Factors that contribute to the uptake of HIV Voluntary Counselling and Testing facility among married partners aged 18 and above in Kinondoni district of Dar Es Salaam Tanzania
Mtenga, Sally M
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Introduction: The recent EN epidemic update indicate the shifting trend of HIV infection from single to people in steady relations including married individuals (UNAIDS and WHO, 2009). Married couples represent the largest risk group in Africa and the majority ofHIV infections in Africa are acquired from a spouse (FHI 360, 2011). In Tanzania, the EN prevalence of married/living together is substantially higher as compared to other groups (THIS, 2003-4). It has been found that, one of the reasons for the growing HIV prevalence among married individuals is that most couples are not aware of their HIV status and the status of their partners (Bunne1.R.et al, 2008; Anglewicz, 2008). HIV VCT services have proved to be the most effective and realistic strategy to increase the practice of safer sex as well as preventing HIV infection among married individuals (Gregorich S, 1998). However, large proportion married individuals in Tanzania are not aware of their HIV status (THMIS, 2007-8). In addition, little information is available on the factors that are associated with the use of VCT services among married individuals or people in steady relations. Objective: To understand factors that contributes to the uptake of VeT services among married individuals in Kinondoni District Dar Es Salaam, Tanzania. Methods: A cross sectional survey study was conducted in as sample of 200 married individuals in Kinondoni District Dar Es Salaam Tanzania to asses their uptake of VCT services as well as to identify factors that associate with VCT use. Quantitative method that include personal interview was employed to the consented individuals. The interview schedule elicited information on social demographic aspects, sexual and social cognitive behavior. Results: Of the respondents, who were interviewed, 58 percent indicated a complete VeT uptake and 42 percent indicated a zero uptake. The Pearson correlation coefficient indicated that, Perceived control [r=+47, n200, p<0.01], Attitude [+0.51, n=200, p<0.01] Subjective norm [r+0.43, n20Op<0.01) were strongly positively associated with VCT uptake among married individuals. Conversely, perceived risk of HIV infection among married individuals indicated a strong negative association with the VCT uptake [r= -1, n=200, p<0.380]. Hypotheses testing results indicated that, perceived control, Attitude towards VCT services and Social norm were statistically sigriificantly related with the uptake ofHIV services p=OOO], except for perceived risk [p=0.642]. Multivariate logistic regression results indicated that, Perceived control and Attitude contributed much variance to the VeT uptake among married individuals. Perceived Control [Wald 12.229, df 1, Sig 0.000,95% CI), Attitude [S.B. 0.016, Wald 8.347, df 1, Sig 0.004,95% en, Subjective norm [S.E 0.005, Wald 3.016, df 1, Sig 0.082, 95% CI], Perceived risk ofHIV infection [S.E 0.091, Wald 0.309, df 1, Sig 0.578,95% CI]. Conclusion: Perceived control, attitude and social norm were both positively associated with VCT uptake. However, while controlling for other variables, perceived control and attitude emerged to be the main contributors of VCT uptake among married individuals. The result implies that, policy makers should consider social cognitive factors when addressing the barriers to VCT uptake among married individuals. And that, social cognitive variables can provide evidence based information for programmes that focus on psychosocial support to strengthen the capacity of individuals to overcome barriers to VeT use as well as to help them develop positive attitude towards VeT services.