Client-provider interactions in provider-initiated and voluntary HIV counseling and testing services in Uganda

Background: Voluntary testing and counseling (VCT) is the process by which an individual undergoes confidential counseling, to enable the individual arrive at an informed choice with respect of learning his or her HIV status and advice on taking the appropriate action. It is vitally important and one of the national strategy to control HIV/AIDS epidemics in the general population and is internationally acknowledged as essential strategy for HIV prevention and entry point to HIV/ AIDS care. HIV/AIDS is a disease which affects the human immune system caused by infection with human immune deficiency virus. According to Ministry of Health, in Ethiopia the highest prevalence of HIV is seen in the age group 15-24 years.
 Objective: This study aimed to assess knowledge, attitude and practice towards HIV voluntary testing and counseling among undergraduate at the Wachemo University, southern Ethiopia.
 Methods: Institutional based cross-sectional study design was conducted at Wachemo University from February 10 to February 30/2018.Multistage sampling method was used to enroll students from different faculties. Main outcome measures included level of knowledge, attitude and practice of VCT for HIV.
 Results: A total of 623 students participated in the study yields the response rate of 100%. The majority, (91.2%) of respondents were heard about voluntary counseling and testing of HIV. More than half, (63.0%) of the students disagreed that voluntary counseling and testing of HIV service in the campus is not functional and not giving service appropriately. The majorities, (93.4%) of the study participants were knowledgeable about voluntary testing and counseling of HIV; and 491 (78.8%) of the study participants had positive attitude towards voluntary testing and counseling of HIV. However, only one thirds (36.7%) of the respondents had practiced voluntary testing and counseling of HIV.
 Conclusion: Despite high knowledge and favorable attitude towards VCT, more than half of the respondents (63.3%) don’t experienced HIV test, for the following reason: Fear of positive result (32.4%), stigmatization (15.9%), while (30.7%) being sure of not having HIV.

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Background HIV voluntary counseling and testing(VCT)services are a key route to the prevention and care of HIV/AIDS. The objective was to assess the uptake and factors associated with HIV voluntary testing and counseling among university students at Bishop Stuart University. Methodology A descriptive cross-sectional study was conducted among Nursing undergraduate students from the faculty of health sciences at Bishop Stuart University with a sample size of 139. Results A total of 139 students participated in this study 72(51.8%) male and 67 (48.2%) female. Out of these, 58(41.7%) were in the age group of 18-23. The majority of participants showed knowledge about HIV transmission and VCT. Overall the uptake of VCT was high at (94.2%) The majority of the participants had a nearby place for HIVCT 136(97.8%), knew about the place through health workers 97(69.8%), took <5km from home to the nearest HIV testing site 93(66.9), waited for <1hour at health facility 97(69.8%) and did not pay for HIVCT 88(63.3%). This study results revealed a significant association between age X2(df=4) =7.608, p-value = 0.017, and X2(df=3) =3.345, P value = 0.034 with having done HIV VCT. This study revealed no significant relationship between the participants’ knowledge and HIV. Conclusion The study showed high knowledge of VCT services, and the uptake of VCT among nursing students was found to be high. Factors that were found to be significant in the uptake of HIV VCT included knowing the place of HIV VCT, quality of services (time taken at the facility), Age, and engagement in sexual relationships. Recommendation More emphasis also should be put on support and care received after knowing the test results to be communicated as it helps motivate more young people towards VCT uptake.

Women who experience intimate partner violence (IPV) are more likely to be HIV positive. Many of these women never receive any relevant services, and those who do often access them only after events have escalated to a crisis requiring the police or emergency medical care. Evidence from other settings suggests that routinely asking women about experiences of partner violence is received positively. Voluntary counseling and testing (VCT) services would seem an ideal opportunity to screen for IPV in South Africa. However, in low resource settings, VCT is carried out by lay counselors with few skills. We therefore conducted a qualitative study that explored women's experience of IPV screening in VCT services, and explored implications for VCT counseling. The study was conducted in a clinic in Johannesburg where we trained the lay counselors to do IPV screening. In-depth interviews were conducted with 35 women attending VCT services. Participants were recruited before they attended VCT, and 12 women participated in a follow-up interview. A focus group was held with lay counselors a year after the intervention was implemented. Findings suggest that women were supportive of being asked about their experiences of IPV during VCT sessions. Reasons for supporting IPV screening at VCT services include the limited access of many women to health services. Many women who were aware of their HIV risk felt powerless to discuss condom use, HIV testing, and infidelity with their male partners. Women directly related such experience of gender power inequality to HIV risk. One year after training, there was no evidence of screening continuing. Our findings suggest that the focus should shift from asking about violence to equipping counselors to discuss gender inequality in relationships more broadly. This needs to be part of basic counselor training as it is integral to approaching HIV risk reduction.

