Voluntary Counselling And Testing Uptake Research Articles

Knowledge, acceptance, and uptake of voluntary counseling and testing for human immunodeficiency virus/acquired immunodeficiency syndrome among undergraduates of a public university in Southwestern Nigeria

Objectives: Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) is a global public health problem, and Nigeria has about 1.9 million people living with the virus. HIV testing and counseling services serve as a very important entry point to HIV/AIDS care and treatment. Voluntary counseling and testing (VCT) is one of the interventions developed to tackle the HIV/AIDS epidemic in Africa. This study determined the knowledge, acceptance, and utilization of VCT for HIV/AIDS among undergraduates in a public University in Southwestern Nigeria. Material and Methods: The study adopted a descriptive cross-sectional design, using the multistage sampling technique to select 425 respondents. A self-administered questionnaire was used for data collection. Data analysis was done using Statistical package for the social sciences (SPSS), version 25. Descriptive statistics were presented in tables and figures, and inferential statistics were analyzed at a level of significance of 0.05. Results: Over half of the respondents, 226 (53.2%) were within the age range of 18–25 years. The majority were female, 345 (81.2%), single 403 (94.8%), and had never had sexual intercourse 300 (70.6%). Over half of the respondents’ 240 (57%), had above average knowledge of VCT for HIV/AIDs, had above average levels of acceptance 254 (59%), and the majority 326 (76.2%) of the respondents had very low level of utilization of VCT for HIV/AIDS. There was a significant association between respondents’ age (χ2 = 55.599a, P = 0.000), gender (χ2 = 19.094a, P = 0.000), religion (χ2 = 8.990a, P = 0,038), marital status (χ2 = 8.411a, P = 0.038), age at first sex (χ2 = 61.847a, P = 0.000), knowledge of VCT (χ2 = 5.297a, P = 0.021), acceptance of VCT (χ2 = 80.235a, P = 0.000), and their uptake of VCT for HIV/AIDs. Furthermore, selected socio-demographic characteristics, knowledge, and acceptance of VCT significantly predicted the uptake of VCT among respondents (F [8,416] = 20.163, P < 0.05). Conclusion: The study concluded that respondents had an above average knowledge and acceptance of VCT but a low level of utilization. To increase the utilization of VCT for HIV/AIDS among undergraduates, public health programs should focus on educating undergraduates and significant others on the importance of VCT in the context of HIV prevention, care, and treatment.

Determination of knowledge, attitude and practice of voluntary counseling testing on HIV among youths from Tepi Town, Ethiopia.

Voluntary counseling and testing (VCT) is an integral component of HIV prevention and care strategies worldwide. VCT is considered as an effective strategy in risk reduction among sexually active youth. There is a high burden of HIV in Ethiopia despite a considerable scale up of comprehensive HIV interventions. Hence, the aim of this study was to assess the level of knowledge, attitude and practice of VCT uptake towards HIV among youth of rural part of Tepi town, Ethiopia. A cross sectional study was carried out from May to August 2020. Total numbers of 127 youths in the age group of 15-24 years were recruited in a self-administered questionnaire with 100% response rate. Descriptive analysis was referred to describe the data. Binary logistic regression analysis was used to measure the effect of different variables by computing odds ratio. Multivariable analyses were utilized to determine the relative effect of explanatory variables. The study showed that out of 127 total youth respondents, 111 (87.4%) of the respondents have good knowledge and 99 (78%) had a positive attitude towards VCT. Whereas, 86 (67.7%) of the respondents are aware of practicing VCT on HIV in the past. The findings revel that gender and father's educational status were among the socio-demographic variables that showed statistically significant association with one or more variables affecting youths' knowledge towards VCT uptake. As such, perceived risk of HIV infection, educational level, gender and marital status were statistically responsible for VCT uptake.

Perception and Uptake of HIV/AIDS Voluntary Counselling and Testing Among Women in Akinyele Local Government Area, Ibadan.

