Factors determining the utilization of HIV Voluntary counselling and testing services among the youth in Nakuru District : A case study of the Rift Valley Provincial General Hospital
Recent health and demographic studies reveal that in Kenya, young people, aged 15-24 years face a greater risk of HIV infection than any other age group. The question of whether the youth have access to and utilize proper/quality health services and other prevention programmes such as VCT is becoming critically important. A lack of timely action can have grave consequences. This work sought to examine the factors determining the utilization of HIV voluntary counseling and testing services, as a strategy in prevention and control of HIV / AIDS among youth, aged 15 - 24 years at the Rift Valley Provincial General Hospital, Nakuru District. More specifically, the study attempted to establish the socio-demographic and economic factors influencing access to VCT services among the youth. It also attempted to identify the experiences/perceptions (social, psychological, emotional) that would motivate or hinder youth receiving HIV counseling and testing on site and to determine the extent of VCT service utilization among the age group of 15 - 24 years. The study also investigated the extent to which the VCT center has addressed /met the counseling and other reproduction health needs of the youth. The study finally attempted to investigate the relationship between these factors and VCT service utilization by testing the hypothesis; Youth attitudes towards the utilization of VCT services are influenced by both community level factors (socio¬demographic, economic factors) and clinic level factors (organization, quality, and availability of VCT services and facilities). To achieve the stated objectives, a descriptive cross sectional survey research combining both quantitative and qualitative methods was adopted. The study population consisted of 100 respondents. They were young men and women purposely selected using convenience sampling method. To obtain additional information, 4 key informants were purposely selected. The selection was also guided by the respondents and key informants willingness to participate in the interview process whose main tools of data collection were the questionnaire and interview guide respectively. The 100 respondents and 4 key informants, who were also the unit of analysis in the study were interviewed. Of the 100 respondents, 60 were interviewed on exit from the vct center and 40 non- VCT users were interviewed while queuing for other medial services within the Provincial General Hospital during the research period. The findings revealed that awareness of VCT was high. Majority, 28.5% of the respondents being television/radio. Although 46% of the respondents indicated that they would wish to know their HIV status, only 11 % knew their HIV status indicating the extent of the reluctance by many to be tested. Of the 58 respondents who received full VCT services during the study period, majority, 52.6% indicated that they were simply motivated by the need to know their HIV status, a variable which the study established to have the most significant relationship with the use of VCT services. This was followed by planning for the future mentioned by 26.2(10 of the 58 respondents as the main reason for HIV testing. The hypothesis tested further confirmed that there is significant association between vct services utilization and other community factors such as, occupation, marital status, residence and feelings/consideration about service charges. Following such findings, it has been concluded that there is low utilization though there is high demand. A significant proportion of young people are in need of VCT services, but that utilization depends not only on tangible community level socio - economic factors to a large extent, but that it is also limited by social, psychological and cultural perceptions. The study's recommendations mainly revolve around efforts aimed at reducing obstacles by addressing the root causes of low service utilization such as the socio-economic hurdles facing the youth. The success of this intervention will ultimately depend on a supportive environment which guarantees access and availability of its services.