Voluntary HIV Counseling And Testing Research Articles

Prevalence of Paid Sex and Associated Factors Among Women and Men Attending HIV Voluntary Counseling and Testing in Kinshasa, Democratic Republic of the Congo: A Prospective Cohort

Paid sex is associated with HIV and other sexually transmitted infections, which are highly prevalent in Sub-Saharan Africa (SSA). However, few data exist on this sexual practice among the general population in SSA, including the Democratic Republic of the Congo, where data on paid sex mainly comes from sex workers. In the DRC, most HIV Voluntary Counseling and Testing (VCT) centers do not discuss paid sex as a risk factor. Thus, we aimed to analyze the prevalence of paid sex, its associated factors and association with HIV among women and men attending HIV VCT at a reference hospital in Kinshasa. From 2016 to 2018, the Observational Kinshasa AIDS Initiative cohort analyzed the impact of HIV VCT on changes in HIV knowledge, attitudes, and sexual behaviors at follow-up. Participants aged 15–69 years were HIV tested and interviewed at baseline and at 6- and 12-month follow-ups. At baseline, participants were asked about their history of “ever” having had exchanged sex for money. At both follow-ups, the frequency of this practice was referred to as “the previous 6 months.” Descriptive, bivariate, and multivariate logistic regression analyses were carried out to evaluate the prevalence of paid sex, its associated factors, and the association between paid sex and HIV. Statistical analyses were performed with Stata 15.1. Among 797 participants at baseline, 10% of those sexually experienced reported having ever had paid sex (18% men and 4% women, p < 0.001). At 6 and 12-month follow-ups, 5% and 2%, respectively. Paid sex was significantly and independently associated with being male (aOR = 2.7; 95% CI = 1.4–5.2), working or studying (aOR = 2.8; 95% CI = 1.5–5.0), daily newspaper reading (aOR = 4.4; 95% CI = 1.7–11.2); daily/weekly alcohol consumption (aOR = 3.3; 95% CI = 1.8–6.1), first sexual intercourse before age 15 years (aOR = 2.3; 95% CI = 1.1–5.0), multiple sexual partners (aOR = 4.1; 95% CI = 2.2–7.7), and extragenital sexual practices (aOR = 2.4; 95% CI = 1.3–4.4). A high religiosity (daily/weekly church attendance and praying) was inversely associated with paid sex (aOR = 0.1; 95% CI = 0.0–0.4). The high prevalence of paid sex among people attending HIV VCT in Kinshasa, associated with other sexual and consumption risk behaviors, highlights the need to include paid sex among the risk factors mentioned in HIV prevention counseling.

Factors associated with voluntary HIV counseling and testing among young students engaging in casual sexual activity: a cross-sectional study from Eastern China

Factors associated with voluntary HIV counseling and testing among young students engaging in casual sexual activity: a cross-sectional study from Eastern China

Diagnostic performance evaluation of urine HIV-1 antibody rapid test kits in a real-life routine care setting in China

ObjectivesTo evaluate the diagnostic performance of urine HIV antibody rapid test kits in screening diverse populations and to analyse subjects’ willingness regarding reagent types, purchase channels, acceptable prices, and self-testing.DesignsDiagnostic...

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

Factors Associated With Participation of Pregnant Women In Examination VCT (Voluntary Counseling And Testing)

HIV/AIDS has become a big scary enemy in Indonesia. The incidence of HIV/AIDS in pregnant women also makes it difficult to achieve the 2015-2019 National Medium Term Development Plan targets in the health sector at 3 points at once, namely maternal mortality, infant mortality and the prevalence of HIV cases. The Voluntary Counseling Testing (VCT) strategy is the core of all efforts to prevent and control HIV/AIDS in the world. The aim to Factors Associated With Participation of Pregnant Women In Examination VCT. The research design is an analytic method with a cross sectional study approach. The population in this study were all pregnant women who had Antenatal Care. The sampling technique used in this study is to use total sampling technique. Data analysis used univariate and bivariate analysis with the chi square statistical test. The result in this study there were 10.0% pregnant women who did not perform VCT examinations, 70% pregnant women who had good knowledge, 80% pregnant women who received support from their husbands, 82.5% pregnant women who get the role of health workers in a good category, 30% pregnant women who have a long distance from the place of health services. There is a significant relationship between knowledge (0.001), attitude (0.000), husband's support (0.000), the role of officers ((0.001) and the distance to HIV VCT examination in pregnant women. The conclusion is that many pregnant women are aware of the importance of the VCT test which can be seen in the number of pregnant women who have done the test.

