Population Services International (PSI) implements HIV voluntary counseling and testing (VCT) programs in over twenty-five countries in Africa, Asia, Latin American and the Caribbean. Three of these programs in East and Southern Africa are examined by analyzing multi-round surveys of sexually active men and women 15-49. This paper investigates the determinants of VCT seeking behavior, changes in these determinants over time, and the impact of VCT social marketing campaigns on HIV testing seeking behavior and its determinants.
The results indicate that social marketing can have a positive impact on the demand and uptake of HIV testing as well as its behavioral determinants. Targeting communication messages at the behavioral determinants that will most influence motivation is essential for increasing the use of VCT services among target populations who are least likely to test. The findings indicate that a variety of communication approaches can be effective, and that modifying campaigns as the program matures and the population awareness around HIV testing benefits is essential. Despite increased access to treatment and prevention services, a large proportion of people in generalized epidemics still do not know their HIV status. Social marketing of VCT is a powerful tool that should be used to continue to expand demand for VCT services in high HIV prevalence countries.