Determinants of HIV voluntary counseling and testing: a multilevel modelling of the Ethiopian Demographic and Health Survey

Background Human immunodeficiency virus (HIV) counseling and testing services are vital to reduce the spread of HIV infection, and to create an opportunity for early treatment and reduction of HIV/AIDS-related mortality. However, only 12 sub-Saharan African (SSA) countries reached the first 90% target (90% of people living with HIV to know their status). Hence, this study aimed to investigate the determinants of HIV counseling and testing among reproductive-age women in Ethiopia. Methods Ethiopian Demographic and Health Survey (EDHS 2016) data was used to identify the determinants of HIV counseling and testing among reproductive-age women in Ethiopia. A weighted sample of 14,599 reproductive age women was included in the study. A multilevel binary logistic regression model was fitted to identify the determinants of HIV counseling and testing. The odds’ ratio with a 95% Confidence Interval (CI) and the corresponding P-value ≤ 0.05 was employed to declare the statistically significant variables. Results In this study, both individual and community-level variables were significantly associated with Voluntary Counseling and Testing (VCT) uptake among women. Women aged 25–34 years (Adjusted Odds Ratio (AOR) 2.29, 95% CI 2.05, 2.56), aged ≥ 35 years (AOR 1.55, 95% CI 1.38, 1.75), attending primary education (AOR 1.68, 95% CI 1.51, 1.88), secondary education (AOR 3.07, 95% CI 2.64, 3.58), and higher education (AOR 5.15, 95% CI 4.17, 6.36), women with medium household wealth (AOR 1.56, 95% CI 1.32, 1.84), richer (AOR 1.88, 95% CI 1.58, 2.24), and richest wealth index (AOR 2.37, 95% CI 1.91, 2.94), having comprehensive knowledge (AOR 1.21, 95% CI 1.06, 1.37), ever married (AOR 3.87, 95% CI 3.46, 4.32), having sexual risky behavior (AOR 2.09, 95% CI 1.69, 2.49), women from communities with high HIV knowledge (AOR 2.03, 95% CI 1.68, 2.45), women from communities with high literacy level (AOR 1.16, 95% CI 1.05, 1.51) and women from communities with high wealth quintile (AOR 1.20, 95% CI 1.03,1.57) had higher odds of VCT uptake. However, those women having stigma (AOR 0.81, 95% CI 0.74, 0.92) had reduced odds of VCT uptake. Conclusion This study revealed that not only individual level factors but also community level factors determine the status of HIV voluntary counseling and testing. Hence, strengthening both individual and community based interventions are crucial to increase the women HIV counseling and testing practice in the country.

What explains gender inequality in HIV infection among high-risk people? A Blinder-Oaxaca decomposition

Background Despite clear evidence on role of gender in vulnerability and exposure to HIV infection, information on gender-related inequalities in HIV and related factors are rarely documented. The aim of this study was to measure gender inequality in HIV infection and its determinates in Tehran city, the capital of Iran. Methods The study used the data of 20,156 medical records of high-risk people who were admitted to Imam Khomeini Voluntary Counseling and Testing site in Tehran from 2004 to 2018. The Blinder-Oaxaca decomposition was used to quantify the contribution of explanatory variables to the gap in the prevalence of HIV infection between female and male. Results The age-adjusted proportion of HIV infection was 9.45% (95%Cl: 9.02, 9.87). The absolute gap in the prevalence of HIV infection between male and female was 4.50% (95% CI: − 5.33, − 3.70%). The Blinder-Oaxaca decomposition indicated that most explanatory factors affecting the differences in HIV infection were job exposure, drug abuse, history of imprisonment, injection drug, heterosexual unsafe sex, and having an HIV-positive spouse. Conclusion The results can provide evidence for health policymakers to better planning and conducting gender-based preventive and screening programs. Policies aiming at promoting HIV preventive behaviors among male may reduce the gap in HIV infection between female and male in Iran.

