Determinants of uptake of HIV counselling and testing among patients with substance use disorder attending services at Mathari hospital

Abstract

Patients with substance use disorder form an important category that need to be targeted by counselling and testing services. The hospital contact during rehabilitation for substance use can be used as an entry point forHIV counselling and testing.The study aimedat exploring the determinants of uptake of HIV counselling and testing among substance users attending services at Mathari hospital.The study design was cross sectional and employedpurposive samplingto recruit participants.Data was collected from 127 participants using questionnaires, two focus group discussions and four key informant interviews. Patients with a doctor‟s diagnosis of substance use disorderwere recruitedandscreened using standard mini mental status examination tool in order to participate in the study. Only those with scoresof 23 points and above were given questionnaires to fill. Permission to conduct the study was obtained from Ethics and ResearchCommittee at Kenyatta National Hospital/University of Nairobi, Medical Superintendent of Mathari Hospital, Department of Continuing Education, the Nursing Officer in charge of the rehabilitation unit andthe manager of Asumbi Rehabilitation Centre.Data was cleaned, coded andanalysed usingSPSS version 20. Determination of association between socio demographic variables and uptake of HIV counselling and testing services was done using Chi square where P ≤ 0.05 was considered to be of statistical significance.Focus group discussions and key informant interviews were capturedverbatim and organised in themes. The findingshave been presented in tables, graphs, pie charts and discussion done to focus on the results in relation to objectives and previous studies. Among the 127, only 4 (3%) were females while 123 (97%) were males. The study revealed that 59.8%of the participants had knowledge of HIV transmission. All the respondents 127 (100%) admitted that there was an increased risk to HIV infection due to substance use. Those who had undergone HIV counselling and testing were 100 (78.8%).They stated that they did so to know their HIV status.Those who did not seek counselling and testing serviceswere 27 (21.2%) and most of them mentioned fear as the main reason for not seeking testing for HIV. There was significant statistical relationship between age, level of education andmarital statusonknowledge on HIV transmission. The study however showed no association between counselling process and uptake.Uptake of HIV counselling and testing is good among patients with SUDs.Fear is a deterrent factor in seeking counselling and testing services.There is therefore need to design programmes that target females with SUDs and address fear to improve uptake. Preventive strategies geared towards patients with SUDs can play a major role in reducing new HIV infections.A total ofKsh 117,500/-for support was receivedfrom Linked Mental Health Research Training for Improved Health OutcomesinKenya. KEY WORDS: Counselling, Perception, Vulnerability, Uptake, substance use disorder.