Assessment of VCT Utilization, and Willingness to Accept Provider-Initiated HIV Counseling and Testing among Tuberculosis Patients in Addis Ababa

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Addis Abeba Universty


Addis Ababa City Administration Health Bureau is recently implementing Provider Initiated HIV Counseling and Testing (PIHCT) in response to the high HIV prevalence among TB patients, and in an attempt to increase the uptake of HIV testing and ART. However, there has not been precise information pertaining to the Voluntary counseling and testing (VCT) utilization status by tuberculosis (TB) patients. This study was conducted in June 2006 to assess VCT utilization rate, perceived barriers for HIV testing, and willingness for PIHCT among TB patients in Addis Ababa. Facility-based, cross-sectional study was conducted and 423 TB patients interviewed. A stratified two stage sampling method was used for the selection of study subjects. In the first stage of sampling, eight health centers were selected by simple random sampling. In the second stage of sampling, patients were systematically selected in each selected health center. The study had used quantitative and qualitative data collection methods. The prevalence of self reported HIV testing among sampled TB patients was 57%. Adjusted correlates of HIV testing include primary education (AOR=2.04, 95% CI=1.03-4.06), being merchant (AOR=5.67, 95% CI=1.56-20.60), had moderate HIV risk perception (AOR=5.30, 95% CI=1.67-16.82), and high-HIV risk perception (AOR=4.38, 95% CI=1.32-14.55). Patients who had willingness for PIHCT found more likely to have been tested for HIV (AOR=2.32, 95% CI=1.23-4.36). While experiences with client and provider-initiated HIV testing overall were positive, 86.2% of the patients were willing for PIHCT. The only adjusted correlates of willingness for PIHCT were being older age group (AOR=4.16; 95% CI= 1.59-10.81), and had demand for HIV testing (AOR=29.13; 95% CI =13.83-61.32). vi Key testing barriers include self trust (41.1%), lack of risk perception for HIV infection (24.4%), fear of learning positive result (13.9%), and stigma and discrimination attached to TB and HIV as identified in focus group discussions. Early evidence of widespread support for PIHCT and moderate acceptance of HIV testing in this study holds significant promise for the control, prevention and treatment of HIV/AIDS and TB. Concerted efforts to scale up PIHCT, however, must be accompanied by intensive IEC on TB /HIV along with tackling of testing barriers.



Assessment of VCT Utilization, and Willingness