The risk of acute and early HIV (AEH) infection among MSM with different behaviour trajectories: an open cohort study in Tianjin, China, 2011–2019

BackgroundAcute and early HIV (AEH) infection is characterized by a high viral load and infectivity. Approximately 50% of cases of HIV-1 transmission occur during AEH. Understanding sexual behaviour trajectories would be useful for predicting changes in the risk of HIV acquisition. However, few studies have investigated sexual behaviour trajectories and their association with AEH acquisition. This study identified behaviour trajectories among men who have sex with men (MSM), determined the risk of AEH infection, and compared risk factors between different behaviour trajectories.MethodsThe study was based on an ongoing prospective open cohort of voluntary HIV counselling and testing (VHCT) among MSM in Tianjin, China. From 2011 to 2019, 1974 MSM were recruited. Group-based trajectory modelling (GBTM) was used to identify behaviour trajectories by constructing a sexual risk behaviour score. Logistic regression and generalized estimating equation (GEE) were used to compare the risk of AEH infection and risk factors for different behaviour trajectories. All data analyses were performed using SAS 9.4.ResultsThe incidence of AEH infection was 1.76/100 person-years, with 64 AEH infections documented in 3633 person-years of follow-up. Three sexual behaviour trajectories were identified: CL (consistently low risk, 35.46%), CH (consistently high risk, 42.71%) and HTL (high to low risk, 21.83%). MSM in the HTL and CH groups had higher AEH infection rates than MSM in the CL group (6.73%, 3.08% and 1.28%, respectively), with ORs of 5.54 (2.60, 11.82) and 2.44 (1.14, 5.25), respectively. MSM aged 30–50 years old and MSM who underwent HIV testing in the last year were more likely to be in the CH group and HTL group. In addition, the HTL group was characterized by a lower likelihood of local registration and a higher likelihood of working as a MSW.ConclusionMSM in the CH group and the HTL group had a higher risk of AEH infection. In the future, VHCT should be performed more often among younger MSM, and HIV counselling should be given the same priority as HIV testing. In addition, VHCT combined with PrEP may have a better preventive impact on MSM with a high risk of AEH infection.

Factors Associated with Utilization of Sexual and Reproductive Health Services among the Youth in Lira City West, Northern Uganda: A Cross-Sectional Study.

The youth in Uganda, as in much of sub-Saharan Africa, face numerous sexual and reproductive health (SRH) challenges, from human immunodeficiency virus HIV infection, and unsafe abortions to unwanted pregnancies. This study, therefore, assessed the utilization of sexual and reproductive health services and associated factors among the youth in Lira city west, northern Uganda. This was a cross-sectional study conducted in January 2023 among 386 young people (15-24 years) in Lira city west division, Lira city. Multistage cluster sampling technique was used to recruit our study participants. Data were collected using an interviewer-administered questionnaire. Data were analyzed using SPSS version 23, descriptive statistics, cross-tabulation, bivariate, and multivariate logistic regression analyses. All variables were set by p values less than 0.05 and reported adjusted odds ratio with its 95% confidence interval. The utilization of SRH services was 42.0% (162/386) among the study participants. Family planning, voluntary HIV counseling and testing (VCT), and general counseling services were the most utilized SRH services in the past 12 months. Young people who were aware of SRH services (AOR: 0.24; 95% CI: 0.08-0.74), were aware of a reproductive health facility (AOR, 4.24; 95% CI: 1.62-11.09), discussed SRH issues with peers/friends (AOR, 3.98; 95% CI: 1.53-10.33), had a sexual partner (AOR, 10.00; 95% CI: 4.05-24.69), had sexual intercourse (AOR, 4.59; 95% CI: 2.18-9.69), and had access to SRH services (AOR, 2.68; 95% CI: 1.12-6.40) were more likely to utilize SRH services compared to their counterparts. This study showed a low utilization of sexual and reproductive health services among youth in Lira city west, northern Uganda. Being aware of SRH services, awareness of reproductive health facilities, discussing SRH issues with peers, having sexual intercourse, having a sexual partner, and access to SRH services were independently associated with the utilization of SRH services. Therefore, there is a need to strengthen sustainable multisector approaches aimed at improving awareness and access to sexual and reproductive health services among the youth.

