Utilization of HIV counseling and testing services among adolescents in Arua Municipality, Arua district: a case control study

Abstract

Introduction and Background: An estimated 35 million people were living with HIV worldwide in 2012. Almost 40% of the 6,800 new HIV infections each day are among adolescents. HIV counseling and testing remains low as only 40% of Ugandans know their HIV status. This may be an indication that utilization of HIV prevention services by the general population of which the adolescents are part is low. In Arua Municipality, the factors which affect the utilization of HCT services are not well documented. Objectives: This study aimed to determine the individual, community and service delivery factors affecting utilization of HIV counseling and testing services among adolescents in Arua Municipality. Materials and Methods: An un-matched case control study with a case to control ratio of 1:2. Adolescents 14-19 years (n=269) were interviewed using semi-structured questionnaires. Cases were sexually active adolescents who had received an HIV test ( were counseled, tested and received results) while controls were sexually active adolescents who had not received an HIV test (not counseled, not tested and not received results) .Observation checklists were also used to examine some health system factors. Key Informant interviews were conducted to augment the results of quantitative data. Results: Data was entered using EPI Info 2000 and analyzed using STATA 12.0.A total of 90 cases and 179 controls was analyzed. There were 127 males compared to 142 females. The mean age of cases was 17.3 years (s.d=0.16) compared to 16.6 years (s.d=0.12) for controls. Multivariable logistic regression results show being female [OR 0.38 CI (0.18-0.79) p (0.010)]; having low knowledge of HIV prevention services [OR 0.37 CI (0.17-0.82) p (0.014)], lack of a xiii trained peer counselor [OR 0.34, CI (0.12-0.93) p (0.036)] and not being tested in the last 6 months [OR 0.09 CI (0.04-0.21) p (0.000)] were significantly associated with not having an HIV test. Conclusions and Recommendations There is need for sensitization of adolescents on comprehensive knowledge of HIV prevention services using channels like mass media, sex education in schools and parents. There is also need to train peer counselors to provide adolescent friendly services that will increase utilization of HCT services. Encouraging both men and women in this age group to go for regular HIV testing is critical in increasing utilization of HCT services.