Voluntary HIV Counseling And Testing Services Research Articles

Prevalence and Predictors of Non-Uptake of HIV Voluntary Counseling and Testing among Undergraduates of Tertiary Institution in Abia State, Nigeria

Background: One of the key strategies in the HIV/AIDS prevention and control programs in Nigeria is Voluntary HIV counseling and testing (VCT). However, its utilization among young adults, particularly undergraduates, is very low. The aim of the present study was to determine the prevalence and predictors of non-uptake of VCT among undergraduates. Methods: A cross sectional study using quantitative methods was conducted. Using simple random sampling, three faculties were selected out of nine and 422 respondents were selected from three faculties. Interviews were conducted using pre-tested semi-structured questionnaires. Data analysis was done using statistical package for social sciences version 20. Prevalence was measured by the percentage of respondents that had never used VCT. Analytical statistics were done using chi-square test to measure strength of association between VCT uptake and knowledge and attitude of respondents. Association with P-value 0.05 was considered significant. Logistic regression was used to identify predictors of non-uptake of VCT. The associations were presented as odds ratios (OR) and 95% confidence intervals. Results: Overall, 59.3% of respondents were knowledgeable about VCT while majority, 64.7% had negative attitude towards it. Knowledge (X2 = 9.89, P-value 2 = 10.78, P-value OR 1.874 (1.058 - 3.289), P Conclusions: VCT uptake among undergraduates was low and determined by VCT-related ignorance, poor attitude, fear of positive result and HIV/AIDS-related stigma/discrimination. In order to change the narrative, HIV/AIDS prevention and control programs in Nigeria should address the identified predictors of non-VCT uptake. There is a need to focus on young adults when designing, expanding and implementing VCT services in the country.

The impact of social capital on civil society organizations delivering voluntary counseling and testing HIV/AIDS service: a cross-sectional study in China.

In China, Voluntary HIV Counseling and Testing (VCT) services are mostly provided by Civil Society Organizations (CSOs). This cross-sectional study investigated the association between CSOs' social capital and VCT service availability in eight Chinese provinces during July-December 2015. Data on CSOs' characteristics were collected through questionnaire-based interviews. Social capital was measured using a purpose-developed questionnaire. Logistic regression models tested the association between social capital and the scale of VCT services. A total of 103 CSOs that provided VCT to MSM (MSM-focused CSOs), and 109 CSOs that provided such service to non-MSM population (other CSOs) were included. Overall, 144 (67.9%) CSOs were not registered with local governments, while 106 (50%) received RMB 50,000 ($7,670) funding in 2014. Multivariate logistic regression analysis indicated that the CSOs with a higher level of shared vision were more likely to provide a large-scale of VCT service than those with a lower level of shared vision (AOR = 1.95). Moreover, intra-networks were positively associated with the VCT service (AOR = 2.87) among other CSOs, while the level of shared vision was positively associated with the VCT service (AOR = 3.08) among other-MSM-focused CSOs. There was no significant association between social capital and total service scale. Our findings suggest that increasing social capital can potentially enhance VCT service and play an important role in AIDS prevention.

Predictors of Consistent Condom and Voluntary Counselling and Testing Services Utilization Among BodaBoda Operators in Coastal Region of Kenya

