Abstract

BackgroundThere is limited information about the psychosocial sub-determinants regarding the use of HIV Testing and Counselling (HTC) services among suspected Tuberculosis (TB) patients in Sudan. This study aimed to assess the association between psychosocial beliefs and the intention to use HTC services and to establish the relevance of these beliefs for developing behaviour change interventions among suspected TB patients.MethodsSuspected TB patients (N = 383) from four separate TB facilities completed a cross-sectional questionnaire which was based on the Reasoned Action Approach theory. Eligibility criteria included attending Tuberculosis Management Units in Kassala State as suspected TB patients and aged 18–64 years. A Confidence Interval Based Estimation of Relevance (CIBER) analysis approach was employed to investigate the association of the beliefs with the intention to use HTC services and to establish their relevance to be targeted in behaviour change interventions.ResultsThe CIBER results showed the beliefs included in the study accounted for 59 to 70% of the variance in intention to use HTC services. The belief “My friends think I have to use HTC services” was positively associated with the intent to use HTC, and it is highly relevant for intervention development. The belief “I would fear to be stigmatized if I get a HIV positive result” was negatively related to the intention to use HTC services and was considered a highly relevant belief. The belief “If I use HTC services, health care providers will keep my HIV test result confidential” was strongly associated with the intention to use HTC services. However, the relevance of this belief as a target for future interventions development was relatively low. Past experience with HTC services was weakly associated with the intention to use HTC services.ConclusionThe intention to use HTC was a function of psychosocial beliefs. The beliefs investigated varied in their relevance for interventions designed to encourage the use of HTC services. Interventions to promote intention to use HIV testing and counselling services should address the most relevant beliefs (sub-determinants). Further study is needed to establish the relevance of sub-determinants of the intention to use HTC services for interventions development.

Highlights

  • There is limited information about the psychosocial sub-determinants regarding the use of Human Immunodeficiency Virus (HIV) Testing and Counselling (HTC) services among suspected Tuberculosis (TB) patients in Sudan

  • The intention to use HIV Testing and Counselling (HTC) was a function of psychosocial beliefs

  • The psychosocial beliefs are important in understanding the intention to use HTC services and in developing interventions to enhance that intention

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Summary

Introduction

There is limited information about the psychosocial sub-determinants regarding the use of HIV Testing and Counselling (HTC) services among suspected Tuberculosis (TB) patients in Sudan. This study aimed to assess the association between psychosocial beliefs and the intention to use HTC services and to establish the relevance of these beliefs for developing behaviour change interventions among suspected TB patients. In 2018, an estimated 81 million TB cases were identified attributable to HIV infection, which accounted for 251 thousand TB deaths [3]. In Sudan, TB infection is an endemic disease, and a national TB survey in 2014, estimated the TB prevalence at 59/100,000 in the population. The death rate of TB co-infected patients increased by 29% between 2018 and 2019 [3, 4]. Unless co-infected TB patients are diagnosed and treated early, death among them remains high

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