Introduction: At the end of 2020, there were reportedly 37.7 million HIV-positive individuals. HIV testing has been marketed as a crucial first step method to diagnose, treat, and prevent human immunodeficiency virus (HIV) infection. It is the cornerstone of all HIV prevention initiatives. The study's main aim was to ascertain the degree of HIV and HIV VCT (voluntary counselling and testing) awareness among women in Akinyele Local Government Area, Ibadan, as well as their attitudes towards HIV VCT and the rate at which they adopted the treatment. Method: This study employed a descriptive study design aimed at assessing the perception and uptake of HIV VCT among women residing in Akinyele Local Government Area, Ibadan, Oyo state. The total population of the women was 410. The sample size was determined using the Taro Yamane formula and the sample size was 220 women which was allocated proportionally to each primary health care center. The research instrument used for the study is a self-administered questionnaire. Results: The results showed that more than 75% of respondents had good understanding of HIV and HIV VCT, and that 65% had positive perceptions of HIV VCT. The study found that there is no significant association between women's level of education and their level of knowledge on HIV and HIV VCT and conclude that there is no significant association between women's perception of HIV and HIV VCT and HIV VCT uptake. Conclusion: In conclusion, the result revealed like other related studies that the attitude of women in Akinyele local government towards HIV Voluntary Counselling and Testing is just a little above average which means quite a number of the respondents are still not willing to take HIV VCT. Hence, the women need more sensitization on the importance and benefits of HIV VCT.

Uptake of HIV Voluntary Counseling and Testing and Associated Factors among Students in the Higher Institutions of Learning in Kigali, Rwanda: A Cross-Sectional Study

BackgroundHIV/AIDS remains a significant global public health challenge with youth bearing the brunt of the burden. One essential method for preventing and accessing AIDS care is through Voluntary Counselling and Testing (VCT). Regardless of this, youth population continues to have low utilization of VCT services.ObjectiveTo assess the uptake of HIV VCT services and associated factors among university students in Kigali.MethodsA cross-sectional study among 374 students recruited using stratified sampling was conducted. A structured questionnaire was used to gather information. A multivariable logistic regression analysis was used to assess the independent factors associated with VCT uptake.ResultsThe prevalence of VCT uptake was 59.9%. The logistic regression revealed that being Catholic (AOR = 11.99, 95%CI: 5.44-26.41) and Moslem (AOR = 37.34, 95%CI: 2.67-128.36) compared to Protestant, as well as availability of VCT services (AOR = 5.15, 95%CI: 3.11 - 8.541) favored the use VCT. On the other hand, being aged 20 to 24 years (AOR = 0.112, 95%CI: 0.04 - 0.29) had low likelihood of using VCT than those more than 24 years of age.ConclusionVCT uptake was significantly positively associated with religion and VCT services availability, and negatively associated with age 20-24 years in the campus. Therefore, targeted actions of disseminating information on benefits of VCT and enhancing accessibility of VCT services among students are necessary for the increased VCT uptake to be attained.Rwanda J Med Health Sci 2023;6(2):104-112

Willingness to Test for Human Immunodeficiency Virus (HIV) Infection among First-Year Students of a Public University in the Volta Region of Ghana

Voluntary counselling and testing (VCT) is key in HIV prevention. Young people aged 15–24 years carry a significant burden of new infections globally, but VCT uptake is low in this population. The study assessed university freshmen’s willingness to test for HIV now, among others, in a cross-sectional study as university campuses are places of risky sexual behaviour. Structured questionnaires were used to collect data on age, sex, marital status, HIV/AIDS knowledge, previous history of testing, willingness to test now, and others. Summary statistics were reported while chi-square and logistic regression methods were used to assess the association between dependent and independent variables with p-values < 0.05 held significant. About 90% (374/412) of respondents had good HIV/AIDS knowledge based on criteria defined by the study, but only 23.3% (96/412) had ever tested and 66.3% (266/401) were willing to test now for HIV. Respondents’ sex, previous sexual intercourse, and whether respondents’ educational support was from parents or non-parents influenced willingness to test for HIV now. The study highlights what appears to be personal beliefs that can potentially hinder HIV testing and control efforts. Relevant stakeholders must address these gaps to improve testing. Further qualitative investigation will improve understanding of the dynamics informing willingness to test for HIV among young people generally.

Voluntary Counseling and Testing, Antiretroviral Therapy Access, and HIV-Related Stigma: Global Progress and Challenges.

