PERCEPTIONS AND PATTERN OF UTILISATION OF HIV VOLUNTARY COUNSELLING AND TESTING SERVICES AMONG SELF-REFERRED CLIENTS IN IBADAN, NIGERIA.

Abstract

A major strategy for the prevention of Human Immune deficiency Virus (HIV) is the promotion of universal adoption of HIV Voluntary Counseling and Testing (HVCT). Several studies have explored the perceptions and practices of patients referred by health workers for HVCT. However, there is dearth of information about the perceptions and practices relating to HVCT among self-referred clients. This study was, therefore designed to determine the perceptions and pattern of utilisation of HVCT services among self-referred clients in Ibadan metropolis. The study was cross-sectional in design. Two different semi-structured questionnaires were used to obtain data: one was used to interview clients while the other was used to collect data from service providers. All the 457 self-referred clients as well as the 32 HVCT services providers in all the nine HVCT centres who agreed to participate in the study were interviewed. These centres consisted of three government and six private facilities. A record review guide was used to extract data from previous HVCT adopters. Descriptive statistics and the chi-square tests were used to analyze the data. The mean age of clients was 29±0.5 years. Majority (60.0%) of the clients were female and virtually all (98.5%) were literate. A larger proportion of the clients (57.3%) were single; 40.3% were married and 2.4% were separated, divorced or widowed. More than half of the clients (57.0%) used government centres. Overall, a majority (91.0%) of them utilised the available five non-fee paying centres. The opinion of majority (70.0%) of the clients was that fear of other people having knowledge of their HIV status was the reason why they did not utilize HVCT services. Majority (70.7%) of the clients came for the HIV test for the first time. Forty percent of clients were motivated to do the test as part of routine medical examination. A few (12.9%) of the clients would not disclose their HIV result to any one if found to be positive, while 87.1% would disclose the result of the test to at least an individual. The perception of the 22.0% of the providers was that an incentive was needed to promote the adoption of client-initiated HVCT. A review of records indicated that over half (55.9%) of the previous clients were patients referred from antenatal clinic. The overall mean knowledge score about HVCT, using a 14-point scale, was 10.5 ± 1.8. clients who had taken the test previously had a mean score of 10.9 while those who had never done so had 10.3 (p<0.05). The highest level of education of clients who had taken the test previously were as follow: tertiary (64.9%): secondary (26.1%): primary (7.5%) and no formal education (0.7%) (p<0.05). Level of education and payment modality appeared to influence of self-referral for HVCT. Educational strategies such as advocacy, public enlightenment, counseling and peer education are needed to promote self-referral for HVCT services.