Utilization Of Voluntary Counseling And Testing Services Research Articles

The Utilization of Voluntary Counseling and Testing by Women of Reproductive Age in West Papua

Women of reproductive age living with the human immunodeficiency virus (WRALHIV) have many complex problems regarding their disease and status. They have to access Voluntary counseling and testing (VCT) as one of the health services where they would receive antiretroviral treatment to optimize their health and improve their quality of life. The study aims to analyze the factors which determine the utilization of VCT for accessing antiretroviral treatment by WRALHIV in West Papua. It was an observational, cross-sectional study. The subject was women of reproductive age (WRA) aged 15-49 years old, receiving antiretroviral treatment at VCT of Hospitals in Manokwari, Sorong, and Fakfak. The total was 140 respondents. Data collection was carried out by interviews using a questionnaire. The data were analyzed statistically using the chi-square and logistic regression tests. Most respondents with high intensity in the utilization of VCT services were aged 15-35 years, graduated from senior high school - university, unemployed, and married. Demographic and predisposing variables were not significantly associated, but there were significant associations between enabling factors (distance) with p value=0.00 and reinforcing factor (social support) with p value=0.03 in the utilization of VCT services by WRALHIV in West Papua, in which the distance was more significant than social support in the utilization of VCT services. The easily accessible distance increases their visitation to VCT. In addition, social support had an impact on increasing the utilization of VCT services, and finally, these may improve WRALHIV quality of life.

Knowledge and reliance on the availability of voluntary counseling and testing (VCT) services relating to the utilization of VCT services by the Man who has Sex with Man community

Introduction: Southeast Asia is the second continent that has a higher population of Human Immunodeficiency Virus (HIV) infection. Indonesia needs to be vigilant to prevent the spreading and transmission of this virus. One of the services provided by the government for the initial screening of HIV/ AIDS is Voluntary Counseling and Testing (VCT). This research aimed to identify the behavior factors related to the utilization of VCT services by the Man who has Sex with Man (MSM) community.

The Role of Pregnant Women's Perception and Social Support on the Utilization of VCT Services

Voluntary Counseling and Testing (VCT) is an HIV/AIDS prevention program that has high evidence of effectiveness, especially for individuals who have HIV/AIDS risk behaviors. The behavior of using VCT services can be seen from the influence of perceptions and social support. This study has the purpose to analyze the correlation between perceptions and social support of pregnant women with the behavior of using VCT services in Banyuwangi. The method used in this study is an analytical observational with a cross-sectional research design. The population of this study was pregnant women in the Kembiritan, Sobo, Genteng Kulon, Kertosari, Singojuruh, and Singotrunan in the range of May - to November 2018. The sampling technique used was proportional random sampling. Most of the respondents have a bad perception that is 51. 6%. The majority of respondents have poor social support, namely 84.1%. The percentage of respondents who have good perceptions and behaviors in utilizing VCT services is 62.4%. Meanwhile, 60.1% of respondents who have social support and good behavior use VCT.

PREVALENCE OF VOLUNTARY COUNSELING AND TESTING SERVICE UTILIZATION AND ITS ASSOCIATED FACTORS AMONG PREPARATORY SCHOOL STUDENTS IN GONDAR TOWN, AMHARA REGION, ETHIOPIA

Objectives: The objective of this study was to assess the prevalence of voluntary counseling and testing (VCT) services utilization and associated factors among preparatory school students in Gondar town, Amhara region, Ethiopia. Methods: Institutional based cross-sectional study design was employed. Multistage sampling procedure was conducted. Data were collected using pre-tested self-administered questionnaire and the data were entered, clean, and analyzed using SPSS software. Descriptive, bivariate, and multivariate analysis were employed. Multivariate analysis with 95% CI was computed to identify factors associated with VCT service utilization at p<0.05. Results: The study included a total of 654 study participants, with a response rate of 97%. According to the research, 48.3% of adolescents used VCT services (95% CI: 44.5–52.1). The results of multivariate analysis revealed that age, site of birth, mother education, and discussion with parents were all substantially associated with the use of VCT services. Conclusions: The majority of those who took part in the survey did not use VCT services. Only a small percentage of respondents have ever taken a VCT test and discussed it with their parents. The primary barrier for adolescents in the study area was cultural taboos, which they did not discuss with their parents. As a result, it will take an endless amount of effort from all relevant parties to promote teenage service use, as well as family life education, to encourage students and parents to use VCT.

