INFLUENCES ON THE UPTAKE OF HIV/AIDS COUNSELLING AND TESTING SERVICES IN RURAL COMMUNITIES OF RIVERS EFFECT OF SPECIFIC BEHAVIOURAL FACTORS AND GENDER STATE

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INFLUENCES ON THE UPTAKE OF HIV/AIDS COUNSELLING AND TESTING SERVICES IN RURAL COMMUNITIES OF RIVERS EFFECT OF SPECIFIC BEHAVIOURAL FACTORS AND GENDER STATE

Abstract

Despite efforts to reduce AIDS morbidity and mortality by improving case findings through the expansion ofHIV counselling and testing services, uptake has been quite low across the country. The aim of this study was to examine the relationship risk perception, stigma, utilization of STI services and uptake of HIV testing services in rural communities of Rivers State, (a state prone to high HIV transmission rates due to its highly mobile populations and history of violence) so as to identify gaps in implementation strategies that may need to be addressed.
The study was a comparative cross-sectional one with quantitative and qualitative components, carried out over a period of one month. A multistage sampling technique was used to enrol 596 adults in the reproductive age groups (15 to 54 years) into the study. Three functional rural HCT centres; Comprehensive Health Centre, Degema, Pope John Paul II Catholic Hospital, Eekenand General Hospital, Ahoada, were selected through simple random sampling, from a list of 12 HCT centres that offered free HCT services and had staffs that were adequately trained in the management of sexually transmitted infections. All communities located within a five kilometre distance or thirty minutes’ walk from the selected health facilities were mapped out and divided into census enumeration areas from which 30 enumeration areas were randomly sampled. A systematic random sampling technique was then employed to select households from which a maximum of three eligible adults per household were enrolled. Quantitative data was obtained using structured interviewer administered questionnaires adapted from the USAID, FHI and MEASURE Evaluation data tools for assessing behavioural factors associated with HIV control. Results were controlled for confounding
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where necessary and focus group discussions were also conducted separately with men and women to validate results from the quantitative survey.
In all, 270 men and 326 women participated in the study. The mean age of respondents was 26.59 years. 30% of men and 42% of women were married. 70% of respondents had at least a secondary education. There was no difference in level of education between men and women. The most common occupation was trading (28.7%) but a large proportion were unemployed (48.8%). 90% of respondents were very knowledgeable about HIV transmission routes and there was no difference in the proportion of men and women that had good knowledge of HIV transmission.39.7% of respondents had tested for HIV. There was no significant difference in rates of testing in men and women (p =0.054). 84.4% of respondents perceived themselves as low risk for infection but 37.8% of men and 21.8% of women were classified as high risk after assessment. Stigmatizing tendencies were generally low (38.4%) and similar in both men and women. Few respondents had observed enacted stigma against positive person (6%) but the most common form of stigma observed was discrimination in access to health care. Over 50% of respondents had at least one symptom of an STI with a higher rate amongst women in all categories (discharge or rash) except genital ulceration. The commonest choice of care was the health centre.
Factors associated with positive history of testing were low stigmatizing tendencies (p=0.000) and seeking for STI treatment in a health facility (p=0.000). Seeking STI treatment at a chemist shop was strongly associated with a negative history of testing (p = 0.000). The rate of testing in women with high risk behaviours was also found to be significantly low (p=0.010)
The large pool of unemployed sexually active youth in these communities who have shown a high incidence of sexually transmitted infection makes these communities very vulnerable for high rates
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of HIV transmission. The study has highlighted two possible behavioural barriers to HIV testing in the communities; stigma and poor utilization of facility based STI services. Addressing these two issues may go a long way to improve acceptability of HIV testing, facilitate early diagnosis and reduce mortality from AIDS.

Title Page———i

Certification——–ii

Dedication———iii

Acknowledgement——-iv

Abstract ———vi

Table of Content——–vii

 

Chapter One

1.0 Introduction ——-1

1.1 Statement of Problem——4

1.2 Purpose of the Study——5

1.3 Significance of Study——8

1.4 Limitation——–9

1.5 Scope of Study——-11

 

Chapter Two

2.0 Review of Related Literature —-12

2.6 Summary of Literature Review—- 19

 

Chapter Three

3.0 Research Methodology and Procedure—22

3.1 Population ——–22

3.2 Sample and Sampling Technique—-22

3.3 Validation of the Instrument —-23

3.4 Reliability of the Instrument —–23

3.5 Data Analysis——-23

 

Chapter Four

4.0 Presentation and Discussion of Result—24

4.1 Analysis and interpretaion of Data—25

4.2 Discussion of Results——38

 

Chapter Five

5.0. Summary, Conclusion, and Recommendation  –40

5.1 Summary——–40

5.2 Conclusion——–41

5.3 Recommendation——42

References ———45

Appendix 1——–47

Appendix ———50

INFLUENCES ON THE UPTAKE OF HIV/AIDS COUNSELLING AND TESTING SERVICES IN RURAL COMMUNITIES OF RIVERS EFFECT OF SPECIFIC BEHAVIOURAL FACTORS AND GENDER STATE

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