Assessment of Utilization and Determinants of Voluntary Counseling and Testing for HIV in the Armed Forces of Ethiopia
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Date
2006-10
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Addis Ababa University
Abstract
Military personnel are among the core groups most at risk to HIV acquisition and transmission
because of their occupation and lifestyle. Available data shows that voluntary counseling and
testing for HIV uptake was low in the members of Ethiopian army. It is known that VCT for
HIV is crucial strategy for HIV prevention. Therefore, identifying rate of VCT and factors
correlated with low uptake in the army could intensify the national responses to the HIV
pandemic.
A cross-sectional survey was conducted on randomly selected 917 male army members of
randomly selected Division of Northern command, deployed in Eastern Tigray about 900km
north to Addis Ababa in October 2006. After data was collected, using pre-tested structured and
standard questionnaire, cleaned, entered and analyzed using SPSS. Odds ratio with 95 %
confidence interval was used to test statistical significance and degree of association.
The median age of respondents was 28(±5.6), with age range from 18-47 years. The majority of
participants 567(61.8%) were between 18–29 years of age. Almost 99% of the participants were
literate, and 441(48.1%) were ever married and the median age at first marriage was 25 years.
The data showed that 430(46.9%) of all participants were tested for HIV of which 421 were
through VCT. The data also revealed that VCT utilization rate in the study subjects was 45.9%.
The most common reason for VCT was ‘to know self’, 86.2%. All participants who had VCT
were satisfied with the service given. Among 487 HIV non-tested participants the reasons given
for non-uptake of VCT were no near by service 38.8%, afraid to get test result 33.9%, fear of
stigma 17.7%, and partner and/or self-trust 13.8%.
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Using multiple logistic regression analysis, controlling for various demographic characteristics,
as well as behavioral, cognitive, social, and VCT service related factors; it was found that
soldiers with the following characteristics were most likely to have undergone VCT. Those who
discussed HIV/AIDS with in the family, those who ever had sexual contact, those who knew a
person infected with HIV or died of AIDS, those who were knowledgeable about the uses of
VCT, and those who had non-stigmatizing attitude towards PLWHA. On the other hand it was
found that soldiers with the following characteristics were less likely to have undergone VCT:
those who were currently not married but living with sexual partner, those who had uncertainty
about their HIV status, and those who preferred integrated VCT clinics located in the civilian
health institution.
This study shown that rate of VCT utilization in the army is increasing and many variables
shown correlation with VCT-uptake. Therefore, we recommend that interventions be aimed at
those variables suggesting causation and to scale up VCT services. Furthermore, we recommend
that qualitative research be conducted to identify which of these correlations have a causal
relationship to VCT-uptake
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Keywords
HIV/AIDS