Utilization of HIV testing services among adolescents aged 10-19 years in Soroti District, Uganda.

Abstract

Introduction: Globally 2,100 adolescents are infected with HIV every day. In Uganda, most adolescents do not know their HIV status. Although generally adolescents know of a place to get tested for HIV, the proportion ever tested remains low at 35.6 % across the country, against the general population HTS access at 83% for women and 70% for men. Utilization of HTS among adolescents aged 10-19 years in Soroti District is very low estimated at 3%; yet adolescents are a priority population to be targeted for HTS. This study therefore, was conducted to determine the factors associated with utilization of HTS among adolescents aged 10-19 in Soroti District. Methods: This was a community-based Cross-sectional mixed methods study in Soroti district. Interviewer-administered paper-based questionnaires were used adolescents and key informant interview guides were used for interviews with health workers. Quantitative data was analysed using STATA/SE, version 14 software. Univariate analysis was done for description of respondents and to determine the proportion that utilised HTS. Modified Poisson model was used for multivariate analysis to determine associations between independent variables and utilisation of HTS. Qualitative data was analysed manually using content analysis. Results: A total of 374 adolescents were interviewed; 202 (54.0%) were females, 335 (89.6) were in school. Their mean age was 14.7, with standard deviation of 2.3, only 49 (13.1%) received HIV testing in the past 12 month and test results and 14 (3.7%) were married. At multivariate analysis, belief that HTS were friendly (APR=0.37; CI= 0.15- 0.95) and perceived parents financial support to go for testing (APR=2.06; CI=1.14-3.75), were associated with utilization of HTS. Based on the qualitative findings, the barriers to HTS utilization included; fear of positive results, limited family support, lack of knowledge on HTS, perception of low risk, poor attitude of health workers, stigma and discrimination and lack of confidentiality in that health workers may disclose their status to the community. Conclusion and Recommendations: Utilization of HTS among adolescents in Soroti was found to be unacceptably low. Therefore, the MOH and the districts should support adolescents to be meaningfully engaged in the design and delivery of HTS in order to protect them from HIV and address the fear associated with HIV. Also understanding the way, in which age and other situations such as gender and sexuality influence on utilization of HTS, is important to the provision of effective interventions targeting adolescents.