Factors associated with uptake of home delivered VCT; findings from a population based survey in Zambia.

Abstract

Background: Voluntary counseling and testing (VCT) has been shown to help change sexual behaviour and to be cost effective in low income settings. Though VCT has been available for a long time in Zambia, acceptability has been disturbingly low. In this study, we examine factors associated with use of home-based VCT. Methods: The study is based on data collected in a population based survey conducted in selected urban and rural communities in Zambia, 2003. The survey employed stratified random-cluster sampling of households. Participants expressing interest (willingness) in being tested for HIV were followed up by counsellors and were given the opportunity to receive VCT at home. Logistic regression was used to come up with factors associated with use of home-based VCT. Results: Common factors associated with increase likelihood to use home-based VCT services included high-self rated "risk of catching HIV" (adults OR= 1.34,young people oR= 1.71 ) and depression (OR = 1.31 and oR = 1.63 for adults and young people respectively). Adults with poor self-rated health (OR 2.4), previous HIV test (OR=1.57), rural residents (OR=1.58) and of male gender (OR= 1.41) were more likely to come for home-based VCT. But adults with higher education attainment [> 13 years (OR=0.52) and history of STI OR= 0.64) were less likely to come for home-based VCT. Conclusion: Major factors positively associated with uptake of home-based VCT among young people were self-perceived risk of catching HIV and depression, whereas poor self-rated health and being previously HIV tested among older age-groups. HIV status was not associated with uptake.