Barriers to HIV testing and counseling uptake among young people aged 18-24 years in Nyeri Municipality

Abstract

Background HIV testing and counseling (HTC) is an important strategy in HIV and AIDS prevention and control in Kenya. The prevalence of testing in Kenya remains low among adults as reported in KAIS 2007 and also in KDHS 2008/9. Objectives This study set out to determine HTC prevalence and testing barriers among young people aged 18-24 years in Nyeri Municipality, Central Kenya. Design A cross sectional study was conducted using cluster sampling technique. A total of 600 young people were sampled in 30 clusters randomly chosen using probability proportionate to the number of households in each sub location. Data were collected using an interviewer administered questionnaire, during the month of August 2011. Data collected was on HIV Testing and Counseling, HIV and AIDS knowledge and attitude, and youths’ perception of HCW attitude. All ethical considerations were respected by ensuring voluntary participation with written consent and upholding of utmost confidentiality. Results The study found near universal HIV and AIDS awareness (99.8%) and a similar level of HTC awareness (99.6%) with 95.8% of the respondents acknowledging that the disease was a serious threat to young people in the community. Nearly all (98.5%) knew of a place where they could access testing and 62% of them thought they were at risk of infection. The mean HIV and AIDS knowledge score was 82.8% and was influenced by education level (p<0.001) and age (p= 0.015). The mean HIV and AIDS attitude score was 71.7% and was influenced by education level (p<0.001). Young people’s perception of counsellors’ attitude mean score was 47.7% and was significantly related to education level (p=0.0047). The study found self reported HIV testing prevalence of 69.2% (CI 65.4%-72.8%) with nearly all those tested reporting they received their results. Their main sources of HIV testing and counselling information were schools (23.8%) followed by health workers (16.7%) and churches (15.2%). The most popular testing places were public health facilities for over 53% of tested youths. Respondents advanced many reasons for never having taken a test; 34.6% thought they were not at risk, 20% had no reason, 18.4% were held back by fear, 14.6% had never been offered a test, 9.7% said they were too young. The rest, less than 3%, of the respondents either did not know about the test, where to get tested, or did not see the need because their partners had tested negative. Conclusion The study showed that HIV testing is significantly related to age (p<0.001), sex (p<0.001), marital status (p<0.001), occupation (p=0.001) and young people’s perception of counsellors’ attitude (p<0.001). The study recommends training and retraining of HTC counselors to enable them provide youth friendly services to improve uptake of HTC by young people.