To date, about 37 million people are living with the human immunodeficiency virus (HIV) and an estimated 680,000 people have died from acquired immune deficiency syndrome (AIDS) related illnesses globally. While all countries have been impacted by HIV, some have been significantly more impacted than others, particularly countries in sub-Saharan Africa. The purpose of this paper was to identify progress made in HIV prevention globally, particularly in the areas of voluntary counseling and testing (VCT) uptake, access to antiretroviral therapy (ART), and HIV-related stigma. With the development of ART, a cocktail of medications for the treatment of HIV, VCT uptake increased, as it became apparent that the medication would only be prescribed after an HIV diagnosis through testing. Widely considered a critical gateway to HIV prevention and treatment, VCT is being implemented in many countries, and as a result, about 38 million people living with HIV in 2018 had access to ART. Regardless of this success, major challenges still remain. We did an electronic search of 135 articles in English related to global HIV progress and challenges indexed in PubMed, ResearchGate, Google, and other search engines from 1998 to 2021. Sixty articles met the inclusion criteria for this paper. Data on trends in ART coverage were obtained from the Joint United Nations Programme on HIV/AIDS (UNAIDS) website. These data were used to show ART coverage globally in World Health Organization (WHO) regions. It was found that while global successes have been chalked in the areas of VCT uptake and ART coverage, HIV-related stigma has impeded greater success. This paper summarizes and discusses global successes and challenges in HIV prevention efforts in the past four decades with a focus on VCT, ART, and HIV-related stigma.

HIV/AIDS KNOWLEDGE AND UTILISATION OF HCT UPTAKE AMONG MUSLIM YOUTH IN SOUTH WEST NIGERIA

Nigeria has the third highest population of people living with human immunodeficiency virus (HIV). Despite this, the knowledge of HIV/AIDS and uptake of voluntary counselling and testing (VCT) is still low, especially in the rural areas. This study assessed knowledge of HIV/AIDS and uptake of VCT among Muslim youths in a community in Oyo State, Nigeria. A pretested questionnaire was administered on a cross-section of 309 Muslim youth attending a religious programme in Iseyin town, Nigeria. Information about knowledge of HIV/AIDS and uptake of VCT was elicited among respondents. The majority of respondents did not know the need to assess and why VCT; however, knowledge of route of disease transmission was high, with majority mentioning sexual activity and unscreened blood transfusion, respectively, as possible transmission routes. Respondents listed avoidance of premarital sex, outlawing prostitution, and screening of blood before transfusion as protective measures respectively. Reasons for rejection of VCT included fear of stigma, marital disharmony, incurable nature of the disease and Islamic belief that HIV is most common among youth that are not religious because Islam is already against sexual intimacy before marriage.

Voluntary HIV Counselling and Testing Amongst Trainee Nurses and Midwives in Ghana and their Perception of Disclosure of HIV Positive Status to Partners

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.

Factors Affecting HIV Voluntary Counseling and Testing Uptake among Usndergraduate Students of Khartoum, Sudan

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.

Factors affecting HIV counselling and testing among Ethiopian women aged 15\u201349

BackgroundHIV voluntary counseling and testing (VCT) is a crucial gateway to all strategies related to care, prevention and treatment of human immunodeficiency virus (HIV) infection. Nevertheless, utilization of voluntary counselling and testing (VCT) service among adults is very low in Ethiopia. The objective of this study is to identify determinants associated with VCT utilization among adult women aged 15–49 in Ethiopia.MethodsA cross–sectional study was conducted based on data taken from the Ethiopian Demographic Health Survey (EDHS) 2016. Using cluster sampling, 14,369 women aged 15–49 years were selected from all the nine administrative regions and two city administrations. Logistic regression was used to analyze factors associated with HIV VCT utilization.ResultsOverall prevalence of ever tested for HIV was 53% (95% CI, 52, 54). Aged 20–44, ever married, being at higher socio economic position (SEP) and having risky sexual behavior were factors which are positively associated with VCT utilization. Being Muslims in urban and protestants in rural were factors significantly and negatively associated with VCT utilization. Those who had stigmatizing attitude both in urban and rural and who had comprehensive knowledge in rural were less likely to utilize VCT service.ConclusionVCT utilization among women in Ethiopia is demonstrating better improvement in recent years. However, stigmatizing attitude continued to be among the major factors, which are negatively affecting VCT uptake among women in Ethiopia. Concerted efforts should be made by all stakeholders to mitigate stigma, improve socio economic inequities and increase awareness on the benefit of VCT in controlling HIV in the society. In this aspect, the role of religious leader, schools, health extension workers and community leaders should not be undermined.