HIV testing service utilization and its association with HIV-related knowledge among students in higher education institutions in Ethiopia: systematic review and meta-analysis

To estimate the pooled prevalence of HIV testing service utilization and its association with HIV-related knowledge among students in higher education institutions in Ethiopia. The MEDLINE, EMBASE, Web of Science, and Cochrane Library databases were systematically reviewed for published articles on HIV testing or voluntary counseling and testing (VCT) service utilization among students in higher education institutions in Ethiopia. The Higgins I2 test was used to assess the heterogeneity between the studies. A random-effects model was applied to determine the pooled prevalence of VCT service utilization. After reviewing 348 studies, 14 studies fulfilled the inclusion criteria and were included in this systematic review and meta-analysis. The pooled magnitude of VCT service utilization among students in higher education institutions in Ethiopia was 46.0% (95% confidence interval [CI]: 35.1, 56.9). The odds of VCT service utilization were 2.6 times as high among students who had good HIV-related knowledge as those who had poor HIV-related knowledge (adjusted odds ratio = 2.64; 95% CI: 1.31–5.31). In general, it was found that VCT service utilization among students at higher education institutions in Ethiopia was low. More than half (54.0%) of students did not know their HIV status. Good HIV-related knowledge was positively associated with VCT service utilization. Therefore, to encourage HIV testing utilization, the HIV education program should be strengthened through institutional capacity-building (training) and improving supply chain systems (AIDS leaflets, stickers, newspapers, and billboards).

Assessment of Intension to Voluntary HIV Counseling and Testing Utilization and Associated Factors Among Youth Living in Mizan Aman Town, South-West Ethiopia By Health Belief Model, A Cross Sectional Study

Background : - Voluntary Counseling and Testing (VCT) services have become one of the most common means of preventing, detecting and improving access to care and support to HIV/AIDS. Currently in Ethiopia, young people are most affected group of HIV/AIDS. Moreover, youth VCT utilization is low in studies among university students. Therefore, this study was aimed to assess youth’s voluntary counseling and testing utilization and associated factors in Mizan-Aman Town, Southwest Ethiopia. Community based cross sectional study was conducted among youth living in Mizan-Aman Twon. The data was collected using pre-tested interviewer administrating questionnaires using simple random sampling technique. Descriptive statistics, bivariate analysis, multivariate logistic regressions ware used accordingly. A total of 389 youths responded the questionnaire making the response rate of 96.6%. Two hundred thirty five (60.4%) were female. VCT utilization was 42.4% (95% CI=37.8%, 47.6%). Factor associated with intension to VCT service utilization are females [AOR=1.69, 95%CI= (1.017-2.814)]; attending secondary education level (AOR=2.099, 95%CI=(1.12-3.929)) and attending college education level (AOR=3.39, 95%CI=(1.783-6.45)); And having low perceived barrier and cue to action are [AOR=2.63,95%CI (1.236-5.614) and [AOR=10.85, 95 % CI=(6.05-19.46)] respectively. Being female, educated, high perceived barrier and cue to action were identified as significant associated factors for intension to utilize voluntary counseling and testing. More emphases should be given by concerned bodies in Mizan-Aman town health unit, Mizan Aman Health Science College on information translation regarding VCT, focus on male youth, collaborating with educational sectors, and assuring youth to benefit more on VCT services. Keywords: Voluntary Counseling and Testing (VCT), Mizan-Aman, Youth. DOI: 10.7176/JMPB/66-03 Publication date: June 30th 2020

Utilization of HIV Voluntary Counseling and Testing (VCT) Services for Pregnant Women in the Working Area of ​​Langsat Health Center Pekanbaru in 2018

