FACTORS AFFECTING UPTAKE OF HIV COUNSELLING AND TESTING AMONG ADULTS

(A CASE STUDY OF BUNKURE LGA KANO STATE)

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Author

Presented To

Department of Medicine

ABSTRACT
HIV Counseling and Testing play a vital role in HIV prevention and control as an entry point of care and support. Globally > 6,800 people became infected and > 5,700 die from AIDS daily, mostly because they have no access to HIV services. In sub-Saharan Africa, most infection occurs due to heterosexual intercourse leading to mother –to- child transmission. In Nigeria, heterosexual sex remains the primary mode of transmission; 80-95%, yet uptake of HIV Testing services was low in Bunkure; 1.2 % in 2015, only 2 centers for PMTCT , one offers HCT, ART and PMTCT. In 2013, Bunkure was ranked 44 out of 44 LGAs in terms of PMTCT, due to 100% absent of HIV services with prevalence of 3.4% and 354 HIV positive pregnant women. The study aimed at determining individual, community and health facility factors affecting HCT uptake in Bunkure. A cross sectional descriptive study was used to select 350 adults using multistage sampling technique. Data was collected using a pre-tested interviewer administered questionnaire and analyzed using Epi-info. Univariate analysis showed age range of 16-62years, mean of 34.5yrs ±10.9, 51.4% were female, about 60% had no formal education, >70% were Hausa farmers and traders, 75% were aware of HCT site in Bunkure, 60% had information through health worker and 79% were willing to do the test although uptake of HCT was 19% due to cultural belief (73%), stigmatization (86%), fear of test (70.5%), location of facility (90.1%), distance (83.1%) and confidentiality (65.2%). Bivariate analysis showed association between uptake of HCT and gender in favor of female (OR 0.3 CI 0.19-0.6 p<0.05), education (OR 2.0, CI 1.2-3.4 p=0.01), Awareness of HCT site (OR 0.9 CI 2.8-30.7 p<0.05), and Willingness to do the test (OR 22.8 CI 3.1-167.6 p<0.05), stigmatization (OR 0.2, CI 0.1-0.3 p<0.05) and fear of test (OR 0.3, CI 0.2-0.5, p<0.05). On logistic regression, tertiary education/ none (p= 0.02), gender male/female (0.00) knowledge of site of HCT (p=0.0002) and stigmatization (p=0.00) were statistically significant. Less than a quarter of adults in Bunkure obtained HIV testing services, being female, having attained tertiary level of education and being aware of HCT site enhanced uptake, and although willingness to do the test was high, stigmatization hindered uptake while health facility factors were not likely. The community, Government and supporting agencies should collaborate in creating awareness and funding research to improve HIV uptake from 19% to 40% by the end of 2018 and PEPFAR target of 90-90-90 model for interruption of HIV transmission by the year 2020. Key words: Factors, uptake, HIV counselling and testing, adults.