Intention to Use Voluntary Counseling and Testing Services among College Students

Background: HIV is a health problem of global concern. A large number of HIV cases in Surakarta is due to various factors such as the characteristics of adolescents, knowledge, attitudes, and beliefs to reduce HIV prevention through the use of VCT services. This study aims to analyze the relationship between age, gender, type of study program, information exposure, organizational participation, knowledge, attitudes, and beliefs in using VCT to use Voluntary Counseling and Testing (VCT) services for college students. Method: This research was a quantitative study with a cross-sectional approach. The study population was all students at one university in Surakarta in the 2016-2017 class as many as 12,457 students, while the research sample was 500 students who were taken using a proportional random sampling technique. Data analysis using chi-square test and logistic regression. Results: The results of the multivariate analysis showed that students' knowledge of HIV / AIDS and VCT affected the intention to use VCT services with an OR = 1.776 (CI = 1.170-2.695). The bivariate test results showed that there was a relationship between information exposure (p-value = 0.001), knowledge (p-value = 0.007), attitude (p-value = 0.006) and belief (p-value = 0.013) with the intention to use VCT services. Meanwhile, there was no relationship between age (p-value = 0.118), gender (p-value = 0.579), type of study program (p-value = 1,000), organizational participation (p-value = 0.352) with the intention of using VCT services. Students' knowledge of HIV / AIDS and VCT was the most dominant VCT intention. Therefore, providing information about VCT to students is necessary to increase students' knowledge and confidence in using VCT services.

Hubungan Voluntary Counseling and Testing (VCT) dengan Tingkat Depresi pada Penderita HIV/AIDS

Introduction: VCT counseling is a counseling activity that provides psychological support, information and knowledge of HIV/AIDS and ensures the resolution of various problems related to HIV/AIDS, including the behavior of prisoners in each prison. Methods: This study used a cross sectional design. The number of samples is 56 prisoners or inmates who suffer from HI/AIDS. The research instrument used a questionnaire measuring instrument and statistical tests using the Chi Square test. Results: Depression of HIV/AIDS sufferers in Cipinang Jati Negara Class 1 Prison experienced depression 61% more. The bivariate results showed that there was a relationship between Voluntary Counseling and Testing (VCT) and the level of depression in HIV/AIDS sufferers in Cipinang Jati Negara Jakarta Class 1 Prison with a P-value of 0.009 and an Odds Ratio of 4.63. Discussion: There is a relationship between Voluntary Counseling and Testing (VCT) and the level of depression in HIV/AIDS sufferers at the Class 1 Cipinang Jati State Prison, East Jakarta in 2020.

Evaluation of microalbumin, cystatin c, creatinine and uric acid levels in HIV patients in Nnamdi Azikiwe University Teaching Hospital, Nnewi

This study evaluated the microalbumin, cystatin C, creatinine and uric acid levels in HIV patients in Nnamdi Azikiwe University Teaching Hospital, Nnewi (NAUTH). A total of one hundred (100) male and female HIV positive and control participants who were aged between 18 and 60 years attending the voluntary counseling and testing unit (VCT) and antiretroviral therapy unit (ART) of NAUTH were randomly recruited for the study and grouped thus: Group A (HIV positive symptomatic participants on long term ART (HPSPLTART) (n= 25); Group B (HIV positive symptomatic participants on short term ART (HPSPSTART) (n= 25); Group C: Asymptomatic HIV positive participants NOT on ART (AHPPNART) (n=25) and Group D: control (n=25).6mls of blood sample and 10mls of freshly voided urine samples were collected from each of the participants for the evaluation of biochemical parameters using standard laboratory methods. Results showed significantly higher BMI and SBP in HPSPSTART than in control (p=0.04; 0.02). SBP was significantly higher in HPSPLTART than in AHPPNART and Control (p=0.00). DBP was significantly higher in HPSPLTART than in HPSPSTART and control respectively (p=0.00). There were significantly higher plasma creatinine and Cys-C levels in both male HIV positives and male HIV positive participants on ART than in both females respectively (p0.00; 0.02). Also, BMI, creatinine, uric acid and Cystatin C levels were significantly higher in male HIV negative participants than in female HIV negative participants (p=0.00; 0.04; 0.02; 0.01). This study has revealed greater risk for renal disease among the HIV participants studied.