Despite recent declines in global HIV/AIDS mortality, HIV/AIDS is still the leading cause of death especially in in Sub-Saharan Countries. Voluntary HIV counseling and testing (VCT) and consistent condom use among BodaBoda operators are very important in the prevention and control of the infection. This study determined the consistent condom and voluntary counseling and testing services utilization among BodaBoda operators in Coastal region of Kenya. A cross-sectional study was carried between February to December 2015. A multi-stage sampling method was applied to randomly select the BodaBoda operators. Stratification, random and systematic sampling techniques were used to identify the study participants. Interviews were conducted using structured questionnaires. Data analysis was done using statistical package for social sciences version 16. Analytical statistics were done using odds ratio to measure strength of association between Condom and VCT uptakes and independent variables. Association with p-value <0,05 was considered significant. Binary regression was used to identify predictors of condom and VCT uptakes. Of 385 participants, 98.7% were male and 1.3% female. This study revealed that the prevalence of VCT uptake and consistent condom use among BodaBoda operators in Coastal Kenya was 53.0% and 60.0% respectively. VCT uptake was found to be significantly predicted bygender (AOR=3.216, 95% CI: 1.410-9.964), visiting a VCT centre with a partner (AOR=16.39, 95%CI: 3.012-17.624), assurance of confidentially of HIV test results (AOR =4.79, 95% CI: 2.033-8.907), known VCT (AOR=0.152, 95% CI: 0.034-0.221) and fear of being seen at VCT centre (AOR=0.551, 95% CI: 0.307-0.988). Consistent condom use was significantly associated with gender (AOR=2.01, 95% CI: 1.04, 2.48), Educational status (AOR=0.80, 95% CI: 0.43, 0.85) and marital status (AOR=1.51, 95% CI: 1.07-2.15). Conclusion: The overall prevalence of VCT uptake and consistent condom use was found to be low. VCT utilization uptake among the operators was influenced by gender, assurance of confidentiality of the HIV test results, going to a VCT with a partner, fear of being seen at a VCT centre and going to a known VCT. The main predictors of consistent condom use were found to be gender, educational level and marital status. Integration of friendly VCT services would increase VCT uptake among BodaBoda operators. Support and care received after knowing the test results should be clearly communicated as it reduces stigma. Therefore, interventions targeting sex, educational status and marital status are recommended.

Factors influencing the uptake of Voluntary HIV Counseling and Testing among secondary school students in Arusha City, Tanzania: a cross sectional study.

BackgroundVoluntary HIV counseling and testing (VCT) is a key strategy towards HIV prevention yet, the uptake of VCT services among young people remains low. This study determined the factors that influence the uptake of VCT among secondary school students in Arusha City, Tanzania.MethodsA cross sectional study using quantitative methods was conducted. A multi-stage sampling method was applied to randomly select the secondary schools. Stratification, random and systematic sampling techniques were used to identify the study participants. Interviews were conducted using structured questionnaires. Data analysis was done using statistical package for social sciences version 16. Analytical statistics were done using odds ratio to measure strength of association between VCT uptake and independent variables. Association with p-value < 0.05 was considered significant. Binary logistic regression was used to identify predictors of VCT uptake.ResultsOf 400 study participants, 50.5% were male and 49.5% were female. 93.5% of the respondents were aware of the VCT services, 79.1% had high knowledge on VCT services and 75.9% had positive attitude towards VCT services. On VCT uptake, only 29.3% had ever tested. VCT uptake was found to be significantly predicted by age (p = 0.003), sex (p < 0.001), religion (p < 0.001), exposure to VCT information from a VCT centre (p < 0.001) and type of school ownership (p < 0.013).ConclusionDespite high knowledge on VCT services, the uptake of VCT among secondary school students was found to be low. The uptake of VCT was mainly found to be influenced by fear of HIV test results, knowledge and attitude on VCT services, age, education, engagement in sexual relationships, stigma and distance to the VCT centre. Integration of youth friendly VCT services in secondary schools would increase VCT uptake among secondary school students. Support and care received after knowing the test results should be clearly communicated as it helps motivate more young people towards VCT uptake and reduce stigma among them.

Assessment of Knowledge, Attitude, Practice and Determinants of VCT Utilization for HIV/AIDS Among Ambo University Students, West Shoa Zone, Oromia Region, Ethiopia: Cross Sectional Study

Voluntary HIV counseling and Testing (VCT) is a process by which an individual undergoes counseling to enable informed about HIV status. The provision of voluntary HIV counseling and testing (VCT) is an important part of any national prevention program. This study tried to assess the knowledge, attitude and practice determinants of voluntary counseling and testing utilization for HIV/AIDS of Ambo University students. Descriptive cross-sectional study design was implemented with multistage sampling apply in the study. There were 93.2 response rates in the study. Three hundred eight nine (51.9%) of the respondents have sexual experience, or ever had sexual intercourse; out of which 288 (38.4%) were males and the rest 101 (13.5%) were females. Among the total participants 504(67.2%) were used VCT services but 246(32.8%) were never used VCT service. Regarding the location of VCT service recommended, health facility, school and youth club were recommended by 337(49.7%), 310(41.3) and 219(29.2%) of the students respectively. There were different determinants those have statistical association with VCT service utilization include sex, batch, sexual exposure and knowledge of the students about VCT. Even though most of the students have adequate knowledge, attitude and practice still there is a gap in the participants KAP towards VCT utilization due to different determinants like sex, sexual exposure and their level of education (batch).

