Effect of Community Conversation towards VCT Utilization in Rural SNNPR.

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Addis Abeba University


Background information: In contrast to, many initiatives implemented to prevent HIV/AIDS infection; many countries have not so far achieved the planned reduction in HIV/AIDS infection; the main reason mentioned so far being low utilization of VCT for HIV/AIDS. Community Conversation (CC) is a community based strategy meant to enhance the community to utilize VCT for HIV among many other functions. Objective: This study is aimed to determine the disparity in knowledge, attitude and practice towards VCT service utilization of population 15-59 years age, between well and poor community conversation performing rural kebeles of Shebe Dino woreda, SNNPR. Methodology: A cross sectional comparative community based study design was employed to compare the knowledge, attitude and practice towards VCT service among 15-59 years age population between poor and well community conversation performing rural kebeles in Shebe Dino woreda, from August 2010-May 2011. Kebeles were classified as poor or well based on their community conversation performance. A total of 6 kebeles (3 from each CC group) were selected by lottery method after stratifying each CC groups into three strata by their relative distance from the Woreda capital. The number of study participants sampled from each kebele is proportional to the size of study population in the kebele. A total sample of size 462, 231 (50%) from each comparative group were selected and studied. The qualitative data was collected from Focused Group Discussion and analyzed by thematic analysis. A hierarchical logistic regression model was used to determine independent predictors of VCT uptake in blocks of two at 95% CI. Result: The two CC groups were homogeneous in their major socio demographic factors using two sample test of proportion (P>0.05), and hence were comparable. VCT Knowledge didn’t show statistically significant difference between well and poor CC performing kebeles, with a two sample proportion test of difference and 95% CI: 0.05 (-0.04, 0.14). But, attitude and utilization of VCT service was statistically higher in well CC performing kebeles than poor CC performing kebeles (73.0% vs.54.1%, P < 0.001) and (97.8 vs. 93.8, P=0.034) respectively. Age group between 15-24 years, single, trader, knowledgeable about HIV transmissions, and positive attitude to VCT services were independent predictors of VCT service utilization. Conclusion: Proportion of study participants’ with positive attitude towards VCT and practice of VCT service utilization was higher in a well CC group compared to a poor CC kebeles. However the study population in the two CC groups is not different by their knowledge towards VCT service (i.e. CC does have effect on VCT attitude and practice but not on knowledge).VCT service utilization depends on one’s age, occupation, marital status and knowledge of HIV transmission. Therefore, there should be consistent monitoring and evaluation of the CC program, not only by the criteria in use but also in terms of its effect on KAP of the target population towards VCT and or HIV to strengthen CC in all CC kebeles.



SNNPR, Shebe Dino woreda, knowledge, attitude and practice, VCT, well and poor community conversation performance