The effect of introducing a fee for HIV counselling and testing at the AIDS Information Centre; Kampala; Uganda. (p.159)

ABSTRACT

"The objective was to assess the impact on demand and return rates of introducing a User-fee for HIV counseling and testing (C/T) services in Uganda. The AIDS Information Centre (AIC) was established in Kampala in 1990 with support from USAID; by 1992 this service was available daily in four main urban areas; and on an intermitent basis; in an additional 14 districts. A modest user fee was introduced in 1994. Data for 1993 (before fees) and 1994 (after fees) were compared to assess the impact of introducing user fees; data from the four urban sites with daily services is presented. Results showed that demand for HIV C/T declined by 8.3; from a total of 45;484 clients in these urban sites in 1993 to 41;686 in 1994. The impact of user fees was much more pronounced for male clients; who declined by 12.6; female clients declined by only 1.8. Those clients who had not completed primary school declined by 44.3; though there was an increase of 20in those with primary education or more. There was a decrease in utilisation for all age groups; though this decrease was greater among youth; especially young men under age 20. It was concludedthat introduction of a user fee may affect both demand and client demographics. Though the decline in clients with less education was expected; it was also expected that the user fee would impact women more than men. There was no significant decline in women clients; suggesting that the demand for HIV C/T continues to be high among women in Uganda. The decline in young male clients suggests the need to introduce alternatives; such as special""free days"" to accommodate this potentiallyt high risk group."