BackgroundKenya experienced rapid scale up of HIV testing and counselling services in government health services from 2001. We set out to examine the human resource policy implications of scaling up HIV testing and counselling in Kenya and to analyse the resultant policy against a recognised theoretical framework of health policy reform (policy analysis triangle).MethodsQualitative methods were used to gain in-depth insights from policy makers who shaped scale up. This included 22 in-depth interviews with Voluntary Counselling and Testing (VCT) task force members, critical analysis of 53 sets of minutes and diary notes. We explore points of consensus and conflict amongst policymakers in Kenya and analyse this content to assess who favoured and resisted new policies, how scale up was achieved and the importance of the local context in which scale up occurred.ResultsThe scale up of VCT in Kenya had a number of human resource policy implications resulting from the introduction of lay counsellors and their authorisation to conduct rapid HIV testing using newly introduced rapid testing technologies. Our findings indicate that three key groups of actors were critical: laboratory professionals, counselling associations and the Ministry of Health. Strategic alliances between donors, NGOs and these three key groups underpinned the process. The process of reaching consensus required compromise and time commitment but was critical to a unified nationwide approach. Policies around quality assurance were integral in ensuring standardisation of content and approach.ConclusionThe introduction and scale up of new health service initiatives such as HIV voluntary counselling and testing necessitates changes to existing health systems and modification of entrenched interests around professional counselling and laboratory testing. Our methodological approach enabled exploration of complexities of scale up of HIV testing and counselling in Kenya. We argue that a better understanding of the diverse actors, the context and the process, is required to mitigate risks and maximise impact.

Background : - Voluntary Counseling and Testing (VCT) services have become one of the most common means of preventing, detecting and improving access to care and support to HIV/AIDS. Currently in Ethiopia, young people are most affected group of HIV/AIDS. Moreover, youth VCT utilization is low in studies among university students. Therefore, this study was aimed to assess youth’s voluntary counseling and testing utilization and associated factors in Mizan-Aman Town, Southwest Ethiopia. Community based cross sectional study was conducted among youth living in Mizan-Aman Twon. The data was collected using pre-tested interviewer administrating questionnaires using simple random sampling technique. Descriptive statistics, bivariate analysis, multivariate logistic regressions ware used accordingly. A total of 389 youths responded the questionnaire making the response rate of 96.6%. Two hundred thirty five (60.4%) were female. VCT utilization was 42.4% (95% CI=37.8%, 47.6%). Factor associated with intension to VCT service utilization are females [AOR=1.69, 95%CI= (1.017-2.814)]; attending secondary education level (AOR=2.099, 95%CI=(1.12-3.929)) and attending college education level (AOR=3.39, 95%CI=(1.783-6.45)); And having low perceived barrier and cue to action are [AOR=2.63,95%CI (1.236-5.614) and [AOR=10.85, 95 % CI=(6.05-19.46)] respectively. Being female, educated, high perceived barrier and cue to action were identified as significant associated factors for intension to utilize voluntary counseling and testing. More emphases should be given by concerned bodies in Mizan-Aman town health unit, Mizan Aman Health Science College on information translation regarding VCT, focus on male youth, collaborating with educational sectors, and assuring youth to benefit more on VCT services. Keywords: Voluntary Counseling and Testing (VCT), Mizan-Aman, Youth. DOI: 10.7176/JMPB/66-03 Publication date: June 30th 2020

BackgroundVoluntary counselling and testing (VCT) is an important component of national HIV programs, which are necessary to realize the right to health. VCT data also provide valuable information on regional HIV epidemiology.MethodsThe study examines data on the population that obtained HIV VCT in Kenema District, Sierra Leone, from 2004 to 2006, using descriptive statistics and exploring potential HIV risk factors using bivariate and multivariable logistic regression. Analysis was performed separately for two subpopulations: those accessing VCT routinely as part of antenatal care and those specifically seeking VCT.ResultsDuring this period, 2230 people accessed VCT: 1213 through antenatal testing and 1017 specifically seeking VCT. The HIV prevalence was 0.6% in women presenting for antenatal care, 12.6% in women specifically accessing VCT, and 6.7% in men specifically accessing VCT. In both bivariate and multivariable analyses, being female was statistically significantly associated with testing positive in people specifically seeking VCT.ConclusionsThese data from the VCT service in Kenema will be used to improve the accessibility of HIV testing. Questions raised by the analysis will be used to enhance data collection and to inform further research on risk factors.