The Utilization of Voluntary Counseling and Testing Through Support and Family Health Care Functions

Background: The transmission of the Human Immunodeficiency Virus (HIV) from mother to baby is now increasing along with the growing number of HIV-infected women. Approximately 15% of pregnant women living with HIV have accessed antiretroviral (ARV) medicine to prevent transmission of the virus to their babies. Purpose: This study aimed to identify the support and healthcare functions available to pregnant women in using the voluntary counseling test (VCT). Methods: This research was conducted in the working area of Gianyar District health center. The independent variables in this study are family support and family healthcare functions. The dependent variable is the utilization of VCT health service facilities. This study employed a cross-sectional research design. The samples were 108 respondents recruited using a probability sampling technique, namely multi-stage sampling. Bivariate and multivariate analysis were conducted using the chi-square test and logistic regression test. Results: The research variable related to the use of VCT health services with family support showed an odds ratio (OR) = 122, while family healthcare function had an OR = 465. Conclusion: Pregnant women with good family support, good healthcare function, increased maternal age, and early gestational age were more likely to use VCT than when they were in opposite situations.

Forced sexual intercourse and its association with HIV status among people attending HIV Voluntary Counseling and Testing in a healthcare center in Kinshasa (DRC)

Sexual violence, an HIV determinant, is an integrated behavior in the D.R.Congo. We aimed to analyze the prevalence of forced sexual intercourse (FSI) among people receiving HIVVoluntary Counseling and Testing in a hospital in Kinshasa, and its association with sociodemographics, behaviors and HIV status.

Utilization of Family Planning And Volunteer Counseling And Testing Service And Associated Factors Among Preparatory School Students In Arba Minch Town, Southern Ethiopia: A Cross- Sectional Study Design

Background: The utilization of reproductive health service plays important role in preventing youths from different reproductive related health problems. Adolescents in Ethiopia have inadequate access to information and services.Objective: To evaluate utilization of reproductive health service and determinant factors among preparatory school students in Arba Minch town.Method: Institutional based cross sectional study was conducted among randomly selected 541 regular preparatory students in Arba Minch Town. Data was entered and clean into Epidata-4.6 templates then transferred to SPSS-25 statistical software for and analysis. A bi-variable and multivariable logistic regression model was used to identify statistically significant variables of the independent variable. Variables with P-value <0.05, CI 95% in the final model were considered significant determinant variables.Result: Out of those who had sexual intercourse 78.6% and 29.3% of them used family planning and voluntary counseling and testing service respectively. Married adolescents were 4.236 times more likely utilized F/P service than their counterparts (AOR=4.236, 95% CI: 1.182-15.183). The study participants living with both parents were about 1.6 times (AOR=1.645, CI: 1.077-2.513 more likely to use voluntary counseling and testing service compared to those who living with others.Conclusions and Recommendations: Majority (more than three fourth) of adolescents used family planning, but voluntary counseling and testing service utilization were low. The reasons for not utilizing family planning and voluntary counseling and testing service were felt ashamed from friends and unfriendly approach of health workers during service provision. Encourage adolescents open discussion about reproductive health service utilization with different peoples, open discussion within couples and encourage to increase female education are important steps to improve adolescent’s reproductive service utilization.

Faktor uang Memengaruhi Pemanfaatan Klinik VCT di Puskesmas Kabanjahe Kabupaten Karo