For more than 20 years VCT services have been provided, global coverage of PLWHA who use VCT services is still low. UNAIDS reports that 80% of people living with HIV in the world do not know that they are infected with HIV because they have not used VCT services to check their health status related to HIV. VCT is voluntary HIV testing and counseling which is the entry point to help everyone get access to all HIV services. Langsat Health Center is a health center with the percentage of pregnant women utilizing the lowest VCT service, which is 21.6%. The purpose of this study was to determine the factors related to the use of HIV Voluntary Counseling and Testing Services in Pregnant Women in the Work Area of ​​Langsat Pekanbaru Public Health Center in 2018. The research method was quantitative observational analytic with cross sectional studies. Study population numbered 571 pregnant women with a sample of 180 mothers. Data analysis was carried out by univariate, bivariate with chi square test, and multivariate by multiple logistic regression test. Based on the results of multivariate analysis, the variables most related to VCT Service Utilization in pregnant women in the Langsat Health Center Work Area in 2018 are variables of Husband / Family Support (POR: 2,002) and support from Health Workers (POR: 2,571). Conclusion The mother who received husband / family support 2 times using VCT services, the mother who received the support of health workers 2.5 times made use of VCT services. Expected to health workers to increase the socialization of VCT programs, especially to pregnant women who are at risk, husbands / families through mass media, print and electronic and improve screening by conducting VCT for all pregnant women who come to ANC to health facilities

Association between Perceived Seriousness, Cues to Action, and Voluntary Counseling and Testing Uptake in Men Who Have Sex with Men in Pematangsiantar, North Sumatera

Background: Utilization of voluntary counseling and testing (VCT) services in male sex with men (MSM) at Tomuan public health center, in Pematangsiantar is still relatively low (34.4%). The low utilization of VCT services in MSM is related to the perception of seriousness and the possibility of taking action. This study aimed to analyze the influences of perceived seriousness and cues to action on the use of VCT in MSM. Subjects and Method: This was a cross sectional study carried out at Tomuan health center in Pematangsiantar, North Sumatera, in 2017. A sample of 61 MSM was selected for this study. The dependent variable was VCT use. The independent variables were perceived seriousness and cues to action. The data were obtained by questionnaire and analyzed by a multiple logistic regression. Results: Utilization of VCT in MSM increased with perceived seriousness (OR= 11.28; 95% CI= 1.24 to 102.89; p=0.032) and cues to action (OR= 11.45; 95% CI= 1.02 to 128.34; p= 0.024). Conclusion: Utilization of VCT in MSM increases with perceived seriousness and cues to action. Keywords: perceived seriousness, VCT utilization Correspondence: Lambok Nita Situmorang. Masters Program in Public Health, Faculty of Public Health, Universitas Sumatera Utara, Jl. Prof. T. Maas, Medan, North Sumatera. Email: nithastmoors@gmail.com. Mobile: 085372537900. Journal of Health Promotion and Behavior 4(2): 121-125 https://doi.org/10.26911/thejhpb.2019.04.02.04

FACTORS AFFECTING THE UTILIZATION OF VOLUNTARY COUNSELING AND TESTING (VCT) SERVICE AMONG FEMALE SEX WORKERS IN INDONESIA: A SYSTEMATIC REVIEW

Human Immunodeficiency Virus - Acquired Immuno Deficiency Syndrome (HIV-AIDS) is one of depressing urban health encountered by the Indonesian citizen. Female sex workers are group at risk and one of the key of HIV transmission. During sexual intercourse, female sex workers didn’t pay attention to the status of customer that infected with HIV / AIDS or not. This review present to identify factors and the most influence factors in the utilization of voluntary counseling and testing (VCT) service among female sex workers in Indonesia The method use online database such as journal.fkm.ui.ac.id, journal.ugm.ac.id, ejournal.undip.ac.id, jornal.unair.ac.id, portalgaruda.id and google scholar. The keywords to search article in database online is fact or VCT or HIV-VCT or female sex workers. There are four eligible articles to review after filtered by inclusion criteria. Result from this review, factors in utilization of VCT services by female sex workers is perception of vulnerability of HIV/AIDS, perception of severity of HIV/AIDS, perception of benefits of VCT, VCT obstacle perception, motivation of VCT, knowledge of HIV/AIDS and VCT, attitude of HIV/AIDS and VCT, facilities, support by councelor, beliefs about VCT, value of knowing their HIV status and motivation to comply other’s support. The most influence factor is level of knowledge about VCT. Based on the result of this review and the description of articles, utilization of VCT Service among Female Sex Workers in Indonesia influenced by knowledge of VCT. For the next research can investigate about comparing the methods in the utilization of services in the female sex workers and other high-risk populations. Article DOI: https://dx.doi.org/10.20319/lijhls.2016.23.3947 This work is licensed under the Creative Commons Attribution-Non-commercial 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc/4.0/ or send a letter to Creative Commons, PO Box 1866, Mountain View, CA 94042, USA.

