Determining the Dynamics of HIV Voluntary Counselling and Testing Uptake among the Rural and Urban Communities of Nakuru District, Kenya

Globally, it is estimated that over 40 million people are living with HIV/AIDS with 67% of these coming from Sub Sahara Africa. While the epidemic has been receiving increasing attention towards and more emphasis placed on access to care and treatment, these efforts are bound to become unsustainable due to a high rate of new infections. In 2007, for every HIV patient who was put on drugs six others became infected with the virus. Voluntary testing and counselling (VCT) has been suggested as the most effective intervention that could reverse this rate of infection. Its utilization in Africa and many parts of the world has however, been at an all time low. In Kenya where populations of over 1.4 million people are living with the HIV/AID virus, less than 20% of the total population knows their status. The aim of this study is, therefore, to establish and document the dynamics of VCT uptake in Nakuru district of Kenya with a view to suggesting measures to increase this uptake. The main objectives of the study were to identify factors that influence VCT uptake and determine the levels of knowledge and prevailing attitudes on HIV testing. The role that gender plays in VCT utilization was also explored. This was a cross sectional study in which a mixed research method methodology employing quantitative and qualitative data collection methods was used. Quantitative data was collected using a structured questionnaire while qualitative data was collected using focus group discussions and key informant interviews. The target population was residents of Nakuru aged 16-60. 480 distributed completed the structured questionnaire out which 422 were completed and returned. Six focus group discussions and five key informant interviews were carried out. The research found that the awareness regarding HIV and VCT among the community members is relatively high. However, there are still a significant proportion of people who hold misconceptions about the disease and the testing service. This may partially explain why people opted not to take the test for the virus. Further, a majority of the people wanted to take up the test but both social and health system barriers such as gender inequality, the cost of taking the service, service operational hours, accessibility; misconceptions about the disease are barriers to the utilization of the service. The study recommends the adoption of more pro-active model of testing which could include mobile and home-based testing to help remove most of these barriers and therefore lead to an increased uptake. Moreover promotional activities targeting couples, providing the service beyond the current normal working hours weekdays and weekends, strengthening the general public health facility to help win back the trust of the service consumer and provision of youth-friendly voluntary counselling and testing for HIV (VCT) service are recommended