Factors affecting uptake of voluntary counselling and testing services among youth in Rukungiri District, Uganda.

Abstract

Introduction: Globally 10 million youth are living with HIV with an estimated 2.5 million new HIV infections occurring each year, 63% live in sub Saharan Africa. Uganda has about 1 million people living with HIV/AIDS; the prevalence of HIV among youth is 6.7%-9.0% in females and 2.6%-5.0% in male youths. In Rukungiri district HIV prevalence is 11.7%, HIV Voluntary Counseling and Testing uptake among the youth is still poor at 2% and the factors responsible for this low uptake are not entirely clear. Objective: To explore uptake of Voluntary HIV Counseling and Testing among youth in Rukungiri.

Methods: This was a cross sectional study conducted in Rukungiri district employing both quantitative and qualitative methods of data collection. Multistage sampling at subcounty, parish and village levels was used to select study subjects. A total of 288 youths were interviewed. Semi structured questionnaires were used for quantitative data and FGD guide for qualitative data. Data was coded, entered and analyzed using Epi-info 3.2.2 version and SPSS soft ware. Univariate analysis was carried out and descriptions of respondents made. Bivariable analysis was done for associations between independent and dependent variables. Odds ratios were used to determine the associations at 95% confidence interval. Multi-variable analysis was applied to variables that were significant after bivariable analysis. Since some of the independent variables were nominal and others numeric with a binary outcome variable logistic regression model was used in order to identify independent variables that are significant while controlling for confounding and checking for effect modification. Master sheet analysis was used for the qualitative data.

Results: The study showed that 25% of the youth, comprising 12.8% of female and12.2% of male respondents had taken an HIV test. Factors associated with uptake of voluntary counseling and testing were having knowledge of place where VCT service are offered (OR=13.7, 95% CI 1.20-158.1,p=0.035) , the distance to the nearest health facility (OR =2.2, 95% CI 1.1 - 4.3, p=0.024) , youth with informal employment (OR= 4.0, 95% CI 1.2 - 13.2,p=0.02) and peers encouragement (OR= 6.7, 95% CI 3.2- 14.1,p=0.000 )

Conclusions: A quarter of the youth in the district have had voluntary counseling and testing services and factors that promote uptake include awareness of place and proximity, encouragement by peers and employment status.

Recommendations: The DHT should develop information education communication materials and use local media to increase awareness of the service and offer VCT outreach services to target in schools and out of school youths. Youths should encourage peers to go for voluntary counseling and testing. The DHT should train peers and facilitate peer groups and have refresher courses to the counselors on VCT, to enable them offer youth friendly services.