Sexual Partner Referral for HIV Testing Through Social Networking Platforms: Cross-sectional Study.

BackgroundMen who have sex with men (MSM) who undergo voluntary HIV counseling and testing (VCT) often report condomless anal sexual intercourse, having many sexual partners, and being exposed to risky sexual networks. Limited research has discussed the application of motivational interviewing and convenience referral platforms to facilitate the referral of sexual partners for HIV testing among MSM.ObjectiveThis study aimed to evaluate the effects of VCT referral by sexual partners through social networking platforms and the test results after elicited interviews with MSM; compare the characteristics and risk behaviors among MSM tested without referral, index subjects, and referred sexual partners; and explore unknown sexual affiliations through visualizing and quantifying the social network graph.MethodsThis was a cross-sectional study. Purposeful sampling was used to recruit index subjects from a community HIV screening station frequented by MSM in Taipei City on Friday and Saturday nights. Respondent-driven sampling was used to recruit sexual partners. Partner-elicited interviews were conducted by trained staff before VCT to motivate MSM to become index subjects and refer sexual partners via the Line app, or to disclose the accounts and profiles of sexual partners on relevant social networking platforms. Referred sexual partners received rapid HIV testing, and the recruitment process was repeated until leads were exhausted.ResultsAfter the interviews, 28.2% (75/266) of MSM were successfully persuaded to become index subjects in the first wave, referring 127 sexual partners via the Line app for rapid HIV testing and disclosing 40 sexual partners. The index subjects and tested sexual partners had more sexual partners (F2=3.83, P=.02), more frequent anal intercourse (F2=10.10, P<.001), and higher percentages of those who had not previously received HIV testing (χ21=6.1, P=.047) compared with MSM tested without referrals. The new HIV-seropositivity rate among tested sexual partners was 2.4%, which was higher than the rate in the other 2 groups. The social network analysis revealed the following 4 types of sexual affiliation: chain, Y, star, and complicated. Among the HIV-negative sexual partners, 26.9% (43/160) had sexual affiliations with HIV-positive nodes, and 40% (10/25) were untested sexual partners with a direct sexual affiliation with an HIV-positive node. Four transmission bridges were found in the network graph.ConclusionsPartner-elicited interviews can effectively promote referral for HIV testing and case identification via Line, and can clarify unknown sexual affiliations of MSM to facilitate the development of a tailored prevention program. Social network analysis is needed for an insightful understanding of the different network structures.

Prevalence of Anxiety Disorder and Associated Factors among Voluntary Counseling and HIV Testing Clients at Governmental Health Centers in 2017 in Addis Ababa, Ethiopia.

Objective: More than 450 million people are considered to be suffered from mental problem in the world nowadays. In Ethiopia, these problems constitute for 12.45% of the impact of diseases and around 12% of individuals are estimated to be develop any form of mental problems, of which 2% are severe cases. One of the most psychiatric problem that cause substantial functional impairment and suffering is anxiety disorders.To assess the prevalence of anxiety disorder and associated factors among voluntary counseling and HIV testing (VCT) clients of Addis Ababa governmental health centers, Ethiopia, 2017. Method : An institutional based cross-sectional study was conducted at Addis Ababa governmental health centers from February 15 to March 10, 2017. A Cluster sampling technique was used and 770 study participants were interviewed. Data were entered into EPI INFO version 2002 and transferred to SPSS version 19.0 windows and was analyzed. The logistic regression of analyses was used. Results: The prevalence of anxiety disorder among VCT clients was 39.2%. Factors that statistically significant with an anxiety disorder: fear of stigma or social discrimination (AOR = 3.01, 95%CI: 1.67, 5.42), history of haven’t been tested before for HIV (AOR = 3.97, 95%CI: 2.32, 6.81), and fear of having a positive result (AOR = 2.60, 95% CI: 1.55, 4.36); the burden of family size was marginally significant at 0.05 level of significance (P = 0.075). Conclusion: The prevalence of anxiety problems among voluntary counseling and HIV testing clients of Addis Ababa governmental health centers was high. Fear of stigma, fear of having a positive result, and no history of a test before were the most factors associated with anxiety disorders. I recommended that increasing awareness in reducing stigma/discrimination, appropriate psychiatry counseling for individuals and community at the health center, and Addis Ababa Health Bureau should be arranged.

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.

