Voluntary Counseling and Testing (VCT) is proven to be one of the most powerful weapons in halting the spread of HIV/AIDS. It is known to be a very important component of HIV/AIDS prevention strategies. Despite the fact that various studies have shown low utilization of VCT service particularly in developing countries this study tried to look in to the level and associated factors of VCT utilization by students in Debre Markos University (14).
The finding indicates that Knowledge of modes of HIV/AIDS transmission and prevention among the students was high. 96% of the respondents were knowledgeable of HIV/AIDS transmission and prevention.
The result also revealed on sexual practice and perceived risk of becoming infected with HIV among the students. Of all the respondents 29.4% had sexual experience, of which, 50% started sex at the age of 15–19 years. The respondents that felt being at risk of HIV infection comprised 66.5% of all.
In this study 81.4% of respondents heard about the availability of confidential VCT services and their major primary sources identified were mass-media and health workers.
The overall prevalence of VCT utilization in the past12 months was 416 (58.5%) with slightly higher utilization by females as compared to males. This result is higher when compared with the health care professional students of Kilimanjaro region revealed that voluntary counseling and testing utilization was 34.5% [12, 13]. It is also higher than the study conducted among students in Bahir Dar University and Debre Birhan Teachers Teaching College with VCT utilization of 38.6 and 35.19 respectively (15,17).
The possible reasons for this could be due to recent accelerated expansion of the VCT service carried out through an increased advocacy and social mobilization in higher institution as well as country-wide and the study participant explained by the high risk perception and more knowledge regarding the VCT benefits.
The most commonly cited reason that VCT users gave for getting an HIV test was 82% to know their status followed by 7% for marriage. This is similar with finding in Debre Birhan Teachers Teaching College which showed 84.15% and 12.20% respectively . The two main reasons mentioned by study participant for not using VCT service were not feeling at risk and trusting one-self and their sexual partner.
Overall, 88% study subjects showed their willingness to undertake HIV counseling and testing in the future. However, this high percentage of willingness to take the VCT service by the study participants different from the actual practice. This might be due to less mobilization activity and fear of testing and its consequences, other reasons to this may be due to lack of perceived benefits of VCT.
Knowledge about HIV/AIDS and VCT utilization has positive association. Students who have knowledge about HIV were 3.69 times more likely to utilize VCT service as compared to those who did not have knowledge about HIV. This finding is supported by the assumption that VCT users could have more exposure/information/knowledge regarding HIV/AIDS before they came to VCT centers (15). This again may indicate the information to be disseminated through health education and counseling sessions may benefit from the inclusion of such topics during the respective sessions, and continuous mass media activity.
In this study, socio-demographic characteristics of the students were not significantly associated with VCT service utilization, which is contradicted with the study conducted among students in Mekele University . Possible reason could be recent accelerated expansion of the VCT service carried out through an increased advocacy targeting disparities in sex, region, religion, age and ethnicity etc.
This study identified the availability of ART as a positive predictor of VCT acceptance. Students who know the availability of ART in the VCT site were 3.12 times more likely to utilize VCT service as compared to those who didn’t know availability of ART in the VCT site. The provision of ART would have a significant effect in prolonging life and this would have an impact on the students in creating positive attitude and acceptance towards the service. Making every effort to make ART available would increase VCT acceptance by all students and students, who perceive risks associated with the HIV/AIDS test result were 2.4 times more likely to utilize VCT service as compared to their counterpart.
In this study perceived stigma associated with the positive test result was found to be important factor of VCT service utilization. Students who perceive stigma and discrimination were 0.013 times less to likely utilize VCT service as compared to their counterparts. This is in line with the study in Bahir Dar University students, where perceived stigma and discrimination was known to be strong predictor of voluntary counseling and testing .
The other finding of this study was the positive association of presence of confidentiality on the VCT site and utilization of VCT service among students. Students who heard the presence of confidentiality in the VCT service site were 3 times more likely to utilize VCT service as compared with those who didn’t hear the presence of confidentiality in the VCT service sites.
This study encountered a number of limitations, among which, as with any observational study, the possibility of residual confounding effect of some factors cannot be excluded. This may result in spurious associations of the factors with some events, and we thus guarded against this possibility by careful sequential building of models in our analyses. Another limitation of this study was findings from this study may not be generalized to the whole population of the young people because the study involved only those young people who are in higher institutions.