Provider initiated HIV testing and counseling, acceptance and disclosure of HIV status and factors related to them among outpatients in Debre Berhan Referral Hospital

Abstract

Background: HIV counseling and testing is the critical entry-point for engagement into treatment and care as well as for primary and secondary HIV prevention efforts. Despite the importance of this step, most HIV infected patients globally, and particularly in resource-poor settings, are unaware of their HIV status and the uptake of voluntary counseling and testing (VCT) services is relatively limited.
Objectives: To assess the magnitude of Provider Initiated Testing and Counseling (PITC) acceptance and disclosure and factors related to them among outpatient department patients.
Methods: A facility-based cross-sectional quantitative survey was taken from December 1, 2010 to January 10, 2011 among 414 clients coming to the outpatient department in Debre Berhan Referral Hospital. Data were collected, entered into EPI info version 3.5.1 and analyzed using SPSS version 16. A logistic regression model was used to assess factors associated with PITC acceptance and disclosure of test results.
Results: A total of 414 study participants (with a response rate of 100 %) responded to the questionnaire. Acceptance of PITC among OPD patients was 83.6%. Adjusted correlates of PITC acceptance included female gender (AOR=2.27, 95% CI=1.16-4.42) and knowledge about HIV transmission (AOR=4.08, 95% CI=1.98-9.91). Key barriers to accepting PITC included being apparently healthy (25%), being tested before (22.1%) and fear of stigma and discrimination (19.1%). Of the 346 respondents who accepted PITC, 288 (83.2%) had a plan to disclose their results to any other person. Compared with the age group 45 and above, those 15-24 years old were less likely to disclose their HIV status (AOR=0.16, 95% CI=0.04-0.62). Disclosure of test result was associated with occupation
(AOR=5.42, 95% CI=1.44-20.43) and negative test result (AOR=4.00, 95% CI=1.53-10.47).
Conclusion and recommendations: In this study, PITC acceptance was promising and should be expanded to other health facilities. Efforts should be strengthened to decrease factors which impede HIV test result disclosure.