Factors influencing uptake of HIV counselling and testing services among TB patients in Mityana District

Abstract

Introduction: Uganda, one of the 22 high burdened countries estimates 50-70% of TB patients are co-infected with HIV (MoH 2006). In 2006, the MoH disseminated a policy on TB/HIV collaborative activities. In 2006, Mityana District integrated TB/HIV activities in the health service delivery in 10 health facilities, but only 23% of the TB patients utilized HCT services (District HMIS 2006).

Objectives: The study established factors influencing uptake of HCT services among TB patients in Mityana District in order to enable the DHT formulate appropriate strategies to increase uptake of HCT services among TB patients.

Methodology: A cross sectional study that employed quantitative and qualitative methods of data collection was conducted in 5 health facilities (purposively selected) from November 2008 to March 2009. A total of 227 adult TB patients were enrolled for the study in health facilities and communities, and interviewed using a semi structured questionnaire. Key informant (KI) interviews were conducted. Quantitative data was analyzed using SPSS version 12.0 presented in tables, figures and text. Bivariate and multivariate data analysis determined independent predictors of uptake of HCT. Qualitative data was analyzed using a master sheet presented in text form.

Results: Most of the respondents had ever taken an HIV test (76.2%), health worker providing an opportunity for testing as the strongest predictor of uptake of an HIV test (Adj. OR 0.19, 95% CI; 0.054-0.698). Only (24.8%) had never tested for HIV mainly due to lack of physical illness (25/54, 46.3%), long distance (9/54, 16.7%) and fear of an HIV test ((9/54, 16.7%). One of the health service delivery factors that motivated uptake of HCT was introduction of routine HIV counseling and testing (RCT) in health services delivery.

Conclusions and recommendations: Individual factors and health service delivery factors were the major facilitating factors to increased uptake of HCT services in Mityana District. Further integration of TB/HIV services at health facility and community level, integration of anti stigma and discrimination initiatives in the TB/HIV collaborative activities may lead to further improvement in uptake of HCT among TB patients in Mityana District.