Voluntary counselling and testing: uptake, impact on sexual behaviour, and HIV incidence in a rural Zimbabwean cohort

OBJECTIVES: To examine the determinants of uptake of voluntary counselling and testing (VCT) services, to assess changes in sexual risk behaviour following VCT, and to compare HIV incidence amongst testers and non-testers. METHODS: Prospective population-based cohort study of adult men and women in the Manicaland province of eastern Zimbabwe. Demographic, socioeconomic, sexual behaviour and VCT utilization data were collected at baseline (1998-2000) and follow-up (3 years later). HIV status was determined by HIV-1 antibody detection. In addition to services provided by the government and non-governmental organizations, a mobile VCT clinic was available at study sites. RESULTS: Lifetime uptake of VCT increased from under 6% to 11% at follow-up. Age, increasing education and knowledge of HIV were associated with VCT uptake. Women who took a test were more likely to be HIV positive and to have greater HIV knowledge and fewer total lifetime partners. After controlling for demographic characteristics, sexual behaviour was not independently associated with VCT uptake. Women who tested positive reported increased consistent condom use in their regular partnerships. However, individuals who tested negative were more likely to adopt more risky behaviours in terms of numbers of partnerships in the last month, the last year and in concurrent partnerships. HIV incidence during follow-up did not differ between testers and non-testers. CONCLUSION: Motivation for VCT uptake was driven by knowledge and education rather than sexual risk. Increased sexual risk following receipt of a negative result may be a serious unintended consequence of VCT. It should be minimized with appropriate pre- and post-test counselling.     

Trends in the uptake of voluntary counselling and testing for HIV in rural Tanzania in the context of the scale up of antiretroviral therapy

Objectives To describe trends in voluntary counselling and testing (VCT) use and to assess whether high‐risk and infected individuals are receiving counselling and learning their HIV status in rural Tanzania. Methods During two rounds of linked serological surveys (2003–2004 and 2006–2007) with anonymous HIV testing among adults, VCT was offered to all participants. The crude and adjusted odds ratios for completing VCT in each survey were calculated to compare uptake by demographic, behavioural and clinical characteristics, stratified by sex. Repeat testing patterns were also investigated. Results The proportion of participants completing VCT increased from 10% in 2003–2004 to 17% in 2006–2007, and among HIV‐infected persons from 14% to 25%. A higher proportion of men than women completed VCT in both rounds, but the difference declined over time. Socio‐demographic and behavioural factors associated with VCT completion were similar across rounds, including higher adjusted odds of VCT with increasing numbers of sexual partners in the past 12 months. The proportion having ever‐completed VCT reached 26% among 2006–2007 attendees, with repeat testing rates highest among those aged 35–44 years. Among 3923 participants attending both rounds, VCT completion in 2006–2007 was 17% among 3702 who were HIV negative in both rounds, 19% among 124 who were HIV infected in both rounds and 22% among 96 who seroconverted between rounds. Conclusion VCT services are attracting HIV‐infected and high‐risk individuals. However, 2 years after the introduction of antiretroviral therapy, the overall uptake remains low. Intensive mobilisation efforts are needed to achieve regular and universal VCT use.     

The associations of voluntary counseling and testing acceptance and the perceived likelihood of being HIV-infected among men with multiple sex partners in a South African township

This paper examines the socio-demographic factors and sexual risk behaviors (condom use, number of sexual partners, STI symptoms) associated with voluntary counselling and testing (VCT) acceptance and self-perceived risk of being HIV-infected among black men with multiple and younger sex partners in a South African township outside of Cape Town. Using respondent driven sampling, we interviewed 421 men, of whom 409 (97.3%) consented to provide a dried blood spot, 12.3% were HIVinfected (95% confidence intervals [CI.] 8.3, 16.9) and 47.2% (CI. 41.1, 53.6) accepted on site VCT. Twenty six percent (CI. 20.2, 30.7) reported having an HIV test in the past year. Few men perceived themselves as very likely to be infected with HIV (15.6%; CI. 10.4, 20.5). VCT acceptance was significantly associated with being older, married or living with a partner, having higher education, having four to six partners in the past three months and testing HIV positive. Self-perceived likelihood of being HIV infected was significantly associated with low condom use and having seven or more partners in the past three months, and testing HIV positive. These findings indicate that men correctly understand that engaging in certain HIV risk behaviors increases the likelihood of HIV-infection. However, those who perceive themselves at high risk of having HIV do not seek testing. Further investigation into the psychological and cultural barriers to reducing risky sexual behaviors and accessing VCT and other HIV services is recommended.     

