An Analysis of Uptake in HIV Voluntary Counselling and Testing Services: Case of Mount Kenya University Students, Kenya

摘要

Early testing for HIV/AIDS offers many benefits for young people but in many countries it is still rare. Where services are still fairly low as in Kenya, people may feel that the risks of knowing and disclosing their sero-status outweigh the benefits; hence one important challenge in addressing the needs of young people lies in understanding the extent to which the young people know about and use protective measures against the risks. VCT is a key intervention in HIV prevention. Being a prevention program VCT seeks to initiate behaviour change yet its uptake is still wanting. Data from the Mount Kenya University HIV/AIDS open day carried out at the main campus in 2010 by LVCT showed that only 18.4% of the students had VCT. Currently, despite 90% of HIV prevention programs targeting the youth, VCT is not taken by all. The rate of HIV VCT among the youth is persistently low with studies showing that only a small proportion of youth have undergone VCT in Kenya. Although there is high awareness among the youth with majority acknowledging the importance of VCT, there was need to investigate the low uptake of VCT amongst university students. From the Kenya National AIDS Strategic Plan 2005/6 - 2009/10, the national target of having 80% of the population being tested by the year 2010 is yet to be achieved. This makes it necessary to assess the uptake of VCT from time to time and explore ways of increasing its uptake. The study employed a cross sectional survey that was conducted among Mount Kenya University students in Thika district. Multi-stage sampling was used to pick the respondents. Only schools and departments with students from year 1 to year 4 of study were considered. The number of participating students from schools and departments were predetermined by population proportionate allocation with individual study subjects being picked using a table of random numbers. A sample size of 283 respondents was used as determined by Fischer et al equation with the expected VCT uptake of 28%. The data was collected using questionnaires and focus group discussions from October to November, 2011. Processing of data was carried out using the Statistical Package for Social Scientists (SPSS Version 16). Descriptive statistics and frequency tables were used to describe the characteristics of participants while chi-square test was used to test association between dependent variables (knowledge, perception, socio-economic, school-based and programmatic factors) and independent variable (Level of uptake). The data was summarized in tables; and presented using graphs and charts. Odds ratio with 95% confidence intervals was used to show associations and p-value <0.05 was considered a statistically significant level of precision. Qualitatitive data fom FGDs was recorded on note books and content analysis technique was used to summarize the findings . Uptake of VCT services was categorized into two: Uptake (at least one visit ) and no uptake ( no visit). The uptake of VCT services among MKU students is 76% with the three leading reasons for uptake being “To satisfy curiosity”, “To seek early treatment” and “To determine a partner’s degree of faithfulness”. Leading reasons for non-uptake of VCT services are “Fear of a positive result”, “Fear of people finding out” and “Not feeling at risk”. Knowledge of VCT is quite high at 80% with the most common sources of first VCT information being radio, television and open forums. Mothers and Nutrition counseling are important in influencing the uptake of VCT by the students. Majority of the students perceive VCT to be important in the fight against HIV. Majority of the students have a positive attitude toward VCT with over 80% of them willing to go for the service. Age affected VCT uptake with older students being more likely to go for VCT. Religion was associated with VCT uptake with majority of the students who went for VCT being protestant or catholic. School-based factors that influence VCT uptake among MKU students are type of course one is studying and year of study; with the final year students having the highest rate of uptake of VCT while pharmacy students have the lowest rate of VCT uptake. The key programmatic factors that influence VCT uptake are quality of services, location and appearance of VCT center. From the findings of this study, there is need to review the design and location of VCT centers targeting the youth to make them more youth friendly. Mount Kenya University can improve VCT service delivery by having the entire health unit staff trained in VCT. This will enable them to provide the service on demand.