Voluntary Counseling and Testing Utilization and Associated Factors among Arba Minch University Students, South Ethiopia

Background: Voluntary Counseling and Testing (VCT) is the key entry point to prevention, care, treatment and support services, where people learn whether they are infected and are helped to understand the implications of their HIV status and make informed choices for the future. Objective: The main objective of this study was to assess voluntary counseling and testing utilization and associated factors among Arba Minch University students. Method: An Institution-based cross-sectional study design with quantitative data collection method was employed among 764 students drawn from selected departments of Arba Minch University; by using multi-stage sampling technique. Data was analyzed by using SPSS version 20. Results: A total of 764 people responded the questionnaire out of 805 proposed study participants with the response rate of 94%, of whom 77.6% were male. From the study participants 97.9% were knowledgeable about HIV transmission and prevention. The prevalence of HIV testing was 61.5% (95% CI=0.58, 0.65). The findings also showed that the participants who are knowledgeable about HIV (AOR=4.46, 95% CI=2.00, 9.89), who are willing to have VCT (AOR=3.22, 95% CI=1.98, 5.25), who heard about presence of confidential testing (AOR=3.66, 95% CI=2.38, 5.62) and who had sex (AO=1.71, CI=1.19, 2.48) were more likely to be tested. Feeling at risk, fear of a positive result and fear of being stigmatized were reported as being the main barriers to VCT utilization. Conclusion: Knowledge about HIV and VCT, willingness to have VCT and presence of confidential testing were independent factors identified as predictors for increased VCT service utilization. Recommendation: More emphases should been given by concerned governmental and non-governmental organizations on independent factors identified as predictors for increased VCT service utilization and removing the main barriers to voluntary counseling and testing.

Voluntary Counseling and Testing (VCT) services and its role in HIV/AIDS prevention and management in Nepal

HIV/AIDS has emerged as a serious epidemic in Nepal, concentrated amongst the most-at-risk populations. Volun-tary Counseling and Testing (VCT) is a proven strategy for the prevention and management of HIV/AIDS especially in developing countries. Given that the utilization of VCT is low in Nepal, it is important to understand the barriers and challenges that Nepal is facing in the provision and utilization of these services. This study aimed to provide recommendations for policy makers to improve the utilization of VCT services in Nepal. A qualitative study of VCT health service providers and government officials was undertaken in 4 cities of Nepal. Sixteen interviews, three joint interviews and one focus group discussion were conducted, audio recorded and transcribed verbatim. Data were then analyzed using a thematic analysis framework and major themes were identified. Various barriers including socio-cultural issues, geography, the presence of stigma and discrimination faced by people with HIV/AIDS and a lack of knowledge and awareness were identified as important factors limiting the utilization of VCT services. Current gov-ernment efforts to improve VCT service provision, although promising, require ongoing development. Systemic barriers included the sustainability of the temporary NGO VCT services, lack of staff and training, inadequate moni-toring and evaluation and limited access to services for people living in rural areas. To increase the sustainability and utilization of VCT services, the Government can intervene in a number of areas including the integration of VCT services with existing primary health care services and addressing ongoing education and quality assurance. South East Asia Journal of Public Health 2013; 3(1): 10-16 DOI: http://dx.doi.org/10.3329/seajph.v3i1.17705

A Study of Factors Influencing VCT Service Utilization among the Youths: A Case Study of Kapsabet Division, Nandi County, Kenya

Voluntary Counseling and Testing (VCT) is important in controlling the spread of HIV/AIDS especially among the Youths. The aim of the study was to determine the extent, to assess the level of awareness and to describe the Youths’ attitude towards VCT Service Utilization in Kapsabet Division, Nandi Central District from 1st February to 30th April 2013. A cross-sectional descriptive study was carried out among male and female Youths aged 18 - 34 years who were selected by convenience sampling, using Quantitative and Qualitative methods of data collection with mean age of 26 years. The study found that 52% of Youths had visited VCT and the majority was aware about VCT through print media, TV/radio and IEC materials. Forth-six percent (46%) said Post-Counseling was poor. Seventy seven (77%) highlighted various challengesi.e. most VCT centers were openly located within the hospital and user fee Ksh. 20 was charged. The study also found that there was high level of awareness but slightly low utilization of VCT Services with only 52% having tested. Posters in VCT rooms were stigmatizing and this could have influenced their low utilization of VCT Services. Therefore there is need for dialogue with policy-makers, Youths and Stakeholders in regards to changing strategy for future efforts to increase the uptake of services among the Youths.

