Willingness by people living with HIV/AIDS to utilize HIV services provided by village health teams in Kalungu district, central Uganda.

Abstract

Introduction: Less than 25% of people in need of HIV services in Uganda have access. Village health teams (VHTs) provide a front-line service at the local level. Made up of volunteers with basic medical training the VHT members could integrate HIV service provision into their activities. This study assessed the willingness of people living with HIV (PLWAs) to utilize HIV services provided by VHT members in Kalungu district, central Uganda. Methods: A cross sectional study was conducted in health facilities providing anti-retroviral therapy. A random sample stratified by gender was used to recruit 312 people living with HIV/AIDS into the study. Participants were visited in their villages and a questionnaire was administered. Quantitative data were analyzed using Stata version 10 software. Univariate analysis was done for descriptive statistics. Bivariate analysis using odds ratios at 95% CI was done to identify important factors associated with willingness of utilization of VHT services. A forward fitting logistic regression model was used to assess the factors associated with willingness of PLWAs to utilize services provided by VHTs while controlling for confounders. Results: Overall, 49% (95% CI 43.43-56.42) of the study participants were willing to utilize HIV services provided by VHTs. This proportion increased to 75.6% (95% CI 70.76-80.36) if the VHT member was HIV positive. PLWAs who resided in urban areas were more likely to utilize HIV services provided by VHTs (Adjusted OR 0.24, 95% CI 0.06-0.87). Barriers to utilizing HIV services provided by VHTs included income level of greater than USD 40 (Adjusted OR 6.43 95% CI 1.19-34.68), being a business person (adjusted OR 8.71 95% CI 1.23-61.72), being a peasant (Adjusted OR 7.95 95% CI 1.37-46.19) lack of peer encouragement (Adjusted OR 6.33 95% CI 1.43-28.09), lack of encouragement from spouse (Adjusted OR 4.93 95% CI 1.23-19.82) and lack of encouragement from community leader (Adjusted OR 9.67 95% CI 3.35-27.92). Conclusion: PLWA are more willing to utilize HIV services provided by HIV positive VHT members compared to VHT members who are HIV negative. Having social support could improve willingness by PLWAs to utilize HIV services provided by VHTs. These factors can be used to increase access of HIV services to the general population.