Factors influencing the uptake of Voluntary HIV Counseling and Testing among secondary school students in Arusha City, Tanzania: a cross sectional study.

Zawadi Sanga,Gibson Kapanda,Sia Msuya,Rose Mwangi

doi:10.1186/s12889-015-1771-9

Abstract

BackgroundVoluntary HIV counseling and testing (VCT) is a key strategy towards HIV prevention yet, the uptake of VCT services among young people remains low. This study determined the factors that influence the uptake of VCT among secondary school students in Arusha City, Tanzania.MethodsA cross sectional study using quantitative methods was conducted. A multi-stage sampling method was applied to randomly select the secondary schools. Stratification, random and systematic sampling techniques were used to identify the study participants. Interviews were conducted using structured questionnaires. Data analysis was done using statistical package for social sciences version 16. Analytical statistics were done using odds ratio to measure strength of association between VCT uptake and independent variables. Association with p-value < 0.05 was considered significant. Binary logistic regression was used to identify predictors of VCT uptake.ResultsOf 400 study participants, 50.5% were male and 49.5% were female. 93.5% of the respondents were aware of the VCT services, 79.1% had high knowledge on VCT services and 75.9% had positive attitude towards VCT services. On VCT uptake, only 29.3% had ever tested. VCT uptake was found to be significantly predicted by age (p = 0.003), sex (p < 0.001), religion (p < 0.001), exposure to VCT information from a VCT centre (p < 0.001) and type of school ownership (p < 0.013).ConclusionDespite high knowledge on VCT services, the uptake of VCT among secondary school students was found to be low. The uptake of VCT was mainly found to be influenced by fear of HIV test results, knowledge and attitude on VCT services, age, education, engagement in sexual relationships, stigma and distance to the VCT centre. Integration of youth friendly VCT services in secondary schools would increase VCT uptake among secondary school students. Support and care received after knowing the test results should be clearly communicated as it helps motivate more young people towards VCT uptake and reduce stigma among them.

Highlights

Voluntary HIV counseling and testing (VCT) is a key strategy towards HIV prevention yet, the uptake of VCT services among young people remains low
It is important to measure the coverage of VCT uptake among young people, because of their vulnerability to HIV, and because they may experience some obstacles in accessing the VCT services [2]
A few respondents reported receiving VCT information from the parents, friends and worshiping places like church and others, implying that, in these key areas VCT services are not yet given priority though in real sense important areas such as worshiping places if given priority may help increase the VCT services awareness and improve HIV testing uptake among the young people. These findings look similar to a study conducted in northern Tanzania among pregnant women whereby partners involvement, parents, and religion were among the factors found to be influencing VCT uptake [14]

Summary

Introduction

Voluntary HIV counseling and testing (VCT) is a key strategy towards HIV prevention yet, the uptake of VCT services among young people remains low. This study determined the factors that influence the uptake of VCT among secondary school students in Arusha City, Tanzania. In Tanzania, despite high awareness on VCT facilities, 65.8% male and 46.3% female of 15–24 years are not aware of their HIV status and this is where the HIV epidemic is concentrated [2]. Sanga et al BMC Public Health (2015) 15:452 or higher education in Tanzania know their HIV status, giving an average of 45% VCT uptake among them [2]. The low response to VCT among young people is said to be associated with different factors, ranging from fear of knowing their HIV status to the limiting factors towards the service and social issues influencing the attitudes and behaviors of the service providers [1]. Approximately 50% increase of HIV related deaths among adolescents between 2005 and 2012 was found to be contributed by inadequate friendly VCT services, poor prioritization of adolescent issues, inadequate treatment and lack of support to the young people [4]

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