Formative Research for the Establishment of HIV Voluntary Counselling and Testing Services in Kintampo District, Ghana

Abstract

A cornerstone of HIV prevention is voluntary HIV counselling and testing (VCT). There are 24 VCT sites in Ghana; Kintampo district has none. Fewer than 10% of people living with HIV/AIDS in Ghana are aware of their sero-status, due to limited availability and limited use of VCT. The District Health Administration Kintampo district has expressed interest in the establishment of VCT services. They therefore asked for infonnation for consideration in planning and establishment of the VCT service to ensure patronage. Objective: This study examined the community and health workers perceptions, attitudes and knowledge of HIV /AIDS and HIV voluntary counseling, testing and related services: in order to asses their willingness and readiness for VCT services with a view of recommending a workable VCT in Kintampo District . Design: A total of300 people participated in the study.Of these, 160 participated in focus group discussions and in depth interviews the rest participated in the quantitative component of the study. Qualitative study elicited information that was used to refine the questionnaire for cross sectional survey and to elicit reasons for the various responses so as to complement quantitative study. Results: HIV/AIDS is perceived by health workers as a public health problem in Kintampo district but a different perception applies to community members. Respondents identified principal modes of HIV transmission as: having multiple sexual partners (70.7%),having unprotected sexual intercourse with an infected person (57.9%) and use of un-sterilized sharp instruments (81.4%),only 15.7% and 7.9% identified transfusion of unscreened blood and mother to child transmission of HIV respectively. Eighty three percent of the respondents recognize medical testing as the sure way of knowing ones sero-status_ Fifty three percent of the respondents have heard of VCT and ninety percent of the respondents expressed willingness to test. Most of the respondents indicated that services should be offered by health workers of both sexes. Sixty five percent of the respondents expressed stigmatizing attitudes to people living with HIV/AIDS (PLWAS). There were a number of factors identified as influencing the willingness to accessing YCT services these include: societal attitude and stigma, perceived consequences of a test result, cost or VCT. physical accessibility of VCT, awareness, perceived risk of HIV infection. need for linking VCT with care and perceived quality of provision of VCT services including issues of privacy and confidentiality. Kintampo district hospital was identified as a suitable site for starting up VCT services on a pilot basis. Conclusions and Recommendation: From the findings it is recommended that community, education on HIV and VCT should be strengthened. There is need to establish a VCT programme preferably in the hospital and at affordable cost. The aim should be to provide high quality VCT services and this should be linked with care and support services and finally positive consequences of VCT should be emphasized.