Effects of Predisposing, Enabling, and Reinforcing Factors on the Uptake of Voluntary Counselling and Testing among Female Sex Workers in Grobogan, Central Java

Background : Human Immunodeficiency Virus (HIV) infection is a global public health issue. Global AIDS Response Progress Reporting (GARP) reported that in 2015, about 36.7 million people worldwide suffered from HIV-AIDS in all age groups. The highest number of HIV/AIDS cases occured in East Africa and South Africa. This study aimed to examine the effects of predisposing, enabling, and reinforcing factors on the uptake of voluntary counselling and testing (VCT) among female sex workers in Grobogan, Central Java. Subje cts and Met hod : This was an analytical observational study with cross-sectional design. It was conducted in Grobogan, Central Java, in July 2017. A sample of 142 female sex workers were selected for this study by exhaustive sampling. The dependent variable was uptake of VCT. The independent variables were attitude, perceived benefit, external motivation from others, and social support. The data were collected by a questionnaire and analyzed by multiple logistic regression. Results : Positive attitude towards HIV status (OR= 6.09; 95% CI= 0.968 to 38.38; p= 0.054), positive perceived benefit (OR= 10.58; 95% CI= 1.48 to 76.93; p= 0.019), external motivation (OR= 8.30; 95% CI= 1.21 to 56.82; p= 0.031), and social support (OR= 9.45; 95% CI= 1.46 to 60.83; p= 0.018), positively affected uptake of VCT. Conclusion : Positive attitude towards HIV status, positive perceived benefit, external motivation, and social support, positively affect uptake of VCT. Keywords : HIV, Voluntary Counselling Testing, female sex workers Correspondence : Muhammad Vidi Perdana. Masters Program in Public Health, Sebelas Maret University, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: vidihse@gmail.com. Journal of Health Promotion and Behavior (2017), 2(3): 242-256 https://doi.org/10.26911/thejhpb.2017.02.03.05

A decade of an HIV workplace programme in armed conflict zones; a social responsibility response of the International Committee of the Red Cross.

The International Committee of the Red Cross (ICRC) works in fragile States and in armed conflict zones. Some of them are affected by the HIV pandemic. Within the framework of its social responsibility programme concerning HIV affecting its staff members, the organization has implemented an HIV workplace programme since 2004.We carried out a retrospective analysis over 10 years. Data collected were initially essentially qualitative and process-oriented, but were complemented over the years by data on annual voluntary counselling and testing (VCT) uptake and on direct annual costs covering awareness, testing and antiretroviral therapy.The number of people covered by the programme grew from none in 2003 to 4,438 in 2015, with an increase in annual VCT uptake over the years increasing from 376 persons (14 %) in 2007 to 2,663 in 2015 (60 %).Over the years, the services were expanded from awareness raising to bringing VCT to the workplace, as well as offering testing and health coverage of other conditions and innovative approaches to facing challenges linked to situations of violence.Within its social responsibility framework, the ICRC has shown the importance and feasibility of a workplace HIV programme in conflict zones. A sustainable workplace programme in these conflict settings requires constant adaptation, with regular follow-up given the relatively high turnover of staff, and ensuring sustainable stocks of condoms and antiretroviral drugs.

Factors influencing the uptake of voluntary HIV counseling and testing in rural Ethiopia: a cross sectional study.

