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      Knowledge, attitude and practice towards voluntary counseling and testing among university students in North West Ethiopia: a cross sectional study

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          Abstract

          Background

          Voluntary counseling and testing (VCT) is one among different approaches which have been implemented as an attempt to slow the spread of HIV infection and minimize its impact at the individual, family and society level. VCT is perceived to be an effective strategy in risk reduction among sexually active young people like tertiary level students. Ethiopia as a country with high burden of HIV started responding to the epidemic by preparing and updating guidelines on VCT. The objective of this study was to assess the level of knowledge, attitude and practice of Voluntary Counseling and Testing (VCT) for HIV among university students in North West Ethiopia.

          Methods

          A cross sectional study was conducted from February to May 2010 using a stratified sampling method to enroll students from different faculties into the study. A total of 330 university students filled in a self-administered questionnaire with response rate of 97.3%. Main outcome measures included level of knowledge, attitude and practice of VCT for HIV. A chi-square test was used to determine an association between a number of independent factors and dependant variables.

          Result

          About 66.1% of the study participants were males with a mean age of 20 years. Majority (75.6%) of the respondents were Orthodox with 63% reported living in urban areas before joining the university. From the study participants 86.3% were knowledgeable on VCT, 73.3% had positive attitude towards VCT for HIV and 61.8% had had VCT for HIV in the past. Previous residence before joining the university, level of education, sex and religion were among the sociodemographic variables that showed statistically significant association with the one or more of the outcome variables. Fear of positive results, stigma and discrimination following the positive results were reported as main barriers for VCT uptake.

          Conclusion

          The findings reveal important barriers for VCT uptake and suggest strategies to reduce stigma and discrimination.

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          Most cited references12

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          Fear of stigmatization as barrier to voluntary HIV counselling and testing in South Africa.

          Arjan Bos, Hans E Onya, Herman Schaalma … (2008)
          The objective of this qualitative study was to identify psychosocial correlates of HIV voluntary counselling and testing (VCT), with an emphasis on the association between fear of AIDS-related stigma and willingness to have an HIV test. The study was executed in Limpopo Province at University of Limpopo, Polokwane, South Africa. Focus group interviews were held among 72 students, divided over 10 groups. Results showed that participants had different levels of knowledge about HIV/AIDS and VCT, and that AIDS was still strongly associated with 'death'. Results further demonstrate that HIV/AIDS related stigma is still a very serious problem in South Africa. Lack of HIV/AIDS related knowledge, blaming persons with HIV/AIDS for their infection, and the life-threatening character of the disease were seen as the most important determinants of AIDS-related stigma. The main benefit to go for VCT was 'knowing your HIV status', whereas main barriers for testing were 'fear of being stigmatised' and 'fear of knowing your HIV positive status'. Fear of stigmatization is an important barrier to HIV testing and has negative consequences for AIDS prevention and treatment. Interventions to reduce HIV-related stigma are needed in order to foster voluntary HIV counselling and testing in South Africa
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            The first postmodern pandemic: 25 years of HIV/ AIDS.

            L O Kallings (2008)
            Science responded to the challenge of AIDS by rapidly identifying aetiology, describing pathogenesis and transmission routes, and developing diagnostic tests and treatment. However, this did not prevent the global spread of HIV, with 25 million fatal cases so far, another 33 million infected, and disastrous socioeconomic and demographic consequences. In spite of unprecedented political attention and financial resources, the response is falling further behind the growth of the epidemic. This is partly due to the unique characteristics of the virus, such as persistent infection, vertical transmission and a variability that allows it to escape immunity and antiretroviral drugs, and partly due to human characteristics such as a strong procreative instinct, drug use and ostracism. Denial, myths and complacency are major obstacles to rational measures. With no cure or vaccine in sight, scaling up prevention is of paramount importance. To meet the goal of universal access to prevention, treatment and care by 2010 would require a quadrupling of funding to an estimated US$42 billion by 2010, including adequate overall strengthening of healthcare systems, but in any case, the world will have to learn to live with HIV for the foreseeable future.
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              Acceptance of and barriers to voluntary HIV counselling and testing among adults in Guizhou province, China.

              Wei Ma, Roger Detels, Zunyou Wu … (2007)
              To find and compare the levels of acceptance of and barriers to voluntary counselling and testing (VCT) among adults in two different counties of Guizhou province, China, one in which the China CARES project was operating and the other in which it was not. A longitudinal design with two-stage cluster sampling was employed. A total of 1012 participants were recruited in the two counties. All participants were interviewed, then given a coupon for free VCT after the interview. Participants were paid for returning the coupon within 2 months, whether tested or not. The uptake of VCT was measured within 2 months after the interview. The study found that the levels of HIV/AIDS knowledge and acceptability of VCT among the adults in both counties were low. Although 459 participants (43.5%) expressed an intent to use the VCT services, only 193 (16.5%) actually visited the VCT facilities, and only 42 (3.7%) actually took an HIV test within 2 months after the interview. The use of VCT was related to occupation, age, transportation difficulties, health status, ethnicity, and high-risk behaviors. The main barriers to HIV testing included perceiving oneself as low risk, fear of unsolicited disclosure, and fear of stigma and discrimination that would result from taking the test. Education about HIV/AIDS and VCT needs to be improved, and levels of stigma and discrimination reduced, in order to enhance the uptake of VCT services, an essential step for the initiation of treatment.
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                Author and article information

                Journal
                Journal ID (nlm-ta): BMC Public Health
                Journal ID (iso-abbrev): BMC Public Health
                Title: BMC Public Health
                Publisher: BioMed Central
                ISSN (Electronic): 1471-2458
                Publication date Collection: 2013
                Publication date (Electronic): 2 August 2013
                Volume: 13
                Page: 714
                Affiliations
                [1 ]University of Gondar, College of Medicine and Health Science, School of Biomedical and Laboratory Sciences, P.O. Box 196, Gondar, Ethiopia
                [2 ]University of Gondar, Hospital Laboratory, P.O. Box 196, Gondar, Ethiopia
                Article
                Publisher ID: 1471-2458-13-714
                DOI: 10.1186/1471-2458-13-714
                PMC ID: 3750598
                PubMed ID: 23914738
                SO-VID: 348dc6f4-dbcf-4190-92a2-90c136d99f95
                Copyright © Copyright ©2013 Addis et al.; licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 8 March 2012
                Date accepted : 1 August 2013
                Categories
                Subject: Research Article

                ScienceOpen disciplines: Public health
                Keywords: voluntary counseling and testing,knowledge,attitude,practice
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: voluntary counseling and testing, knowledge, attitude, practice

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