Elevated HIV seroprevalence and risk behavior among Ugandan TB suspects: implications for HIV testing and prevention.

OBJECTIVES: Voluntary counseling and testing (VCT) for the human immunodeficiency virus (HIV) is recommended for persons treated for tuberculosis (TB). Opportunities to diagnose HIV may be missed by limiting HIV testing to only persons diagnosed with TB. Among TB suspects in Uganda, we determined HIV prevalence, risk behaviors, and willingness to refer family for VCT. METHODS: Consenting adult patients presenting for evaluation at a referral TB clinic received same-day VCT. TB diagnosis data were abstracted from clinical records. RESULTS: Among 665 eligible patients, 565 (85%) consented to VCT. Among these, 238 (42%) were HIV-positive. Of the HIV-infected patients, 37% had received a non-TB diagnosis. HIV seroprevalence was higher in patients with a non-TB diagnosis (49%) than those diagnosed with TB (39%) (P = 0.02). Fewer than 6% of HIV-infected patients reported always using condoms with sexual partners. The majority of patients (86%) reported being 'very willing' to refer family members for VCT. CONCLUSIONS: Over 35% of HIV-infected cases in our population would have been undetected if HIV testing was limited to cases with diagnosed TB. The high HIV seroprevalence in both TB and non-TB cases merits HIV testing for all patients evaluated at TB clinics. HIV-infected TB suspects reporting high-risk behavior are at risk for HIV transmission, and should receive risk-reduction counseling.     

Empowering HIV testing as a prevention tool: targeting interventions for high-risk men who have sex with men

In France, HIV testing can be easily performed in free and anonymous voluntary counselling testing (VCT) centres. The recent national study among French men who have sex with men (MSM) showed that 73% of those already tested for HIV had been tested in the previous two years. Nothing is known about the risk behaviours of MSM attending VCT centres. This study aimed to characterize sexual risk behaviours of MSM tested for HIV in such centres and identify factors associated with inconsistent condom use (ICU). A cross-sectional study was conducted from March to December 2009 in four VCT centres where a self-administered questionnaire was proposed to all MSM about to have a HIV test. ICU was defined as reporting non-systematic condom use during anal intercourse with casual male partners. Among the 287 MSM who fully completed their questionnaire, 44% reported ICU in the previous six months. Among those who had been already tested, 63% had had their test in the previous two years. Factors independently associated with ICU included: never avoiding one-night stands, not having been recently HIV tested, experiencing difficulty in using condoms when with a HIV negative partner or when under the influence of drugs or alcohol and finally, reporting to have had a large number of casual male partners in the previous six months. The rate of recently tested MSM was high in our study. Nevertheless, this rate was lower than that found in the last national study. Furthermore those not recently tested were significantly more likely to report high risk behaviours. We therefore recommend that further efforts be made to adapt the offer of both HIV testing and counselling to meet the specific needs of hard-to-reach MSM. Accordingly, an additional community-based offer of HIV testing to reach most-at-risk MSM is forthcoming in France.     

Uptake of HIV voluntary counselling and testing services in rural Tanzania: implications for effective HIV prevention and equitable access to treatment

Objective To describe the associations between socio‐demographic, behavioural and clinical characteristics and the use of HIV voluntary counselling and testing (VCT) services among residents in a rural ward in Tanzania. Methods Eight thousand nine hundred and seventy participants from a community‐based cohort were interviewed, provided blood for research HIV testing, and were offered VCT. Univariate and multivariate logistic regression was used to identify socio‐demographic, clinical and behavioural factors associated with VCT use. Results Although 31% (1246/3980) of men and 24% (1195/4990) of women expressed an interest in the service, only 12% of men and 7% of women subsequently completed VCT. Socio‐demographic factors, such as marital status, area of residence, religion and ethnicity influenced VCT completion among males and females in different ways, while self‐perceived risk of HIV, prior knowledge of VCT, and sex with a high‐risk partner emerged as important predictors of VCT completion among both sexes. Among males only, those infected with HIV for 5 years or less tended to self‐select for VCT compared to HIV‐negatives (adjusted odds ratio = 1.43; 95% CI: 0.99–2.14). This contributed to a higher proportion of HIV‐positive males knowing their status compared to HIV‐positive females. Conclusions In this setting, a disproportionate number of HIV‐positive women are failing to learn their status, which has implications for equitable access to onward referral for care and treatment services. Evidence that some high‐risk behaviours may prompt VCT use is encouraging, although further interventions are required to improve knowledge about HIV risk and the benefits of VCT. Targeted interventions are also needed to promote VCT uptake among married women and rural residents.     