Factors influencing the acceptability of HIV/AIDS voluntary counselling and testing: a quantitative study of 41336 female university students in China

This study shows that there is a huge gap between young females' willingness and practice of accepting voluntary counselling and testing (VCT). Only 2.16% (894/41336) of the participants have had HIV/AIDS tests. The study identified age, education major, confidentiality, attitude, accuracy, self-assessment and expense as major factors associated with young female people's acceptance of VCT in China. Therefore, in order to promote HIV VCT among young females, it is necessary for future programs to be sensitive to the targeted population's needs.

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.

HIV testing uptake among pregnant women attending private midwife clinics: challenges of scaling up universal HIV testing at the private sectors in Indonesia.

Being ranked seventh among countries with the highest number of new pediatric HIV infection, around 3% of new pediatric HIV infection worldwide occurs in Indonesia. UNAIDS has set a goal of elimination of mother-to-child HIV transmission, and private sector plays a critical role in achieving this goal. More than half of pregnant women in Indonesia seek antenatal care (ANC) services at private sectors, particularly at private midwife clinics. However, no published data is available on the rates of HIV testing uptake among pregnant women at these clinics, reflecting important gap on prevention of mother to childHIV transmission programmatic data. A longitudinal study was conducted to examine the rates of HIV testing uptake among pregnant women attending private midwife clinics in Bali and were referred to Voluntary HIV counselling and testing (VCT) clinics for a HIV test. Seventy midwives from private clinics were asked to suggest women, who were deemed to be at risk of HIV, to seek HIV testing at the nominated VCT clinics and to provide the women with a referral. Data were then analyzed to identify the percentage of women who took HIV testing at the VCT clinics among those referred by the midwives. The midwives referred 619 women to VCT clinics. Of the referred women, only 321 (52%; 95% CI, 47.8%-55.9%) took a HIV test at the appointed clinics. Among these who tested, three (0.9%) were HIV positive. This study identified a challenge in scaling up HIV testing coverage among women seeking ANC services at private sectors. Implications and recommendations are discussed.

610. Barriers and Facilitators to Uptake of Male Partner Attendance for HIV VCT During Prenatal Care in Brazil

BackgroundMale partner involvement in sub-Saharan Africa has been investigated and shown to improve outcomes for the entire family. However, little research is available in other regions. In Porto Alegre, Brazil, partners of pregnant women are encouraged to attend prenatal care for HIV voluntary counseling and testing (VCT) to decrease acute HIV serconversion during pregnancy. Uptake of this intervention has been sub-optimal.MethodsFrom November 2016 to July 2017, 202 men who attended prenatal care at Hospital Conceicao and 201 men who did not attend prenatal care were interviewed using computer-assisted telephone interviews regarding individual, relationship and system-wide facilitators and barriers to attending prenatal care. Multivariate regression was performed to identify factors associated with male involvement in prenatal care.ResultsOf 403 men interviewed, 91% stated they had been invited to prenatal care, 94% of men stated they would accept HIV testing if offered, but only 50% attended. Men identified making their partner happy as the most important facilitator for prenatal care attendance, and having to miss work as the most significant barrier. Frequency of commonly identified barriers and facilities are indicated by Figure 1. Individual factors that predicted prenatal care attendance included over-estimating the risk of mother-to-child transmission (AOR 2.1 95% CI 1.3–3.3), and endorsing that HIV-infected individuals can live satisfying lives (AOR 7.8, 95% CI 2.1–50.8). Partnership factors associated with attendance included being invited by partner (AOR 5.6, 95% CI 2.4–15.6), whereas admitting jealous behavior was negatively associated with attendance (AOR 0.82 95% CI 0.7–0.97). Systemic factors negatively associated with prenatal care attendance included a history of not affording medical care (AOR 0.28, 95% CI 0.15–0.55) and identifying work as a barrier (AOR 0.19 95% CI 0.11–0.31).ConclusionInvolvement of male partners during pregnancy may be enhanced by providing free care during flexible hours. Partners should be actively invited to prenatal care as once involved, almost all would accept HIV VCT and other interventions to protect partners and infants from HIV and other sexually transmitted diseases during this vulnerable period. Disclosures All authors: No reported disclosures.

The Intention of Men Who Have Sex With Men to Participate in Voluntary Counseling and HIV Testing and Access Free Condoms in Indonesia.