Is community conversation associated with human immunodeficiency virus voluntary counseling and testing service uptake in rural communities in Ethiopia? A comparative cross-sectional study

Background:Voluntary counseling and testing (VCT) is a cost-effective tool to prevent and control human immunodeficiency virus (HIV)/acquired immodeficiency syndrome. Community conversation (CC) is a community-based strategy meant to enhance the community utilization of VCT. However, the role of CC in VCT service uptake has not yet been evaluated.Aims:This study was conducted to compare VCT service utilization between rural communities with well CC performance and rural communities with poor CC performance in Shebedino woreda.Materials and Methods:A cross-sectional comparative community-based study was conducted in 2010 among 462 selected adults in the age bracket of 15-59 years. VCT service uptake was compared between well CC performing communities and poor CC performing communities using two sample test of proportion. Predictors of VCT service uptake were determined using logistic regression model.Results:Uptake of VCT service and the related VCT knowledge were statistically higher in well CC performing communities than poor CC performing communities; [73.0% vs. 54.1%, P < 0.001) vs. 97.8% vs. 93.8%, P = 0.034]. CC, VCT knowledge, and knowledge on HIV transmission were independent predictors of VCT service utilization.Conclusion:Uptake of VCT service is higher in well CC performing communities. Emphasis should be given to strengthen CC performance.

Reproductive health service utilization and associated factors among adolescents (15–19 years old) in Gondar town, Northwest Ethiopia

BackgroundThe utilization of reproductive health services is an important component in preventing adolescents from different sexual and reproductive health problems. It plays a vital role in safeguarding youth in Sub-Saharan African countries including Ethiopia, which accounts for a high proportion of the region’s new HIV infections as well as maternal and infant mortality ratios. Due to this, assessing adolescent reproductive health service utilization and associated factors has its own contribution in achieving the national Millennium Development Goals (MDG), especially goals 4 to 6.MethodsA community based cross-sectional study was conducted from April 5–19, 2012, in 4 randomly selected administrative areas of Gondar town. A total of 1290 adolescents aged 15–19 were interviewed using a pre-tested and structured questionnaire. Data were entered in to the EPI INFO version 3.5.3 statistical software and analyzed using an adapted SPSS version 20 software package. Logistic regression was done to identify possible factors associated with family planning (FP), and voluntary counseling and testing (VCT) service utilization.ResultsOut of the total participants, 79.5% and 72.2% utilized FP and VCT services, respectively. In addition, among sexually experienced adolescents, 68.1% and 88.4% utilized contraceptive methods and VCT service during their first sexual encounter, respectively. Educational status, discussion with family/relatives, peer groups, sexual partners and teachers were significantly associated with FP service utilization. Also, adolescents who had a romantic sexual relationship, and those whose last sexual relationship was long-term, were about 6.5 times (Adjusted Odds Ratio [AOR] = 6.5, 95% CI: 1.23, 34.59), and about 3 times (AOR = 3, 95% CI: 1.02, 8.24) more likely to utilize FP services than adolescents who had no romantic relationship or long-term sexual relationship, respectively. In addition, the variables significantly associated with VCT service utilization were: participants who had secondary education and above, schooling attendance, co- residence with both parents, parental communication, discussion of services with peer groups, health workers, and perception of a risk of HIV/AIDS.ConclusionsThe majority of the adolescents were utilizing FP and VCT service in Northwest Ethiopia. But among the sexually experienced adolescents, utilization of FP at first sexual intercourse and VCT service were found to be low. Educational status, schooling attendance, discussion of services, type of sexual relationship and perception of risk were important factors affecting the utilization of FP and VCT services. Building life skill, facilitating parent to child communication, establishing and strengthening of youth centers and school reproductive health clubs are important steps to improve adolescents’ reproductive health (RH) service utilization.