BackgroundVoluntary counseling and testing (VCT) has been one of the key policy responses to the HIV/AIDS epidemic in Ethiopia. However, the utilization of VCT has been low in the rural areas of the country. Understanding factors influencing the utilization of VCT provides information for the design of context based appropriate strategies that aim to improve utilization. This study examined the effects of socio-demographic and behavioral factors, and health service characteristics on the uptake of VCT among rural adults in Ethiopian.Methods/designThis study was designed as a cross sectional study. Data from 11,919 adults (6278 women aged 15–49 years and 5641 men aged 15–59 years) residing in rural areas of Ethiopia who participated in a national health extension program evaluation were used for this study. The participants were selected from ten administrative regions using stratified multi-stage cluster sampling. Multivariate logistic regression analysis was performed accounting for factors associated with the use of VCT service.ResultsOverall, men (28 %) were relatively more likely to get tested for HIV than women (23.7 %) through VCT. Rural men and women who were young and better educated, who perceived having small risk of HIV infection, who had comprehensive knowledge, no stigmatization attitude and discussed about HIV/AIDS with their partner, and model-family were more likely to undergone VCT. Regional state was also strongly associated with VCT utilization in both men and women. Rural women who belonged to households with higher socio-economic status, non-farming occupation, female-headed household and located near health facility, and who visited health extension workers and participated in community conversation were more likely to use VCT. Among men, agrarian lifestyle was associated with VCT use.ConclusionsUtilization of VCT in the rural communities is low, and socio-economic, behavioral and health service factors influence its utilization. For increasing the utilization of VCT service in rural areas, there is a need to target the less educated, women, poor and farming families with a focus on improving knowledge and reducing HIV/AIDS related stigma. Strategy should include promoting partner and community conversations, accelerating model-family training, and using alternative modes of testing.

Health Belief Model Theory Application on Voluntary Counseling and Testing among Homosexual Men in Bandung Greater Area

Background : The number of human immunodeficiency virus (HIV) cases is high and is constantly increasing. Homosexual men as a transmission niche is not only significant in terms of numbers, but also in natural aspects of anal sex, tropism of HIV-1, and high-risk behavior. Voluntary Counseling and Testing (VCT) is important for accelerating diagnosis and management plan; yet the uptake on high-risk population in Indonesia is low. A behavior-reasoning theory, Health Belief Model (HBM), attempts to explain whether or not individuals engage in certain health behavior. This study tries to assess participation rate of VCT, to portray HBM variables perception, and to depict significance of HBM variables towards VCT uptake or VCT intention. Methods : This study was conducted in October-November 2014 using cross-sectional design; 127 respondents were gathered according to Respondent Driven Snowball Sampling. This study used an internet-based questionnaire derived from Champion’s 1984 mammogram HBM questionnaire. Privacy and compensation were obtained. The Chi square test and logistic regression of HBM variables were done. Results : The VCT uptake was low (15.7%). Certain sexual experience and commitment were significant (Commitment to Men p=0.027, Oral Sex experience with men p=0.001, Anal Sex Experience with men p=0.038). Chi Square test revealed significance on Perceived Susceptibility, Perceived Benefit, and Cues to Action. Conclusions : Uptake of VCT is considerably low compared with total high risk population and other similar studies. Personal Susceptibility to HIV/AIDS is recommended to be emphasized; while VCT Benefit and Cues to Action in young homosexual men communities are better encouraged. [AMJ.2016;3(4):595–604] DOI: 10.15850/amj.v3n4.945

HIV testing service awareness and service uptake among female heads of household in rural Mozambique: results from a province-wide survey.

BackgroundHIV voluntary counseling and testing (VCT) utilization remains low in many sub-Saharan African countries, particularly in remote rural settings. We sought to identify factors associated with service awareness and service uptake of VCT among female heads of household in rural Zambézia Province of north-central Mozambique which is characterized by high HIV prevalence (12.6%), poverty, and suboptimal health service access and utilization.MethodsOur population-based survey of female heads of household was administered to a representative two-stage cluster sample using a sampling frame created for use on all national surveys and based on census results. The data served as a baseline measure for the Ogumaniha project initiated in 2009. Survey domains included poverty, health, education, income, HIV stigma, health service access, and empowerment. Descriptive statistics and logistic regression were used to describe service awareness and service uptake of VCT.ResultsOf 3708 women surveyed, 2546 (69%) were unaware of available VCT services. Among 1162 women who were aware of VCT, 673 (58%) reported no prior testing. In the VCT aware group, VCT awareness was associated with higher education (aOR = 2.88; 95% CI = 1.61, 5.16), higher income (aOR = 1.41, 95% CI = 1.06, 1.86), higher numeracy (aOR = 1.05, CI 1.03, 1.08), more children < age 5 in the home (aOR = 1.53; 95% CI = 1.07, 2.18), closer proximity to a health facility (aOR = 1.05; 95% CI = 1.03, 1.07), and mobile phone ownership (aOR = 1.37; 95% CI = 1.03, 1.84) (all p-values < 0.04). Having a higher HIV-associated stigma score was the factor most strongly associated with being less likely to test. (aOR = 0.41; 95% CI = 0.23, 0.71; p<0.001).ConclusionsMost women were unaware of available VCT services. Even women who were aware of services were unlikely to have been tested. Expanded VCT and social marketing of VCT are needed in rural Mozambique with special attention to issues of community-level stigma reduction.