High Rates and Positive Outcomes of HIV-Serostatus Disclosure to Sexual Partners: Reasons for Cautious Optimism from a Voluntary Counseling and Testing Clinic in Dar es Salaam, Tanzania

The rates, barriers, and outcomes of HIV serostatus disclosure to sexual partners are described for 245 female voluntary counseling and testing (VCT) clients in Dar es Salaam, Tanzania. VCT clients were surveyed 3 months after HIV testing to describe their HIV-serostatus disclosure experiences. Sixty-four percent of HIV-positive women and 79.5% of HIV-negative women (p = 0.028) reported that they had shared HIV test results with their partners. Among women who did not disclose, 52% reported the reason as fear of their partner's reaction. Both 81.9% of HIV-negative women and 48.9% of HIV-positive women reported that their partner reacted supportively to disclosure (p < 0.001). Less than 5% of women reported any negative reactions following disclosure. VCT should continue to be widely promoted. However, intervention approaches such as development of screening tools and new counseling approaches are important to ensure the safety of women who want to safely disclose HIV serostatus to their sexual partners.     

2008-2011年上海市长宁区VCT情况分析

目的分析上海市长宁区艾滋病自愿咨询检测（VCT）人群相关情况,以及艾滋病病毒（HIV）抗体检测和部分人群梅毒检测结果,为今后艾滋病性病防治干预工作提供科学的依据。方法搜集2008-2011年上海市长宁区疾病预防控制中心VCT门诊求询者的基本信息,以及HIV抗体及部分求询者梅毒检测结果等资料进行统计学分析。结果 2008-2011年,长宁区疾病预防控制中心VCT门诊接受咨询检测服务共计3 382人,求询者男女性别比为11.6∶1;求询者以25～44岁的青壮年人群为主,占66.74%（2 257/3 382）。求询者均有性接触史（非婚异性性行为、男男性行为、配偶/固定性伴阳性）,且男男性行为人群（MSM）比例呈逐年上升趋势。求询者中曾经接受过HIV抗体检测所占比例总体呈上升趋势（z=18.854,P〈0.000 1）;2008-2011年,96.24%（3 255/3 382）的求询者接受了HIV抗体检测,且阳性率呈逐年升高的趋势（z=5.680 5,P〈0.000 1）。HIV抗体阳性人群中,配偶/固定性伴阳性者及MSM人群阳性率较高,分别为10.53%（8/76）、7.45%（89/1 195）,其中MSM人群HIV抗体阳性率总体呈上升趋势。同时接受HIV和梅毒抗体检测的1 713名求询者中,梅毒抗体阳性人群的HIV阳性率为24.62%（16/65）,梅毒抗体阴性人群的HIV抗体阳性率为4.49%（74/1 648）,两者之间的差异有统计学意义（χ2=50.88,P〈0.000 1）。结论今后的工作重点在于加强对配偶/固定性伴阳性者的知识宣传和行为干预,尽早发现感染者,减少二代传播;MSM人群的干预以及其阳性感染者获得很好的后续服务及管理,也是今后干预工作的一项重要内容。     

HIV incidence and risk behaviours after voluntary HIV counselling and testing (VCT) among adults aged 19-35 years living in peri-urban communities around Chiang Mai city in northern Thailand, 1999

The Thai government began HIV voluntary counselling and testing (VCT) in all provinces in 1992. We evaluated HIV incidence after participants utilized VCT and its effect on risk behaviours among northern Thai adults aged 19-35 years. A total of 924 men and 1,327 women volunteered to participate in the study. Subjects were counseled, interviewed (socio-demographic, HIV risk behaviour, and HIV testing history), and tested for HIV infection at baseline and at 6 months follow-up. All participants were provided group pre-test counselling; HIV test results were provided in individual confidential post-test counselling. Overall, 329 of 391 men and 621 of 669 women who reported a prior HIV test before participating in our study reported negative results at the previous test. Of these, nine men and 13 women tested positive at baseline, giving incidence rates of 1.04 and 0.69 per 100 person years (PY), respectively. Recent risk behaviour was rare; as a result, the effects of VCT on risk behaviours among the study participants could not be determined. The HIV incidence after VCT among this study population is substantial. Studies to investigate factors associated with HIV incidence among VCT clients could provide insights for more effective HIV prevention.     

