7th IAS Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2013)


TUAD0105 - Oral Abstract

Use of referral vouchers to measure increased demand of HIV counseling and testing among key populations in Kyrgyzstan

Presented by Djamila Alisheva (Kyrgyzstan).

S. Aufenkamp1, I. Shayakhmetov2, L. Koushenova1, M. Bakpayev1, J. Gall1, M. Kan1, D. Alisheva3

1Population Services International, Almaty, Kazakhstan, 2Bishkek City AIDS Center, Bishkek, Kyrgyzstan, 3Population Services International (PSI), Bishkek, Kyrgyzstan

Background: The USAID Dialogue on HIV and TB Project aims to improve health behaviors among key populations in Central Asia, including increased utilization of government-provided HIV counseling and testing (HCT) services. The five-year project is implemented by a consortium of NGOs that provide a targeted outreach package of services including HIV education and, for individuals not tested in the previous 12 months, referral to HCT. Here we present on the success of a referral voucher system used to measure the intervention's direct contribution to increased uptake of HCT in Kyrgyzstan.
Methods: A referral voucher system was established in partnership with NGOs, Ministry of Health, AIDS Centers and other service providers. To increase service uptake, the Project trains providers on the use of the referral system, stigma reduction, and communication skills with key populations.
The referral system uses vouchers with two sections. One section is kept by outreach workers who provide the referral; the second is given to the referred individual and collected by the service provider when HCT is accessed. Unique identifier codes (UIC) on each section are matched to track the uptake of referrals while ensuring confidentiality.
Results: In the first three years of the project, 17,390 individuals were reached, and among those 4,807 were referred for HCT. The percentage of people who inject drugs who accessed HCT after receiving a project referral increased from 6.2% in year one to 10.5% in year two to 28.2% in year three. Among sex workers who were reached, use of HCT after referral increased from 17.0% to 18.6% to 22.0% over three years. Among men who have sex with men who were reached, use of HCT after referral increased from 6.6% to 35.1% to 54.3% over the same period. Individuals tested without referral vouchers are not included in these results.
Conclusion: A referral voucher can be used to track a program's contribution to increased demand for HCT and other health services, providing evidence of the intervention's effectiveness. This requires close collaboration between providers and NGOs to ensure key populations feel comfortable seeking services, enabling long-term behavior change and sustained service demand.

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