Determinants of Health Seeking Behaviour Among Young Women: a Case Study of Voluntary Counselling and Hiv Testing Practice in Nairobi, Kenya.

Abstract

In Kenya, 80 -90% of infections are among the young people aged 15 to 49 years. 60% of new HIV/AIDS infections worldwide occur among girls and young women aged 15-24 years. (AIDSCAP/FHI, 1996) Women risk becoming infected at a much younger age than do boys. They are vulnerable to HIV biologically, socially, and economically. Gender inequality fuels the HIV crisis among women. (Overall, C and Zion, W 1991) Based on the current trends and dynamics of the HIV/AIDS virus, all sectors of the society face the challenge of controlling and reducing HIV prevalence. The high level of new infections among young women and their vulnerability is an area of growing concern. This study was occasioned by the reality of the increasing infection in young women, which is not reflected in the policy and program responses. The study undertook to analyse the determinants of health seeking behaviour and VCT practice as they relate the young women. Due to the high prevalence of HIV infection in young women, the following areas were examined; young women and susceptibility, the HIV/AIDS and STIs risk perception of young women and factors increasing the rate of HIV infection in young women. The issues that were scanned in regard to VCT and young women are issues of demand for VCT, factors that influence the uptake of VCT and possible outcomes and effects of VCT uptake. Voluntary counselling and HIV testing as a preventive and care strategy and vulnerability of young women, was the focus of this study. The study sought to provide a better understanding of the issues of motivation, knowledge and attitudes of young women on VCT and perceived possible outcomes of the VCT test. While several studies have shown the efficacy of VCT, many questions remain unanswered regarding motivation, how to attract more people to the sites and specifically this high-risk category of young women. Realising that there is a growing tendency for HIV/AIDS programs to focus on VCT it is essential to get accurate and reliable information relating to demand. The findings reveal that there is a shift from the previous studies that portrayed young women to demonstrate a lack of understanding about key aspects of HIV/AIDS. Contrary to this their knowledge level is very high and their HIV risk perception is similarly high which has brought about the increase in VCT uptake among this category. The study further established that increased VCT uptake is determined by high knowledge level about HIV/AIDS and VCT. Availability of care and support services will correspondingly motivate more young women to take up VCT services. The study found out that the VCT personalised approach with the counselling offered is a motivating factor which needs to be reinforced and further used as a tool for addressing specific issues like family planning, STI services, PMTCT, Condom distribution and other issues as they relate to young women. The study confirmed that a high level perceived discriminative outcomes of VCT HIV positive results would lead to decreased uptake of service. The study further concluded that VCT uptake among young women increased because of the favourable opinion about the benefits of VCT. Of great significance is that VCT uptake is an effective intervention taken voluntarily by the young women, not for normal HIV diagnostic purposes but as a prevention strategy.