Abstract
BackgroundVoluntary HIV counselling and testing (VCT) is one of the key strategies in the prevention and control of HIV/AIDS in Uganda. However, the utilization of VCT services particularly among men is low in Kasese district. We therefore conducted a study to determine the prevalence and factors associated with VCT use among men in Bukonzo West health sub-district, Kasese district.MethodsA population-based cross-sectional study employing both quantitative and qualitative techniques of data collection was conducted between January and April 2005. Using cluster sampling, 780 men aged 18 years and above, residing in Bukonzo West health sub-district, were sampled from 38 randomly selected clusters. Data was collected on VCT use and independent variables. Focus group discussions (4) and key informant interviews (10) were also conducted. Binary logistic regression was performed to determine the predictors of VCT use among men.ResultsOverall VCT use among men was 23.3% (95% CI 17.2–29.4). Forty six percent (95% CI 40.8–51.2) had pre-test counselling and 25.9% (95%CI 19.9–31.9) had HIV testing. Of those who tested, 96% returned for post-test counselling and received HIV results. VCT use was higher among men aged 35 years and below (OR = 2.69, 95%CI 1.77–4.07), the non-subsistence farmers (OR = 2.37, 95%CI 2.37), the couple testing (OR = 2.37, 95%CI 1.02–8.83) and men with intention to disclose HIV test results to sexual partners (OR = 1.64, 95%CI 1.04–2.60). The major barriers to VCT use among men were poor utilization of VCT services due to poor access, stigma and confidentiality of services.ConclusionVCT use among men in Bukonzo West, Kasese district was low. In order to increase VCT use among men, the VCT programme needs to address HIV stigma and improve access and confidentiality of VCT services. Among the more promising interventions are the use of routine counselling and testing for HIV of patients seeking health care in health units, home based VCT programmes, and mainstreaming of HIV counselling and testing services in community development programmes.
Highlights
Voluntary HIV counselling and testing (VCT) is one of the key strategies in the prevention and control of HIV/AIDS in Uganda
Uganda has reversed the HIV sero-prevalence from 30% in 1990 to 6.5% in 2003 [2]. This remarkable success has been achieved through promotion of the ABC strategy, effective treatment of opportunistic infections, prevention of mother-to-child transmission of HIV (PMTCT), use of antiretroviral therapy (ART) and HIV voluntary counselling and testing (VCT) [2]
VCT is the gateway to comprehensive HIV care and support including access to antiretroviral therapy [9]
Summary
Voluntary HIV counselling and testing (VCT) is one of the key strategies in the prevention and control of HIV/AIDS in Uganda. Uganda has reversed the HIV sero-prevalence from 30% in 1990 to 6.5% in 2003 [2] This remarkable success has been achieved through promotion of the ABC strategy (abstinence, be faithful, condom use), effective treatment of opportunistic infections, prevention of mother-to-child transmission of HIV (PMTCT), use of antiretroviral therapy (ART) and HIV voluntary counselling and testing (VCT) [2]. HIV voluntary counselling and testing (VCT) is widely accepted as the cornerstone of HIV prevention programmes in many countries because of its multiple benefits [3,4,5,6,7,8]. Newer approaches of VCT delivery including routine HIV counselling and testing[10], home-based VCT[11,12], use of community-based lay counsellors[13], couple counselling and testing[14], and same-day mobile VCT[15,16], have been added to the traditional VCT delivery systems of free standing, health unit based, and outreach VCT services [17]
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