This study aimed to identify factors that influenced the intention of men who have sex with men (MSM) to participate in voluntary counseling and HIV testing (VCT) and in accessing free condoms. A qualitative inquiry using one-on-one in-depth interviews was conducted with MSM participants who were recruited using a purposive sampling technique. Data analysis was guided by a framework analysis for qualitative data by Ritchie and Spencer, and the Theory of Planned Behavior (TPB) framework was used to analyze the data. The findings were grouped into three themes—namely, (a) attitude encompassing knowledge about HIV/AIDS and HIV/AIDS services and the belief about the positive outcomes of the services; (b) subjective norms including support from MSM peers and family members and motivation to comply with the support; and (c) perceived behavioral control, which is associated with resource availability and having confidence and positive intention to participate in VCT and willingness to access free condoms. Findings indicated that personal, community, and structural factors were predictors to intention to accessing services. Interventions targeting large numbers of MSM population and further studies to understand what needs to be done by nongovernmental organizations and governmental institutions to halt the spread of HIV infections among MSM populations and increase their intention to use HIV/AIDS services are also recommended.

Co-infections of HIV, syphilis and HSV-2 among men who have sex with men at the voluntary HIV counseling and testing clinics in Shanghai

Objective: To understand the prevalence rates of HIV-syphilis and HIV-herpes simplex virus 2 (HSV-2) co-infections and related factors among men having sex with men (MSM) who had visited the voluntary HIV counseling and testing (VCT) clinics in Shanghai, China. Methods: 756 eligible MSM who attended the VCT clinics of Shanghai Municipality and Putuo district during March to August, 2015 were recruited to participate in a cross-sectional survey with questionnaire interview and blood testing for HIV, syphilis and HSV-2. Results: A total of 732 participants completed a valid questionnaire survey. The prevalence rates were 3.3% (24/732) for HIV/Syphilis co-infection, 1.9% (14/732) for HIV/HSV-2 co-infection, and 0.7% (5/732) for HIV/Syphilis/HSV-2 co-infection, respectively. HIV prevalence appeared significantly higher among syphilis-infected participants (45.3%, 24/53) than those without Syphilis (7.2%, 61/679) (χ(2)=63.11, P<0.001), and was also significantly higher among HSV-2 infected participants (34.1%, 14/41) than those without the HSV-2 infection (10.3%, 71/691) (χ(2)=21.49, P<0.001). Results from the Multivariate regression analysis indicated that participants who were migrants (OR=3.50, 95%CI: 1.01-12.17), having had middle school or lower levels of education (OR=4.46, 95%CI: 1.54-12.87) or ever used illicit drugs (OR=4.25, 95%CI: 1.67-10.82, P=0.002) were under possible risks on HIV and Syphilis co-infection. Those participants who had high middle school or lower levels of education (OR=6.87, 95%CI: 1.86-25.42; OR=9.82, 95%CI: 2.25-42.85) were under risk on HIV and HSV-2 co-infection. Conclusion: HIV/Syphilis and HIV/HSV-2 co-infection were seen among MSM who attended the VCT clinics in Shanghai that called for special attention, especially on migrants, those with low education or illicit drug users.

English

Voluntary counseling and testing (VCT) for HIV is essential and critical way for prevention, care and treatment of HIV. It allows early detection of illness, reducing transmission, morbidity and mortality from it. But youth knowledge and attitude towards HIV testing services is not universal. The aim of this study was to assess knowledge, attitude, practice and factors associated with VCT for HIV among University Students in Ethiopia. Institution based cross sectional study was conducted among University students in Ethiopia using pretested, structured self-administered questionnaire. Single proportion formula was used to calculate the sample size (361). Multistage sampling with stratified sampling technique was used. Data was analyzed using SPSS version 16.0 with chi square test, bi-variate and multivariate analysis via OR, AOR, p-value and confidence interval. Binary logistic regression was used. Out of 361 sample 93.6% of them responded, with 178 (52.7%) male and most are below 25 years. Majority were single, orthodox in religion, and from urban residence. 86% of them have heard of voluntary testing for HIV and know that having early test will prevent future spread of HIV. Based on the scoring 66% are knowledgeable about VCT. Almost 60% of participants were willing to undergo the test and 80% advices their friends to have test. Also 40.5% had good attitude toward test for HIV and 65.7 and 29.6% were ever tested and tested in the previous year respectively. Fear of HIV test results, stigma, and service related factors were major barriers for testing. Being male (AOR=1.607, CI: (1.01-2.57) p value= 0.047) and first year (AOR= 3.25, 1.33 &ndash; 8.83) were significantly had lower odds of being knowledgeable than females and seniors respectively. Those who were not knowledgeable have two times odd of poor attitude (AOR=1.901(1.20-3.02) P=0.006)). Students from urban (AOR=2.088, CI: (1.273- 3.425) P=0.004), unseparated family (AOR=2.24CI: (1.02-4.92) P=0.045) and with poor attitude (AOR= 1.76 CI: (1.08-2.89) p=0.024) were more likely not to have test than counterparts. Knowledge and attitude towards HIV testing is not satisfactory. Freshman students are the target for behavioral interventions. Improving awareness and attitude of students through peer to peer discussion and other packages is crucial to increase the practice and ultimately combat HIV in higher institutions. Key words: Attitude, HIV/AIDS, Knowledge, University, voluntary counseling and testing (VCT), associated factors.