Background: HIV Voluntary Counseling and Testing (VCT) services provide an importatnt start to HIV/AIDS prevention and care. The literature showed that the uptake of VCT is very low, and it is affected by many factors among university students, which are considered as high-risk group for HIV/AIDS infection. Objective: The objective of this study is to identify the factors that affect the uptake of voluntary counseling and testing among the undergraduate students. Methodology: A descriptive cross-sectional study was conducted among the undergraduate students from the faculty of sciences at the Khartoum university with a sample size of 192. The students were selected by systematic random technique. A structured questionnaire was used for data collection, and data were entered and analyzed by using the SPSS (computer program). IRB approval was obtained from the University of Science and Technology, and informed consent was taken from all participants. Results: A total of 192 students participated in this study 107 (55.7%) male and 85 (44.3%) female. Out of these, 100 (52.1%) were in the age group of 15-20, while 92 (47.9%) were in the age group of 21-25. Regarding the knowledge about VCT; 149 (78%) students had good knowledge. The study revealed that about 17 (9%) of the students took the HIV test, and 118 (62%) expressed their willingness to uptake VCT in the future. Reasons that hindered HIV testing during this study include: 1) Some students did not consider themselves at risk (84 i.e. 44%), some students did not know the place where the test is provided (74 i.e. 38.%), some of them did not hear about VCT (32 i.e. 17%) and some were afraid of the test results (17 i.e. 32%). The study found that VCT uptake is positively associated with age, sexual intercourse, and considering themselves self at risk of HIV infection (p=0.05,0.00.0.03 respectively). Moreover, the study also found an association between willingness to uptake VCT in the future with sexual intercourse and considering themselves at risk of HIV of HIV infection (p = 0.03, 0.00 respectively). Conclusion: The uptake of VCT is very low among university students, and it is associated with age and risk perception and sexual intercourse. The most important factors include not considering themselves at risk or not knowing the place of testing or no knowledge about the test or the fear of being positive. On the other hand, willingness to uptake the test was considerably high.

Background: Voluntary counseling and testing (VCT) is an entry point for the prevention of HIV transmission from mother to child and accessing VCT benefit from PMTCT services. Even though, some pregnant women clearly know the benefits /advantages of PMTCT services, they are not willing to test and access the services. Hence, this study was aimed to assess the willingness of pregnant women attending antenatal care towards VCT/PMTCT at Adare general hospital in southern Ethiopia. Method: An institution-based cross-sectional study was conducted at Hawassa Adare hospital, southern Ethiopia from February to April/2018. A total of 338 randomly selected pregnant women who were attending antenatal care clinic were included. Data was collected using structured and pretested questionnaire; entered and analyzed using SPSS version 20 computer software. Important descriptive and logistic models were used for data analysis assuming statistical significance at p < 0.05. Result: A total of 338 mothers were interviewed with a response rate of 100%. The willingness towards voluntary HIV counseling and testing among study participants was 82.2%. Participants who attended primary and High school and above were 3.9 (AOR= 3.87, 95% CI- 1.705, 8.782) and 9.5 times (AOR 9.53 at 95% CI- 3.155, 28.76); those who had good knowledge about VCT/PMTCT were 3.47 times (AOR=3.47, 95% CI-1.721, 7.003); women who followed two to three ANC visit, were 5.1 times more likely have willingness towards VCT/PMTCT (AOR 5.11 at 95% CI -1.095, 23.81) more likely willing to be tested than their counterparts respectively. Conclusion: Willingness towards voluntary HIV counseling was encouraging however it needs advancement. Since boosted knowledge and awareness promote willingness to VCT/PMTCT uptakes, initiation of community-based information dissemination, increased quality of ANC service, and empowering women to be educated could be effective in order to promote high VCT and PMTCT program uptakes

