Mobile HIV Counselling and Testing (HCT) Outreach: A Model for Community based Approach to Increasing Uptake of HCT and Antiretroviral Therapy (ART) Services in Benue State Nigeria

Abstract

Background: HIV testing is a key component of prevention and entry point to HIV/AIDS care and treatment, however, coverage and access to testing remains low in Nigeria. HIV Counselling and testing (HCT) scale up is needed in other to meet with the growing demand for universal access to HCT services. In recent times, Primary Health Centres (PHCs) and hospitals have provided the only access to HIV Counselling and testing (HCT) in Nigeria and other high prevalence settings. This study aimed to assess uptake of HCT and Antiretroviral therapy (ART) services in Benue state with HIV prevalence of 15.4% and look at the characteristics of clients who self- initiated HCT at mobile outreaches. Methodology: Cross sectional study using multistage sampling to identify 422 participants who are 18 years and above in Guma, Benue State from September to October 2015. Information on demographic characteristics, knowledge, attitude and perception of HIV and stigma associated with uptake of HCT were asked. Data was analysed using descriptive, chi square and odds ratio on SPSS version 20.0. Results: Findings showed 52.4% were male, 48.1% farmers, single individuals (OR=0.634; 95%CI: 0.178-2.263), Age <30 years (OR=1.459; 95%CI:0.114-1.843) and participants with tertiary education are more likely to assess HCT. Static model of HCT was preferred by individual 18 years and above with P>0.05, there is evidence of significant association between facility testing and community HCT uptake (p=0.000). About 77 %( 326) of those have been tested for HIV, 65% will not be ashamed if tested positive to HIV (P=0.094). Conclusion: With HIV/AIDS continuing to be a major public health concern in Benue state and Nigeria, the issues surrounding acceptance and use of HCT need to be addressed. Respondents who were male, farmers, single, age below 30 years, and tertiary education were more likely to access HCT services. Static model of HCT led to access and utilization of HCT in the community. Community awareness, sensitization and benefits of early HIV diagnosis, increasing access to HCT and treatment sites for general population, with focus on key population like adolescent and young person and most at risk populations (MARPS) need to be explored. Strategies to target women in churches, markets, integrated community outreaches should be implemented. Further research is needed, possibly qualitative, to explore motivation for testing or not testing in rural populations.