Pendahuluan ; Pemanfaatan pelayanan klinik Voluntary Counseling and Testing (VCT) sangat penting dan strategis sebagai pencegahan, perawatan, dukungan, dan pengobatan penderita HIV. Data laporan cakupan kunjungan klinik VCT Puskesmas Kabanjahe mengalami peningkatan mencapai dari 11% tahun 2015 dan meningkat menjadi 24,5%. Penderita HIV lebih banyak lelaki dalam usia produktif, tamatan SMA dan sudah menikah. Mereka tidak memanfaatkan klinik VCT diduga disebabkan kurangnya pengetahuan, rendahnya dukungan keluarga, persepsi yang keliru bahwa HIV tidak dapat diobati, kurang puas terhadap layanan petugas VCT/konselor. Tujuan; penelitian adalah menganalisis faktor predisposisi (umur, jenis kelamin, pendidikan, pekerjaan, pengetahuan, dan persepsi) dan faktor pemungkin (dukungan keluarga dan dukungan tenaga kesehatan) yang memengaruhi pemanfaatan Klinik VCT. Metode; Metode penelitian adalah survei dengan pendekatan cross sectional. Populasi adalah seluruh penderita HIV yang terdaftar di Klinik VCT Puskesmas Kabanjahe sebanyak 266 orang dan jumlah sampel sebanyak 160 orang Data dianalisis secara univariat, bivariat menggunakan chi-square dan multivariat menggunakan analisis uji regresi logistik berganda pada taraf kemaknaan 5%. Hasil ; penelitian menunjukkan faktor predisposisi yaitu umur, jenis kelamin, pendidikan tidak berpengaruh terhadap pemanfaatan klinik VCT, tetapi pekerjaan, pengetahuan dan persepsi berpengaruh terhadap pemanfaatan klinik VCT. Faktor pemungkin yaitu dukungan keluarga/teman berpengaruh terhadap pemanfaatan klinik VCT, tetapi dukungan tenaga kesehatan tidak berpengaruh. Keseimpulan ; pimpinan Puskesmas Kabanjahe dan tenaga kesehatan melakukan evaluasi dan monitoring dalam meningkatkan cakupan kunjungan klinik VCT dengan memberdayakan LSM dan kader dan melakukan promosi kesehatan untuk meningkatkan pengetahuan masyarakat tentang HIV/AIDS. Penderita HIV yang aktif dan keluarga dapat dijadikan sebagai pendamping, pengawas dan pemantau dalam proses pengobatan dan perawatan.

GAMBARAN PENGETAHUAN IBU HAMIL TENTANG PEMERIKSAAN VOLUNTARY COUNSELING AND TESTING (VCT) DI PUSKESMAS TAPAIAN DOLOK

Kehamilan merupakan suatu peristiwa yang penting dalam kehidupan seorang wanita dan keluarga pada umumnya. Kehamilan yang diharapkan oleh seorang wanita dalam keadaan normal, sehat dan tidak menyulitkan baik bagi calon ibu maupun bayi. Penyakit yang dialami selama kehamilan akan berdampak kurang menguntungkan bagi bayi. Salah satu penyakit yang saat ini sangat ditakuti adalah Human Immunodeficiency Virus . Menurut World Health Organization hal ini disebabkan belum ada vaksin untuk mencegah HIV/AIDS dan untuk pengobatannya juga belum ditemukan. PMTCT adalah sebuah strategi untuk memberikan harapan bagi anak-anak untuk lahir bebas dari HIV dari ibu yang terinfeksi. Penularan HIV dari Ibu ke anak tanpa adanya upaya pencegahan adalah sebesar 20%-45%. Dengan pencegahan yang berkualitas angka tersebut dapat diturunkan hingga sekitar 2%-5%. Lampiran Peraturan Menteri Kesehatan Nomor 51 tahun 2013 tentang Pedoman Pencegahan Penularan HIV dari Ibu ke Anak, data Kementerian Kesehatan tahun 2012 menunjukkan dari 21.103 ibu hamil yang menjalani tes HIV, terdapat 534 orang atau 2,6 % diantaranya positif terinfeksi HIV. Prevalensi HIV pada ibu hamil di proyeksikan meningkat dari 0,38% pada tahun 2012 dan menjadi 0,49% pada tahun 2016, dan jumlah ibu hamil HIV positif yang memerlukan layanan PPIA juga akan meningkat dari 13.189 orang tahun 2012 menjadi 16.191 orang pada tahun 2016. Keluarga dengan status sosial ekonomi rendah cenderung memiliki pengetahuan yang kurang. Hal ini pendidikan berkaitan dengan pengetahuan yang dimiliki ibu. Konsep dasar pendidikan adalah suatu proses belajar, jadi semakin tinggi pendidikan ibu maka semakin mudah pula menerima informasi, sehingga banyak pengetahuan yang dimiliki, sebaliknya pendidikan yang kurang akan menghambat perkembangan sikap seseorang terhadap nilai- nilai baru yang diperkenalkan. Selain itu tingkat pendidikan berkaitan dengan pendapatan seseorang, semakin tinggi tingkat pendidikan makan semakin tinggi pulang pendapatan yang dihasilkan .