Barriers and facilitators for men to attend prenatal care and obtain HIV voluntary counseling and testing in Brazil.

BackgroundProviding HIV voluntary counseling and testing (VCT) to men who attend their partner's prenatal care is an intervention with potential to reduce HIV transmission to women and infants during the vulnerable period of pregnancy. Little is known about the acceptability of this intervention in global settings outside of Africa.MethodsWe conducted in-depth qualitative interviews to evaluate potential barriers and facilitators to prenatal care attendance for HIV VCT with 20 men who did and 15 men who did not attend prenatal care with their partners at Hospital Conceiçao in Porto Alegre, Brazil. Men were recruited at the labor and delivery unit at Hospital Conceiçao via a scripted invitation while visiting their newborn infant. Interviews lasted from 35–55 minutes and were conducted in Portuguese by a local resident trained extensively in qualitative methods. All interviews were transcribed verbatim, translated, and then analyzed using Atlast.ti software. An analysis of themes was then conducted using direct quotes and statements. We applied and adapted the AIDS Risk Reduction Theoretical Model and HIV Testing Decisions Model to the qualitative data to identify themes in the 35 interviews.ResultsIf offered HIV testing during prenatal care, all men in both groups stated they would accept this intervention. Yet, individual, relationship and systemic factors were identified that affect these Brazilian men's decision to attend prenatal care, informing our final conceptual model. The men interviewed had a general understanding of the value of HIV prevention of mother to child transmission. They also described open and communicative relationships with their significant others and displayed a high level of enthusiasm towards optimizing the health of their expanding family. The major barriers to attending prenatal care included perceived stigma against HIV infected individuals, men’s lack of involvement in planning of the pregnancy as well as inconvenient scheduling of prenatal care, due to conflicting work schedules.ConclusionsBrazilian men displayed high levels of HIV-related knowledge as well as open communication about HIV testing; especially when compared to findings from African studies. Future efforts should reorient prenatal care towards providing care to the entire family with a clear focus on protecting the infant from preventable diseases. Formally inviting men to prenatal care and providing them an acceptable medical excuse from work may enhance male involvement.

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.

Evaluation of the integrated clinic model for HIV/AIDS services in Ho Chi Minh City, Viet Nam, 2013–2014

Setting: Ho Chi Minh City (HCMC), Viet Nam. Objective: To evaluate a new integrated service model for human immunodeficiency virus/acquired immune-deficiency syndrome (HIV/AIDS) care. Design: In HCMC, co-located services, including voluntary HIV counseling and testing (VCT), HIV treatment at out-patient clinics (OPC), and methadone maintenance therapy (MMT) for persons who inject drugs, have operated under different administrative structures. In the context of decreasing international financial support, integration of these services into one administrative structure with reduced staff occurred in seven districts in HCMC between October 2013 and June 2014. We used a pre-post study design to compare service-related outcomes from routinely collected data at health facilities 6 months before and 6 months after integration. Results: The proportion of HIV-infected persons linked from VCT to OPCs was unchanged or increased following integration. A higher percentage of patients eligible for antiretroviral therapy (ART) were started on ART. The proportion of ART patients lost to follow-up remained unchanged. The proportions of MMT patients who tested positive for heroin or other substances decreased or were unchanged. Conclusions: VCT, OPC and MMT service delivery quality remained the same or improved during the 6 months following the integration. Expansion of the integrated model should be considered for HIV-related services.