Predicting intention to use voluntary HIV counseling and testing services among health professionals in Jimma, Ethiopia, using the theory of planned behavior

BackgroundTo endorse involvement in voluntary HIV counseling and testing (VCT), it is essential to recognize factors that influence people in deciding whether to access VCT services and their underlying route factors. Theory of planned behavior (TPB) constitutes a proficient framework for predicting behaviors and intentions.ObjectiveThe aim of the study reported here was to assess the predicting ability of TPB in determining the intended use of VCT services among health professionals in Jimma, southwest Ethiopia.MethodsThis was an institution-based cross-sectional quantitative study of a sample of 336 health professionals in 12 selected districts of Jimma, southwest Ethiopia between February 5 to March 28, 2012. Data were collected using structured questionnaire self-administered by the study participants. A hierarchal multivariable linear regression model was used to predict the role of TPB constructs that can influence the intention to use VCT services.ResultsThe constructs of TPB explained the variability in intention to use VCT by 27% (R2 adjusted = 0.27). The standardized regression coefficients showed that the strongest predictor of intention to use VCT was subjective norms (β = 0.32, P < 0.0005) followed by attitude (β = 0.21, P < 0.002). Perceived behavioral control was not a significant predictor of intention to use VCT among the study group (P = 0.12).ConclusionThe study revealed the possibility of describing the intention to use VCT among health professionals using TPB, with perceived social pressure being the leading predictor. In light of this, health intervention programs should be designed to develop health professionals’ ability to resist norms that oppose the use of VCT and to change community-held norms against VCT use, provided they help individuals develop a positive attitude toward the services.

Intention to voluntary HIV counseling and testing (VCT) among health professionals in Jimma zone, Ethiopia: the theory of planned behavior (TPB) perspective

BackgroundVoluntary HIV Counseling and Testing (VCT) forms one of the cornerstones of HIV prevention strategies. It is imperative to understand HIV testing correlates and their theoretical underpinnings in order to promote VCT uptake. The aim of this study was to predict the intention to VCT and associated factors among health professionals in Jimma zone, Ethiopia using the theory of planned behavior.MethodsAn institution based cross-sectional quantitative study among a sample of 336 health professionals in 12 selected districts of Jimma, Ethiopia was conducted in 2012. The constructs and principles of the theory of planned behavior (TPB) were measured. Data were collected using structured questionnaire on self administered basis. A multivariable linear regression model was used to predict the role of independent variables/TPB constructs on the intention to use VCT using SPSS version 16.0.ResultsThe components of TPB independently explained the variance in intention to VCT by 30.3%. Both components of TPB and socio-demographic characteristic in the final model explained 32.7% of variance in the intention to use VCT services. Significant proportions (33.0%) of the respondents have never been tested for HIV. The respective indirect components of the TPB predicted the direct components. The strongest predictors of intention to VCT were subjective norm (β=0.39, p<0.001) and attitude (β= 0.19, p<0.001) whereas, none of the socio-demographic variables were significantly predicted the intention to use VCT. Past VCT experience did not have significant statistical association with VCT use intention.ConclusionsBehavioral intention to use VCT was a function of attitude and perceived social pressure. Demographic related social determinants were not barriers for VCT use intention. Most health workers test their blood by themselves. Strategies to empower health professionals on social pressure resistance and programs targeted at changing negative attitude on VCT use can enhance intention of health professionals to use VCT.