Strategies to Boost the Uptake of Voluntary Counselling and Testing (VCT) by University Students

Voluntary counselling and testing (VCT) is internationally recognised as a gateway to HIV prevention, care and treatment. However, VCT uptake among university students is still low. As there is presently no cure for HIV/AIDS, strategies to boost VCT uptake among university students are critically important. This study explored the strategies to improve the uptake of VCT by university students. The study employed an exploratory and descriptive qualitative study. Focus group discussions (FGD) and field notes were used to collect data. Analysis was done using thematic analysis. The study revealed that VCT services uptake for university students could be improved by increased resource allocation (incentives, human and infrastructural resources), increased awareness campaigns, and improved counselling and making VCT services more accessible. DOI: 10.5901/mjss.2014.v5n15p458

Voluntary Counseling and Testing and Celebrity-Based HIV/AIDS Prevention Education: A Pilot Program Implemented in Cape Town Secondary Schools

This study evaluates a newly designed HIV/AIDS program that combined Voluntary Counseling and Testing (VCT) services with online prevention education videos featuring South African celebrities. Learners from five public secondary schools in Cape Town participated in the pilot study (N = 3,271). Results indicated participant reactions to the video were overwhelmingly positive, and there were both significant increases in HIV knowledge and significant decreases in fear of being tested. Eighty-eight percent of learners received HIV tests and indicated much higher rates of VCT uptake than comparable programs implemented in South Africa. Future research possibilities are discussed, as well as recommendations for programs delivering similar services among diverse populations.

The impact of voluntary counselling and testing services on sexual behaviour change and HIV incidence: observations from a cohort study in rural Tanzania

BackgroundIt is widely assumed that voluntary counselling and testing (VCT) services contribute to HIV prevention by motivating clients to reduce sexual risk-taking. However, findings from sub-Saharan Africa have been mixed, particularly among HIV-negative persons. We explored associations between VCT use and changes in sexual risk behaviours and HIV incidence using data from a community HIV cohort study in northwest Tanzania.MethodsData on VCT use, sexual behaviour and HIV status were available from three HIV serological surveillance rounds undertaken in 2003–4 (Sero4), 2006–7 (Sero5) and 2010 (Sero6). We used multinomial logistic regression to assess changes in sexual risk behaviours between rounds, and Poisson regression to estimate HIV incidence.ResultsThe analyses included 3,613 participants attending Sero4 and Sero5 (3,474 HIV-negative and 139 HIV-positive at earlier round) and 2,998 attending Sero5 and Sero6 (2,858 HIV-negative and 140 HIV-positive at earlier round). Among HIV-negative individuals VCT use was associated with reductions in the number of sexual partners in the last year (aRR Seros 4–5: 1.42, 95% CI 1.07-1.88; aRR Seros 5–6: 1.68, 95% CI 1.25-2.26) and in the likelihood of having a non-cohabiting partner in the last year (aRR Seros 4–5: 1.57, 95% CI 1.10-2.25; aRR Seros 5–6: 1.48, 95% CI 1.07-2.04) or a high-risk partner in the last year (aRR Seros 5–6 1.57, 95% CI 1.06-2.31). However, VCT was also associated with stopping using condoms with non-cohabiting partners between Seros 4–5 (aRR 4.88, 95% CI 1.39-17.16). There were no statistically significant associations between VCT use and changes in HIV incidence, nor changes in sexual behaviour among HIV-positive individuals, possibly due to small sample sizes.ConclusionsWe found moderate associations between VCT use and reductions in some sexual risk behaviours among HIV-negative participants, but no impacts among HIV-positive individuals in the context of low overall VCT uptake. Furthermore, there were no significant changes in HIV incidence associated with VCT use, although declining background incidence and small sample sizes may have prevented us from detecting this. The impact of VCT services will ultimately depend upon rates of uptake, with further research required to better understand processes of behaviour change following VCT use.