岱山县2010-2012年艾滋病VCT结果分析

目的了解岱山县接受艾滋病自愿咨询检测（VCT）服务人群的特征和艾滋病病毒（HIV）感染状况,为更有针对性地开展VCT工作提供科学依据。方法收集2010-2012年岱山县艾滋病自愿咨询点,接受VCT服务的人群资料并进行分析。结果共有1032人接受咨询检测服务,男女性别比为2.42∶1,以21~40岁青壮年占86.72%（895人）;求询者类型以非婚异性性行为占67.44%（696人）。接受HIV检测1032人,检出阳性5例,检出阳性率0.48%。配偶/固定性伴阳性者的阳性率最高为7.14%,其次有男男性行为史者为1.45%,有非婚异性性行为史者为0.43%。结论 VCT是发现HIV感染者的有效途径,开展干预的重要窗口,应针对不同人群进一步规范VCT服务,预防和减少艾滋病在社会上的传播。     

Why are People Getting Tested? Self-Reported Reasons for Seeking Voluntary Counseling and Testing at a Clinic in Chennai, India

VCT has been shown to be an important HIV risk reduction strategy; however, little is known about who attends VCT or why people seek VCT. A retrospective analysis was performed on charts of 6330 clients who attended VCT between 1994 and 2002 at Y.R. Gaitonde Centre for AIDS Research and Education, a non-governmental organization in Chennai, Tamil Nadu, India. Most clients reported more than one reason for attending VCT, and the most commonly reported reasons were risk behavior, having symptoms, having a current HIV-positive partner, and reconfirming a previous positive HIV test. Reasons varied by gender and over time, and the likelihood of testing positive for HIV varied by reason reported. Understanding why people seek VCT informs an understanding of knowledge and attitudes about HIV and HIV testing, which has implications for the development of education, outreach and other HIV prevention services.     

HIV testing is associated with increased knowledge and reductions in sexual risk behaviours among men in Cape Town,South Africa

HIV testing benefits those who test positive, allowing them to receive treatment, but the benefits for those who test negative remain controversial. We evaluated the impact of testing on HIV knowledge and sexual risk among men in South Africa. Men were recruited from townships outside Cape Town and completed a survey that assessed testing history, knowledge, and sexual behaviours. Among the 820 participants, 516 (63%) reported being tested (82% tested negative, 6% tested positive, and 12% unknown). Compared to those who had never been tested for HIV, men who tested for HIV were more knowledgeable about HIV transmission, but did not differ on sexual risk behaviour. Knowledge moderated the effect of testing on sexual risk such that men reported fewer sexual partners (incidence rate ratio (IRR) = 0.91, 95% CI = 0.84, 0.98) and fewer unprotected anal sex events (IRR = 0.81, 95% CI = 0.66, 1.00) if they had been tested for HIV and were knowledgeable about HIV transmission. For men testing HIV-negative, knowledge predicted fewer sexual risk behaviours. Previous HIV testing is associated with enhanced knowledge, which moderates sexual risk behaviour among South African men living in Cape Town. Results suggest that HIV testing may increase knowledge and lead to reductions in sexual risk even when results are negative.     

Characteristics of Individuals and Couples Seeking HIV-1 Prevention Services in Dar Es Salaam, Tanzania: The Voluntary HIV-1 Counseling and Testing Efficacy Study

The objective of this paper is to describe the baseline characteristics, risk behavior, and HIV prevalence of individuals and couples who enrolled in the Voluntary HIV Counseling and Testing Efficacy Study at the study site in Dar es Salaam, Tanzania. Participants were recruited through flyers, radio, and outreach to schools and workplaces to participate in a randomized clinical trial testing the effectiveness of HIV voluntary counseling and testing (HIV VCT) for prevention of new HIV and STD infections. Recruitment was stratified to include men and women enrolling alone and as couples. Baseline data were collected in face-to-face interviews, then participants were randomized to receive HIV VCT or health information. A total of 1,427 participants were recruited, 708 women and 719 men; 444 participants enrolled as part of a couple. HIV seroprevalence for those who received VCT at baseline was 21% overall (12% men, 30% women). Those enrolled as couples reported less sexual risk behavior than those enrolled as individuals. Both couples and individuals reported high rates of unprotected sexual intercourse with commercial partners. Overall 45% of participants self-reported an STD symptom (54% of women and 36% of men), and men were more likely to have received treatment for their symptoms. A large number of individuals and couples responded to advertisements for VCT in Dar es Salaam, Tanzania. High rates of HIV seroprevalence and couple serodiscordance, self-reported STD symptoms, and sexual risk behavior indicate that at-risk participants were recruited. Implications for delivery of HIV VCT and related services are discussed.     