Applicability of the theory of planned behavior in predicting intended use of Voluntary HIV Counseling and Testing services among teachers of Harari Region, Ethiopia

Background: The predictive validity and applicability of Theory of Planned Behavior (TPB) may be a promising model for understanding and predicting intended behaviors to use VCT services. The need for theory based study would thus be essential in designing evidence based HIV-related interventions in the future. Objectives: To examine the applicability of the Theory of Planned Behavior and the additional predictive role of perceived risk in predicting intended use of Voluntary HIV Counseling and Testing (VCT) services. Methods: A cross sectional study design was conducted among 20 randomly selected schools in Harari Region between March and April 2009. Four hundred ninety seven randomly selected teachers consented to participate in the study giving a response rate of 87.8%. Self administered questionnaire, adopted from the TPB was used for data collection. Multiple linear regression models were used to predict the role of important variables that can influence the intention to use VCT among teachers using SPSS version 15.Result: More than half (53.7%) who had never used VCT service were considered in the analysis for the intended VCT service use. All the modal variables correlated significantly with behavioral intention. Subjective norm (r=0.45, p

HIV infection and contraceptive need among female Ethiopian voluntary HIV counseling and testing clients

Despite political endorsement of voluntary HIV counseling and testing (VCT), and family planning integration in Ethiopia, little is known about the reproductive health needs of VCT clients. We estimated contraceptive prevalence and need among 646 Ethiopian female VCT clients. We compared socio-demographic characteristics of contracepting VCT clients to those with unmet need and examined how these characteristics are associated with having unmet contraceptive need and being HIV-positive using multinomial logistic regression. We also assessed the quality of VCT services from clients' reports of reproductive health topics discussed in VCT sessions. Nearly 34% of female VCT clients have unmet contraceptive need. Three socio-demographic characteristics are consistently associated with both risk for unintended pregnancy and HIV: older age, marriage, and lower education. In the multivariate analysis, older age, marriage, and belonging to a minority ethnic group are significantly associated with being both HIV-positive and having unmet contraceptive need. Conversely, higher education, larger families, and frequent sexual activity are associated with reduced likelihood of experiencing these two adverse health outcomes. VCT clients report infrequent reproductive health counseling, although HIV-positive women are more likely than HIV-negative women to have discussions about contraception with VCT counselors. At the time of this study, family planning was not offered as part of VCT programs, although VCT clients demonstrate considerable need for contraceptive services.

Knowledge, Attitudes, and Practices of Voluntary HIV Counseling and Testing among Rural Migrants in Shanghai, China

A study of knowledge, attitudes and practices (KAP) of voluntary HIV counseling and testing (VCT) among rural migrants was conducted in Shanghai, China. An anonymous questionnaire was administered face-to-face. Among 2,690 participants, 78% reported having had lifetime sexual intercourse with 41.3% of singles reporting sexual intercourse, 9.2% having had multiple sex partners in the past year, only 19% of the participants always using condoms whereas 61.6% did not use in their sexual acts in the past month, 80% knew HIV infection was diagnosed through a blood test, 46.5% had heard of VCT ever before, but only 3.5% felt that they were likely to be HIV-infected now or in the future and only 62 (2.3%) had ever had HIV testing with 19 of them getting tested at a VCT site. Gender, working venue, multiple sex partnerships and knowledge of VCT were independently correlated with having had HIV testing. This study suggests that a much greater effort is needed to promote safer sex and to improve VCT knowledge and services among rural migrants particularly those who are engaging in risky behaviors.

Male Perspectives on Incorporating Men into Antenatal HIV Counseling and Testing

BackgroundMale partner involvement in antenatal voluntary HIV counseling and testing (VCT) has been shown to increase uptake of interventions to reduce the risk of HIV transmission in resource-limited settings. We aimed to identify methods for increasing male involvement in antenatal VCT and determine male correlates of accepting couple counseling in these settings.Methodology/Principal FindingsWe invited women presenting to a Nairobi antenatal clinic to return with their male partners for individual or couples VCT. Male attitudes towards VCT and correlates of accompanying female partners to antenatal clinic and receiving couple counseling were determined. Of 1,993 women who invited their partner, 313 (16%) returned with their partners to ANC. Men attending antenatal clinic were married (>99%), employed (98%), and unlikely to report prior HIV testing (14%). Wanting an HIV test (87%) or health information (11%) were the most commonly cited reasons for attending. Most (95%) men who came to antenatal clinic accepted HIV testing and 39% elected to receive counseling as a couple. Men who received counseling with partners were younger, had fewer children, and were less knowledgeable about prevention of mother-to-child HIV transmission (PMTCT) than those who received counseling individually (p<0.05). Only 27% of men stated they would prefer HIV testing at a site other than the ANC. There was agreement between male and female reports for sociodemographic characteristics; however, men were more likely to report HIV preventive behaviors and health communication within the partnership than their partners (p<0.05).Conclusions/SignificanceOffering VCT services to men at antenatal clinic with options for couple and individual counseling is an important opportunity and acceptable strategy for increasing male involvement in PMTCT and promoting male HIV testing.