Factors Determining Voluntary Counseling and Testing (VCT) for the Human Immunodeficiency Virus (HIV) among Low Income Women: Focus Group Findings from Rural, Urban, and Peri-Urban Women Groups in Lilongwe District-Malawi

Most high prevalence sub-Saharan African countries tend to over-emphasize fidelity and condom use as major preventative measures relative to HIV and AIDS prevention. Studies of behavior change that focus exclusively on these strategies of most interest to the prevention community bias examinations of behaviour change downward by ignoring other potentially effective ways of limiting the epidemic. Regardless of the dearth in efficacy, as well as tolerance bottlenecks; the prevailing debate over provider initiated testing in Malawi may depict a shift towards HIV Testing and Counseling (HTC) in Acquired Immunodeficiency Syndrome (AIDS) prevention. The current study examines factors that determine VCT uptake among low income women in the Lilongwe district. A qualitative paradigm- the Focus Group Discussion (FGD) was utilized to inform the study. Convenient sampling was used to isolate three women groups namely; St John Nsamba, Women of Action, and National Association of People Having AIDS in Malawi (NAPHAM) support group as participants. The first two groups were sampled as primary groups, the former representing the urban domain with the later representing the rural domain respectively. Between 10 – 15 participants from each group, approximately within the age category 20-49 were involved. Findings suggest socio-cultural gender stereotypes inhibiting negotiating testing with partners as well as the social comparison or optimistic bias motivating ordinary women to underestimate their risk of contracting HIV relative to significant others as major barriers. Recurrent illnesses was considered the major motivator, downplaying the empirical impression about access to treatment as major incentive. The methodical conclusion drawn from the study is that VCT has the potential to mitigate the spread of HIV but for the preventative measure to be successful there is need to surmount various ethnographic and socio-cultural constraints currently impeding the intervention.

Do accurate HIV and antiretroviral therapy knowledge, and previous testing experiences increase the uptake of HIV voluntary counselling and testing? Results from a cohort study in rural Tanzania

BackgroundDespite the introduction of free antiretroviral therapy (ART), the use of voluntary counselling and testing (VCT) services remains persistently low in many African countries. This study investigates how prior experience of HIV and VCT, and knowledge about HIV and ART influence VCT use in rural Tanzania.MethodsIn 2006–7, VCT was offered to study participants during the fifth survey round of an HIV community cohort study that includes HIV testing for research purposes without results disclosure, and a questionnaire covering knowledge, attitudes and practices around HIV infection and HIV services. Categorical variables were created for HIV knowledge and ART knowledge, with “good” HIV and ART knowledge defined as correctly answering at least 4/6 and 5/7 questions about HIV and ART respectively. Experience of HIV was defined as knowing people living with HIV, or having died from AIDS. Logistic regression methods were used to assess how HIV and ART knowledge, and prior experiences of HIV and VCT were associated with VCT uptake, with adjustment for HIV status and socio-demographic confounders.Results2,695/3,886 (69%) men and 2,708/5,575 women (49%) had “good” HIV knowledge, while 613/3,886 (16%) men and 585/5575 (10%) women had “good” ART knowledge. Misconceptions about HIV transmission were common, including through kissing (55% of women, 43% of men), or mosquito bites (42% of women, 34% of men).19% of men and 16% of women used VCT during the survey. After controlling for HIV status and socio-demographic factors, the odds of VCT use were lower among those with poor HIV knowledge (aOR = 0.5; p = 0.01 for men and aOR = 0.6; p < 0.01 for women) and poor ART knowledge (aOR = 0.8; p = 0.06 for men, aOR = 0.8; p < 0.01 for women), and higher among those with HIV experience (aOR = 1.3 for men and aOR = 1.6 for women, p < 0.01) and positive prior VCT experience (aOR = 2.0 for all men and aOR = 2.0 for HIV-negative women only, p < 0.001).ConclusionsTwo years after the introduction of free ART in this setting, misconceptions regarding HIV transmission remain rife and knowledge regarding treatment is worryingly poor, especially among women and HIV-positive people. Further HIV-related information, education and communication activities are urgently needed to improve VCT uptake in rural Tanzania.