Factors Influencing Uptake of Hiv Testing Services Among Older Persons in Kotido District

Abstract

In the face of endless efforts by the Ministry of Health and other non-governmental organizations to curb the HIV/AIDS scourge in Uganda using HIV Testing Services (HTS) as one of the preventive strategies, the uptake of HTS is still the lowest and there is limited information about the uptake of HTS services for older adults in a resource limited setting.

Therefore, the main objective of this study was to establish factors influencing uptake of HIV testing services (HTS) among adults aged 50 years and above in Kotido district. Specifically, it sought to estimate the level of uptake of HTS among adults aged 50 years and above; to assess the knowledge and perception influencing uptake of HTS; to establish the channels of communication that influence uptake of HTS, and to determine the health system factors that influence uptake of HTS among adults aged 50 years and above.

A descriptive cross-sectional study design was used to gather both qualitative and quantitative data. A total of 370 respondents (households) of adults aged 50 year were enrolled into the study at a margin of error5%−+.

Findings revealed that 49.3% (179) of the interviewed adults aged 50 years and above had ever accessed HIV testing services (i.e. they had ever tested for HIV), hence the uptake of HTS was fairly low. Respondents’ knowledge had significant influence on their uptake of HIV testing services, these knowledge areas included: Awareness of HIV testing services in the area/district (P<0.000); The knowledge of whether it was necessary to go for HIV testing services now at an old age (P<0.000); The importance of HIV prevention strategy for all ages (P<0.000). Likewise, respondents’ perceptions were found to have significantly influenced on their uptake of HTS, these included: A feeling of being comfortable where HTS is offered (P<0.000); Suspicion of sexual partner's infidelity (P<0.015); The need/feeling of one to get a confirmatory test (P<0.039); The feeling of one being at risk of HIV infection (P<0.000); Acceptability of HTS socially within the community (P<0.000); Stigmatization (P<0.002); and Discrimination (P<0.001). Furthermore, communication modes which influenced uptake of HTS were found to be Radio (P<0.000); as well as Village meetings and VHTs (P<0.018). However, billboards, Posters, and Fliers were deemed to have no significant influence on the uptake of HTS. A number of health system factors were deemed to influence uptake of HTS among adults aged 50 years and above, these included: HTS approaches such as Community based HIV testing services (P<0.034), and Provider-initiated testing services (P<0.000). Likewise, accessibility of a health facility (how close it is to the respondent (P<0.000)); as well as health care providers’ attitude (such as; Friendliness of the health workers/counselors (P<0.006), amongst others.

The study therefore recommended that level of HTS be increased by improving the various knowledge and perceptions of the adults aged 50 years and above, as well as using some appropriate communication modes to pass on the right messages to a specific target group, bearing in mind the local context. And finally adopting a holistic approach in improving the health system factors (not looked at in isolation of other components-health system building blocks) so as to increase uptake of HTS among adults aged 50 years and above.

The study suggested that further studies be undertaken to determine the extent to which the various communication strategies affect the uptake of HTS, with special interest in the participatory communication development of health messages with the older persons. Likewise, more studies should be conducted to further investigate in detail how and the extent to which the various components of a health system can enhance uptake of HTS. Finally, further research should be done in order to establish factors that impede effective use of the various communication modes in enhancing HTS among older persons

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