Community Perspectives Towards Provider- Initiated Testing for HIV in Macha

Abstract

Background: In Zambia, at least eighty per cent (80%) of the adult population does not know about their HIV
status¹¹. In order to increase uptake of HIV testing, Ministry of Health introduced provider- initiated HIV counseling and testing for individuals attending health facilities in 200812. However, since the policy was introduced, there has been no research evidence on how the community perceives the policy and how it has influenced their health seeking behavior.

Objectives: The aim of this study was to explore community perspectives on provider-initiated HIV testing.

Design: The study was a cross-sectional descriptive design. The study used both qualitative and quantitative approaches. Multistage sampling was used to select households for interviews. Adults above 18 years of age were interviewed from the selected households using a structured interview questionnaire. The questionnaire was translated into the local language to enhance understanding of the subject. Purposive sampling was instituted to  select key informants for in-depth interviews. Logistic regression was applied to determine  independent predictors  for supporting provider- initiated HIV testing. In-depth interviews were translated and transcribed into computer files; common themes were identified, after which data was categorized using the Nvivo statistical package.

Results: A total of 809 respondents and 12 (twelve) key informants participated in the study. The age range for the cohort was 18-80 years, with mean age of 35.8 years. Of the whole study population, 42.8% were males while 57.2% were females.The study found that the majority of respondents (61.9%) were not aware of the  providerinitiated HIV  testing policy. Despite this scenario, the majority (80.3%) of respondents and all the key informants supported the  policy. Furthermore, most (89.5%) respondents indicated that they would accept to be tested if they were to be  hospitalized. Support for the policy was on the premise that the community has realized the importance of HIV  testing as an entry point to HIV care, treatment, and support.

Conclusion: The Macha community is in support of provider –initiated HIV testing policy although awareness of  the policy is low. It is evident that the majority of respondents have been able to observe benefits associated with  testing through the ART services going on at the hospital. However, there was more preference for  communitybased voluntary counseling and testing. According to the community, mobile VCT services were more preferred because they saved costs of travel to the health facility and reduced stigma.