艾滋病低流行区自愿咨询检测实施三年效果评价

目的评价自愿咨询检测（VCT）策略在艾滋病低流行区（江苏）实施三年（2005-2007年）的效果,为进一步深化VCT策略提供依据。方法在性病门诊设置独立的艾滋病咨询室,提供规范的VCT服务,并实施社会动员、高危人群外展服务。收集2005-2007年在江苏省疾病预防控制中心VCT门诊接受咨询检测的求询者的信息,Epi data 3.1录入、建立数据库,并用SAS 9.1统计分析。结果三年共接受咨询检测4 439人。其中男男性行为者（MSM）369人,异性性行为者3 962人,血液接触者96人,职业暴露12人;重复检测1 342人。4 439人的HIV阳性检出率为1.01%,男女性之间HIV阳性检出率无显著性差异。HIV阳性检出率在≥30岁的求询者中为1.57%,在〈30岁的求询者中为0.67%,两者差异有显著性。MSM的HIV阳性检出率为5.69%,显著高于异性性行为者（0.28%）。在首次咨询检测者中阳性检出率为0.97%,重复检测者中为1.12%,两者差异无显著性。45例HIV感染者100%接受阳性结果告知和首次随访。多因素Logistic回归分析显示,HIV感染率与求询者特征中年龄≥30岁（OR=3.20,95%CI1.66～6.17）和同性接触（OR=28.20,95%CI13.20～60.30）有统计学关联。结论在低流行区,VCT服务在艾滋病综合防治中发挥着重要作用,也在为区域性艾滋病防治策略的调整提供线索。该地区艾滋病流行的危险因素仍然广泛存在。VCT点已成为发现HIV感染者实施综合防治措施的重要窗口。     

Investigating the relationship between HIV testing and risk behaviour in Britain: National Survey of Sexual Attitudes and Lifestyles 2000

OBJECTIVES: To estimate the prevalence of, and identify factors associated with, HIV testing in Britain. DESIGN: A large, stratified probability sample survey of sexual attitudes and lifestyles. METHODS: A total of 12,110 16-44 year olds completed a computer-assisted face-to-face interview and self-interview. Self-reports of HIV testing, i.e. the timing, reasons for and location of testing, were included. RESULTS: A total of 32.4% of men and 31.7% of women reported ever having had an HIV test, the majority of whom were tested through blood donation. When screening for blood donation and pregnancy were excluded, 9.0% of men and 4.6% of women had had a voluntary confidential HIV test (VCT) in the past 5 years. However, one third of injecting drug users and men who have sex with men had a VCT in the past 5 years. VCT in the past 5 years was significantly associated with age, residence, ethnicity, self-perceived HIV risk, reporting greater numbers of sexual partners, new sexual partners from abroad, previous sexually transmitted infection diagnosis, and injecting non-prescribed drugs for men and women, and same-sex partners (men only). Whereas sexually transmitted disease clinics were important sites for VCT, general practice accounted for almost a quarter of VCT. CONCLUSION: HIV testing is relatively common in Britain; however, it remains largely associated with population-based blood donation and antenatal screening programmes. In contrast, VCT remains highly associated with high-risk (sexual or drug-injecting) behaviours or population sub-groups at high risk. Strategies to reduce undiagnosed prevalent HIV infection will require further normalization and wider uptake of HIV testing.     

Motives,sexual behaviour,and risk factors associated with HIV in individuals seeking voluntary counselling and testing in a rural district of Malawi

A study was conducted among individuals seeking voluntary HIV counselling and testing (VCT) in order to (a) describe their motives and source(s) of information, (b) describe their sexual behaviour; and (c) identify risk factors associated with HIV infection. Of 723 individuals who sought VCT, the most common reason (50%) was recent knowledge of HIV/AIDS and a desire to know their HIV status. The majority (77%) underwent VCT after being encouraged by others who knew their status. Ninety five per cent reported sexual encounters, with 337 (49%) engaging in unprotected sex. HIV prevalence was 31% and an HIV-positive status was associated with being female, being over 25 years of age and/or being a farmer. There is a demand for VCT, and the service provides an opportunity for intensive education about HIV/AIDS prevention on a one-to-one basis. It could also be an entry point to prevention and care for those who are infected.     