BackgroundHIV testing and counseling interventions have been pivotal in efforts to curb the HIV epidemic, with diverse delivery models implemented globally. However, existing studies primarily focus on individual perspectives, with limited attention given to the essential role of health care workers in the effective implementation of voluntary counseling and testing (VCT) and provider-initiated testing and counseling (PITC) services in China.ObjectiveThis protocol describes the design of the Provider-initiated Views on PITC and VCT Study (PIVOT Study), which aims to assess health care workers’ perceptions, barriers, and facilitators related to the implementation of PITC and VCT in Guangdong Province, China.MethodsThe PIVOT Study is a multicenter, cross-sectional observational study. Eligible participants are health care workers employed at various health care service institutions, including hospitals, VCT clinics, the Centers for Disease Control and Prevention, and community health centers. We will use a convenience sampling method. Data will be collected via a structured digital questionnaire covering 5 domains: sociodemographic information, general health status, psychosocial characteristics, knowledge related to PITC and VCT, and experiential insights regarding service provision. Descriptive statistics will be used to characterize variable distributions, and multivariable logistic regression models will assess associations between independent and outcome variables. Secondary analyses will explore subgroup differences based on age, years of experience, sex, institution type, and geographical location. A total of approximately 400 health care workers will be recruited.ResultsThe PIVOT Study proposal was submitted in December 2024 and received funding approval in May 2025, with official project initiation planned for July 2025. Study design and survey instrument revisions were completed between December 2024 and March 2025. A pilot survey was completed from April to May 2025, followed by questionnaire testing and refinement from June to August 2025. Formal data collection was conducted from September to November 2025, with data cleaning and preliminary analyses scheduled from December 2025 to January 2026. Final data analysis and manuscript preparation are planned from February to June 2026.ConclusionsThe PIVOT Study will generate important insights into health care workers’ perspectives on PITC and VCT service delivery in China. The findings are expected to inform the development of targeted strategies to strengthen HIV testing efforts, particularly among underrepresented populations such as older adults. Study results will be disseminated through peer-reviewed journals and national and international conferences.

Voluntary Counseling and Testing (VCT) is the best strategy for a successful HIV prevention, care, and support service implementation among HIV-negative and positive individuals. VCT is also recognized as a critical component in the reduction of risk among sexually active young people. This study aims to assess the voluntary HIV counseling, testing, and utilization amongst student nurses and midwives in Ghana and their perception of the disclosure of HIV-positive status to partners. This study used a cross-sectional quantitative descriptive survey amongst 98 nursing and midwifery students at the Nursing and Midwifery Training College, Koforidua. A simple random sampling was used in selecting the participants. Data collection was done using a structured questionnaire. Females dominated the study with the majority of respondents being single. VCT uptake among the respondents was low. Only 26.5% had ever undertaken VCT. It was observed that their willingness to accept VCT does not translate into actual testing. The majority (83%) of respondents perceived that HIV-infected persons should disclose their status to a sexual partner. Fear of stigma (96.0%), fear of loss of friends (98.0%), and fear of being abused (88.8%) were identified as the barriers to HIV status disclosure. To promote VCT services among trainees, these services need to be periodically included in school activities. A comprehensive VCT training module needs to be included in the school curriculum. More emphasis should be placed on the benefits of VCT so that students will understand the importance of implementing VCT services.

BackgroundGlobally, there is a consensus to end the HIV/AIDS epidemic by 2030, and one of the strategies to achieve this target is that 90% of people living with HIV should know their HIV status. Even if there is strong evidence of clients’ preference for testing in the community, HIV voluntary counseling and testing (VCT) continue to be undertaken predominantly in health facilities. Hence, empirical cost-effectiveness evidence about different HIV counseling and testing models is essential to inform whether such community-based testing are justifiable compared with additional resources required. Therefore, the purpose of this study was to compare the cost-effectiveness of facility-based, stand-alone and mobile-based HIV voluntary counseling and testing methods in Addis Ababa, Ethiopia.MethodsAnnual economic costs of counseling and testing methods were collected from the providers’ perspective from July 2016 to June 2017. Ingredients based bottom-up costing approach was applied. The effectiveness of the interventions was measured in terms of the number of HIV seropositive clients identified. Decision tree modeling was built using TreeAge Pro 2018 software, and one-way and probabilistic sensitivity analyses were conducted by varying HIV positivity rate, costs, and probabilities.ResultsThe cost of test per client for facility-based, stand-alone and mobile-based VCT was $5.06, $6.55 and $3.35, respectively. The unit costs of test per HIV seropositive client for the corresponding models were $158.82, $150.97 and $135.82, respectively. Of the three models, stand-alone-based VCT was extendedly dominated. Mobile-based VCT costs, an additional cost of USD 239 for every HIV positive client identified when compared to facility-based VCT.ConclusionUsing a mobile-based VCT approach costs less than both the facility-based and stand-alone approaches, in terms of both unit cost per tested individual and unit cost per HIV seropositive cases identified. The stand-alone VCT approach was not cost-effective compared to facility-based and mobile-based VCT. The incremental cost-effectiveness ratio for mobile-based VCT compared with facility-based VCT was USD 239 per HIV positive case.

