaviour and Communication Survey. In. Cape Town - South Africa: Human Sciences Research Council; 2005.

Yawson AE, Dako-Gyeke P, Snow R: Sex differences in HIV testing in Ghana, and policy implications. AIDS Care 2012, 24(9):1181-1185.

GSS: Provisional National Population and Housing Census. In. Accra-Ghana: GSS; 2011.

Dako-Gyeke P, Snow R, Yawson AE: Who is utilizing anti-retroviral therapy in Ghana: an analysis of ART service utilization. Int J Equity Health 2012, 11:62.

Hirsch JS: Gender, sexuality, and antiretroviral therapy: using social science to enhance outcomes and inform secondary prevention strategies. AIDS 21 (5), 21-29. AIDS 2007, 21(5):21-29.

Glick P, Sahn D: Changes in HIV/AIDS knowledge and testing behavior in Africa: How much and for whom. Journal of Population Economics 2007, 20(2):383422.

Ghana Statistical Service (GSS): Ghana Health Service (GHS), and ICF Macro (2009). Ghana Demographic and Health Survey 2008: GSS, GHS, and ICF Macro. Accra, Ghana.

Misra V, Vaessen M, Ties Boerma J, Arnold F, Way A, Barrere B: HIV testing in national populationbased surveys: Evidence from the demographic and health surveys. Bulletin of the World Health Organization 2006, 84(7): 537-545.

Macro International: Ethiopia Demographic and Health Survey, Final report. Macro International: Calverton: MD, 2005.


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