2011--2012年泸西县艾滋病自愿咨询检测资料分析

目的了解泸西县艾滋病自愿咨询检测（VCT）工作的开展情况,为制定艾滋病预防控制对策提供科学依据。方法收集泸西县2011—2012年艾滋病VCT相关资料,分析求询者的人口学特征和检测情况。结果2011—2012年泸西县VcT门诊求询人数为1130人,检出艾滋病病毒（HIV）抗体阳性70例,求询者HIV抗体阳性总检出率为6．2％。求询者中,男性多于女性,以20-39岁青壮年为主,文化程度较低,有非婚异性性行为史者所占比例高达72．4％。配偶／固定性伴HIV抗体阳性的求询者,其HIV阳性检出率最高,为17．5％。结论把VCT与高危行为干预有效地结合,将充分发挥它们在艾滋病防治工作中的特有作用和优势。     

A Venue-Based Approach to Reaching MSM,IDUs and the General Population with VCT: A Three Study Site in Kenya

A venue-based HIV prevention study which included Voluntary Counseling and Testing (VCT) was conducted in three diverse areas of Kenya-Malindi, Nanyuki and Rachounyo. Aims of the study were to: (1) assess the acceptability of VCT for the general population, men who have sex with men (MSM), and injecting drug users (IDUs) within the context of a venue-based approach; (2) determine if there were differences between those agreeing and not agreeing to testing; and (3) study factors associated with being HIV positive. Approximately 98% of IDUs and 97% of MSM agreed to VCT, providing evidence that populations with little access to services and whose behaviors are stigmatized and often considered illegal in their countries can be reached with needed HIV prevention services. Acceptability of VCT in the general population ranged from 60% in Malindi to 48% in Nanyuki. There were a few significant differences between those accepting and declining testing. Notably in Rachuonyo and Malindi those reporting multiple partners were more likely to accept testing. There was also evidence that riskier sexual behavior was associated with being HIV positive for both men in Rachounyo and women in Malindi. Overall HIV prevalence was higher among the individuals in this study compared to individuals sampled in the 2008-2009 Kenya Demographic and Health Survey, indicating the method is an appropriate means to reach the highest risk individuals including stigmatized populations.     

Personal History of Voluntary HIV Counseling and Testing (VCT) Among Adults Aged 19–35 Years Living in Peri-urban Communities,Chiang Mai,Northern Thailand

This study investigates the self-reported history of HIV voluntary counseling and testing (VCT) among adults, aged 19–35 years, in northern Thailand. Participants were interviewed about their HIV testing history and risk behavior. Overall, 47% of 2251 participants had previously been tested, of whom 64% were tested at government clinics. Of those tested at private clinics, 50% reported not receiving pre- and post-test counseling, compared to 15% of those tested in government clinics. Ten percent of those tested had not received their test results. Among those who had never been previously tested for HIV, 66% believed they were not at risk, although 1.5% (2.7% among men) were HIV infected. Although VCT is widely available and utilized by the population of northern Thailand, substantial numbers of HIV infected persons have not been tested for HIV and among those tested many have not received comprehensive counseling. A Thai government policy enforcing effective counseling to accompany HIV testing is urgently needed.     

Correlates of HIV Test Results Seeking and Utilization of Partner Counseling Services in a Cohort of Male Factory Workers in Zimbabwe

Correlates of individual HIV test results-seeking and utilization of partner counseling services were identified among male factory workers who participated in a longitudinal HIV prevention intervention study in Harare, Zimbabwe. Men working at participating factories were offered HIV voluntary counseling and testing (VCT) for themselves and their partners. While risk assessment counseling was offered in the workplace, result disclosure and partner counseling occurred at an off-workplace location. Of the 3,383 men undergoing risk assessment and testing, 1,903 (56%) chose to receive their test results and 230 (7%) brought their partners for VCT. Factors associated with receiving test results were history of STD and lower salary. Factors associated with bringing a partner for VCT were history of STD, being married, being employed at a factory with a peer educator, lower salary, and no prostitute contact. Incorporating VCT into STD treatment services is likely to reach a large number of men and their partners at highest risk for both types of infections. Because men are often the main decision-makers in sexual and reproductive matters, VCT must be easily accessible to urban, working African men.