Providing family planning in Ethiopian voluntary HIV counseling and testing facilities: client, counselor and facility-level considerations

Governments and donors encourage the integration of family planning into voluntary HIV counseling and testing (VCT) services. We aimed to determine whether VCT counselors could feasibly offer family planning and whether clients would accept such services. We employed a quasi-experimental, pre and postintervention survey design, interviewing 4019 VCT clients attending eight Ethiopian public sector facilities and 4027 additional clients 18 months after introducing family planning services in the same facilities. We constructed sex-stratified multilevel models assessing three outcomes: whether clients received contraceptive counseling, whether clients obtained contraceptive methods during VCT and whether clients intended to use condoms consistently after VCT. Clients demonstrated lower than expected immediate need for contraception. After intervention, only 29% of women had sex in the past 30 days, and 74% of these women were already using contraceptives. Despite the relatively low risk this population had for unwanted pregnancy, family planning counseling in VCT increased from 2 to 41% for women and from 3 to 29% for men (P < 0.01). Approximately, 6% of clients received contraceptive methods. However, sexually active men and women and those with more perceived HIV risk were more likely to obtain contraceptives and intend to use condoms consistently. Men attending facilities with higher client loads were 88% less likely to receive family planning information and 93% less likely to receive contraceptives than those attending facilities with lower client loads. Male and female clients whose counselors perceived contraceptive availability to be adequate were four and two times more likely, respectively, to receive contraceptive methods than those counseled by providers who felt supplies were inadequate (P < 0.01). Integrating VCT and family planning services is likely to be an effective programmatic option, but populations at risk for HIV or unintended pregnancy should be targeted.

Factors Related to Female Sex Workers’ Willingness to Utilize VCT Service: A Qualitative Study in Jinan City, Northern China

While national HIV prevalence remains low in China, female sex workers (FSWs) have become infected at high rates. Free voluntary HIV counseling and testing (VCT) has been offered in recent years; however, its utilization rate is low. This study explored factors related to FSWs' willingness to utilize a VCT clinic. Qualitative interviews informed by the Ecological Perspective were conducted to interview 17 FSWs and 12 managers from 23 selected entertainment establishments in Jinan, the capital of Shandong province in northern China. While the majority of FSWs professed willingness to use VCT services, they described barriers to actual utilization of services which included: misunderstandings about HIV; low perceived risk and HIV prevalence; mistrust of the free VCT; and especially anxiety about the implications of possible test results. This research suggests that increasing FSWs' utilization of VCT will require increased knowledge of HIV and VCT, and acceptance of testing and on-site VCT services.

Voluntary HIV counseling and testing acceptance, sexual risk behavior and HIV incidence in Rakai, Uganda