Assessment of voluntary counseling and testing service utilization and associated factors among Debre Markos University Students, North West Ethiopia: a cross-sectional survey in 2011

BackgroundVoluntary Counseling and Testing (VCT) is the key entry point to prevention, care, treatment and support services, where people learn whether they are infected or not and to understand the implications of their HIV status and make informed choices for the future.MethodsA cross sectional study design was done among 753 students drawn from selected departments in Debre Markos University, Ethiopia, using multi-stage sampling technique. Self-administered questionnaire was used to estimate the prevalence of VCT service utilization and to assess associated factors. Data were entered and analyzed using SPSS version 16.Results711 students were participated in the study, of whom, 521 were males. Majority (93.8%) were within the age range of 15 to 24 years. The mean age was 21.5 (3.2±); most of the respondents (91.6%) were single. Majority (81.4%) heard about the confidential VCT service, and their major sources of information were mass media (73.3%) and health workers (71.1%). The study revealed that 58.5% of the study participants had undergone voluntary counseling and testing. It was shown that VCT service utilization was significantly associated with availability of ART drug in VCT site, heard presence of confidentiality, perceived stigma, risk perception and knowledge about HIV.ConclusionThe major factors identified for increased VCT service utilization were knowledge about availability of ART drug in VCT site, information about confidentiality, absence of perceived stigma, higher risk perception and knowledge about HIV. Therefore, actions targeting on these predictors are necessary to effectively enhance the use of the VCT services utilization.

Prevalence and pattern of utilization of voluntary counseling and testing services and HIV infection in Ogbomoso, southwestern Nigeria

Objective:Human immunodeficiency virus, HIV, infection has been a major problem across the globe with a high socioeconomic burden. Voluntary Counseling and Testing (VCT) is a measure put in place to encourage people to know their HIV status with essential counseling support to help them cope with a positive or a negative test result. This study was carried out to determine the utilization of VCT services, prevalence of HIV among VCT attendees, and the distribution of the viral infection based on gender and age in Ogbomoso, an urban community, southwestern Nigeria.Materials and Methods:The health records of patients in Adebayo Alata Primary Health Centre, Ogbomoso South, Nigeria, between 2008 and 2011, were used.Results:A total of 1,490 patients used the VCT services during the period of study, out of which 271 (18.19%) were males and 1,219 (81.81%) were females. A consistent number of people used the VCT service throughout the period of study. HIV infection was higher in females (2.15%) than males (0.54%). The viral infection was more prevalent in people above 14 years of age (2.62%). However, none of these differences observed in gender and age were statistically significant (P < 0.05).Conclusion:It was concluded that HIV infection has neither gender nor age bias. Efforts should be made to increase the provision of VCT services and ensure its continued utilization in an attempt to maintain a healthy social and reproductive health culture, improve maternal and child health in the context of HIV transmission, and improve global child survival.

Utilization rates and perceptions of (VCT) services in Kisii Central District, Kenya.

Voluntary counseling and testing (VCT) services have been set up in most Districts in Kenya due to the rising surge of HIV/AIDS. However, the use of these services among married persons has not been fully explored. In Kissi, the issue of VCT is pressing as the rate of HIV prevalence is close to 3%. In 2006, about 20 000 clients came for VCT services in Kenya yet only 165 of these were married persons. In the Keumbu sub-district hospital, of the more than 1000 clients that came for VCT services, approximately 29% were married persons. This paper therefore aims at determining the utilization of VCT services by married persons in the study area. The qualitative data was obtained principally through two focus group discussions (FGDs) in which the respondents were asked to comment on their use of VCT services while the quantitative data was obtained from interviews with 245 respondents. The qualitative data was analyzed through verbatim transcription while for the quantitative data; the responses were coded and populated into SPSS from which the frequencies and percentages were calculated. The results show that actual use of the VCT services is low (28.1%) but slightly higher among female respondents than males. The low usage may be attributed to (a) fear of results, (b) death anxiety, (c) lack of confidentiality and lastly, (d) fear of stigmatization. Female respondents were found to have a greater awareness of VCT and thus its potential use.

Utilization of voluntary counseling and testing services in the Eastern Cape, South Africa

This analysis uses data from a population-based household survey and a government clinic survey in the Eastern Cape Province of South Africa to examine attitudes towards voluntary counseling and testing (VCT) services, patterns of utilization of VCT services and the relationships between HIV/AIDS-related stigma, VCT service availability and quality and the use of VCT. The household survey data are linked with clinic-level data to assess the impact of expanded VCT services and access to rapid testing on the likelihood of being tested in rural areas and on HIV/AIDS stigma. Our analysis finds that while overall use of VCT services is low, utilization of VCT services is positively associated with age, education, socioeconomic status, proximity to clinics, availability of rapid testing and outreach services and lower levels of HIV/AIDS stigma. Importantly, the effects of stigma appear considerably stronger for females, while men are more heavily influenced by the characteristics of the VCT services themselves.