Voluntary Counselling and Testing is one of the strategies to respond to the increasing number of Human Immunodeficiency Virus/Acquired immunodeficiency syndrome (HIV/AIDS) new infections. The purpose of this study was to assess the current status of HIV Voluntary Counselling and Testing (VCT) in Rundu urban and identify the barriers to fully effective service.The objectives of the study was to identify the barriers that prevents effective HIV Voluntary Counselling and testing services; asses its success and determine its status in urban, Namibia. A qualitative explorative and descriptive design was employed in this study where all health care and HIV/AIDS professionals including hospital nurses, employees and New Start VCT Centres, and representatives from relevant NGOs, Community-Based Organizations (CBOs), and the Ministry of Health and Social Services (MoHSS)providing Voluntary Counselling services in Rundu urban in Namibia were interviewed. In this study, in depth individual interview structured in accordance with interview guide was used. Content analysis method was employed to analyze the data. Themes that emerged from this study includes: Fear of a positive results (stigma that accompanies seropositivity) and lacks of perceived benefit to getting tested. In addition, financial barriers affecting the poorest populations in Rundu. To increase access and relevance of VCT services, it is recommended that the Ministry of Health and Social Services should develop more detailed counselling guidelines and increase the scope of counselling by addressing the inadequacies of current risk reduction. Despite these hopeful possibilities a number of barriers remains before VCT can be fully effective.

Background: The entry point to prevention, treatment and control measure of HIV infection is Voluntary Counseling and Testing (VCT).
 Objective of Study: This study sought to assess the level of awareness, attitude and preception of VCT among women of reproductive age group in passo community, Abuja, Nigeria.
 Materials and Methods: Between 1st May to 31st July of 2017, interviewer-based questionares was used to assess the socio-demographic data, knowledge of VCT, perception and attitude towards utilization of VCT and factors affecting VCT utilization. The community was d
 ivided into three (3) settlements, each having fifty (50) households, from which one respondent was randomly selected for the study.
 Results: Seventy (46.7%) of the 150 respondents were aware of VCT; sixty two (62) were not aware and have no knowledge of VCT. There is a significant associtaion between occupation and level of education (p<0.05) and knowledge of VCT. There is no significant associacation between marital status, age and the level of awarenes of VCT (p>0.05). Ninety persent of the respondents believed VCT is usefull in preventing mother to child transmission of HIV, 116(89.9%) believed its useful to those preparing for marriage, 112 (86.8%) believed VCT is necessary for pregnant women, whil 102 (79.1%) believed VCT is useful to those who need to know their HIV status. Respondents believed that stigmatization and discrimination (87.3%), attitude of health workers administering VCT (78.7%), location of VCT center (76.7%), and doubt about clients'confidentiality (63.3%) are the leading factors affecting VCT utilization.
 Conclusion: Despite favourable attitude towards VCT by study respondents, majority of them were not aware of VCT. In consideration to factors that may limit VCT utilization by people, it's recommended that mass education of utilization of VCT using appropriate physiological approach be considered by health workers and policy makers.
 

For more than 20 years VCT services have been provided, global coverage of PLWHA who use VCT services is still low. UNAIDS reports that 80% of people living with HIV in the world do not know that they are infected with HIV because they have not used VCT services to check their health status related to HIV. VCT is voluntary HIV testing and counseling which is the entry point to help everyone get access to all HIV services. Langsat Health Center is a health center with the percentage of pregnant women utilizing the lowest VCT service, which is 21.6%. The purpose of this study was to determine the factors related to the use of HIV Voluntary Counseling and Testing Services in Pregnant Women in the Work Area of ​​Langsat Pekanbaru Public Health Center in 2018. The research method was quantitative observational analytic with cross sectional studies. Study population numbered 571 pregnant women with a sample of 180 mothers. Data analysis was carried out by univariate, bivariate with chi square test, and multivariate by multiple logistic regression test. Based on the results of multivariate analysis, the variables most related to VCT Service Utilization in pregnant women in the Langsat Health Center Work Area in 2018 are variables of Husband / Family Support (POR: 2,002) and support from Health Workers (POR: 2,571). Conclusion The mother who received husband / family support 2 times using VCT services, the mother who received the support of health workers 2.5 times made use of VCT services. Expected to health workers to increase the socialization of VCT programs, especially to pregnant women who are at risk, husbands / families through mass media, print and electronic and improve screening by conducting VCT for all pregnant women who come to ANC to health facilities