To assess the acceptance of voluntary HIV counseling and testing (VCT) and the effects of VCT on sexual risk behavior and HIV acquisition in Rakai, Uganda. In a rural cohort, 10 694 consenting adults were interviewed, provided blood for HIV testing and were offered free VCT by community resident counselors. The proportions receiving VCT and the adjusted risk ratio (adj. RR) of VCT acceptance were estimated by log binomial regression. Risk behaviors and HIV incidence per 100 person-years (PY) in HIV-negative acceptors and non-acceptors of VCT were assessed prospectively. Although 93% initially requested HIV results, 62.2% subsequently accepted VCT. VCT acceptance was lower among persons with no prior VCT [Adj. RR = 0.88; 95% confidence interval (CI), 0.85-0.90], individuals with primary education (adj. RR = 0.94; 95% CI, 0.90-0.99) or higher (adj. RR = 0.91; 95% CI, 0.87-0.97), individuals who were HIV-positive (adj. RR = 0.72; 95% CI, 0.68-0.76), and persons reporting condom use in the past 6 months (inconsistent users, adj. RR = 0.95; 95% CI, 0.90-0.99; consistent users, adj. RR = 0.88; 95% CI, 0.82-0.95). VCT acceptance was higher among the currently married (adj. RR = 1.14; 95% CI, 1.08-1.20) and previously married (adj. RR = 1.11; 95% CI, 1.04-1.18). Receipt of results was not significantly associated with age, gender, and self-perception of HIV risk. There were no significant differences in sexual risk behaviors, or in HIV incidence between acceptors (1.6/100 PY) and non-acceptors (1.4/100 PY) of VCT. In this rural cohort where VCT services are free and accessible, there is self-selection of individuals accepting VCT, and no impact of VCT on subsequent risk behaviors or HIV incidence.

"To know or not to know": service-related barriers to voluntary HIV counseling and testing (VCT) in South Africa.

Voluntary HIV Counselling and Testing (VCT) is still in its infancy in South Africa, and although the necessary infrastructure in terms of clinics and hospitals exists, a VCT culture is not yet established in the country. The purpose of this study was to determine the needs, attitudes and beliefs of a sample of South Africans towards VCT, and to investigate possible barriers affecting participation in VCT programs in South Africa. A semi-structured questionnaire was used to survey the views of 1422 people. Results indicate that while subjects were not opposed to VCT in principle, 33% would go to clinics where nobody would know them. The following problems with VCT services were mentioned: Logistical problems (not enough counsellors, long lines, lack of privacy); no trust in the health care system or fearing a breach of confidentiality; fear of rejection; and a lack of follow-up support after diagnosis. Suggestions are made on how to improve VCT services in South Africa.

Profiles of HIV voluntary counseling and testing of clients at a district hospital, Chiang Mai Province, northern Thailand, from 1995 to 1999.

Voluntary HIV counseling and testing (VCT) is a central component of comprehensive HIV prevention strategies targeting individual risk reduction. VCT data are essential for planning and improving HIV/AIDS intervention strategies. The objective of this study is to describe demographic profiles, reasons for seeking HIV counseling and testing, rate of declining HIV testing after pretest counseling, rate of failure to return for HIV test results, and HIV prevalence and associations among 3570 clients who sought VCT at Sansai Hospital in northern Thailand from 1995 to 1999. Data were abstracted retrospectively from client-level data recorded by the hospital counselors on a standard form. HIV prevalence was 29% and remained high throughout the study period. Reasons for seeking VCT for men and women were markedly different and highly correlated with rates of declining the test, failure to return for test results, and HIV prevalence. Declining VCT and failing to return were high among uneducated clients (p <.001). Failure to return among men was associated with HIV prevalence (OR = 1.72, p =.003), particularly for those who had risk behaviors (OR = 5.92, p <.001) and those who wanted to know their HIV serostatus (OR = 4.44, p =.002). Overall, VCT acceptance and returning for test results were high. VCT services at the community level can reach high-risk individuals, especially male partners of women tested as part of routine prenatal care.

Clients' Perspective of the Role of Voluntary Counseling and Testing in HIV/AIDS Prevention and Care in Dar Es Salaam, Tanzania: The Voluntary Counseling and Testing Efficacy Study

There is a growing body of evidence that voluntary HIV counseling and testing (VCT) is effective for the primary prevention of HIV as well as for the care and support of individuals affected by HIV in developing countries. This qualitative study offers an additional perspective: the experiences and perceptions of men and women receiving VCT services. As a substudy of a large multisite clinical trial testing the effectiveness of VCT, 81 study participants at the Tanzania study site who were randomized to VCT at baseline were interviewed at the time of their 6-month follow-up. Findings are based on textual analysis of the following themes: HIV in the context of other life issues, motivations for receiving services, positive and negative consequences of VCT, and the role of VCT in risk reduction. Implications for service provision in developing countries are discussed.