Acquired immunodeficiency syndrome (AIDS) caused by the human immunodeficiency virus (HIV) is a major health problem in many parts of the world, and is considered as a pandemic disease . By the year 2010, the World Health Organization (WHO) estimated 34 million people living with HIV and an estimated 1.8 million deaths around the world . Sub-Saharan Africa remains the region most heavily affected by HIV. In 2010, about 68% of all people living with HIV resided in sub-Saharan Africa. Sub-Saharan Africa also accounted for 70% of new HIV infections and almost half of the deaths from AIDS related illness in 2010 . Almost a quarter of people living with HIV are under the age of 25. Young people ages 15–24 represent 45% of all new HIV infections. In sub-Saharan Africa, nearly 3.3 million youth are living with HIV. Lack of information, skills, and access to services for youth is expected to fuel the epidemic .
Ethiopia, as a country in the Sub-Saharan region, is a country with high HIV prevalence. According to the single point estimate, the Ethiopian adult HIV prevalence was 2.2% in 2008 with an estimated 1,037,267 people living with HIV in the country . According to the Ethiopian demographic and health survey report of 2011, the percentage of HIV positive in the age group 15–24 years was less than one percent .
Many countries have been trying to take many different approaches in an attempt to slow the spread of HIV infection and minimize its impact on the individual, family and society. Among these strategies include; voluntary counseling and testing (VCT), provider initiated counseling and testing (PICT), diagnosis of HIV in infants and young children, family care and partner testing and counseling based on index care, condom promotion and provision, detection and management of sexually transmitted infections, safer sex and risk reduction counseling, male circumcision, targeted interventions for sex workers and homosexuals . Among these VCT is internationally recognized as an effective and important strategy for both prevention and care of HIV .
VCT is the process by which an individual undergoes counseling enabling him or her to make an informed choice about being tested for HIV. This decision must be entirely the choice of the individual and he or she must be assured that the process will be confidential .
VCT is an effective strategy for facilitating behavioral change around both preventing HIV as well as getting early access to care and support. It is also instrumental in bringing about behavioral change, reducing unprotected sex and helping reduce the incidence of HIV and other STIs . However, the availability of VCT services in Ethiopia has been uneven, and even when available, uptake has been relatively low .
Ethiopia responded to the HIV epidemic as early as 1985 by developing polices different guidelines (PMTCT, ART, IP, VCT etc.) and strategic documents to create an environment conducive for the implementation of HIV prevention, care, and treatment and support programs. As part of this effort, the first counselling and testing guidelines were published by the Federal Ministry of Health (FMOH) in 1996 and subsequently edited in 2002 and 2007 .
Studies in different areas indicated that knowledge, attitude and practice of tertiary school students towards VCT is low and its uptake is minimal. The low uptake was found to be associated with ignorance, fear of being positive, cost of VCT, inadequate number of VCT centers and stigmatization constituted major hindrances to acceptances of VCT for HIV [7, 8, 12–14].
There are reports on the awareness and uptake of VCT service among different study groups in the study area [10, 15]. However, there are no studies conducted on the knowledge, attitude and practice of University students towards VCT service. Interventions developed for general population may not be appropriate for university students. In order to develop the body of knowledge needed to develop interventions targeted to different category of people, it is necessary to study the overall KAP of university students towards VCT in a variety of institutional settings. The university environment offers great opportunity for HIV high-risk behaviors, including unsafe sex . University students are at risk because they tend to be sexually adventurous, often with multiple partners and do not consistently use condoms [17, 18]. Moreover youths, students of tertiary level, constitute a significant proportion of persons affected by HIV and a good number of them are also sexually active. Knowing the benefits of VCT, it is important to determine their awareness and utilization of VCT services, willingness to undergo and pay for VCT so that barriers can be identified and interventions can be planned. Hence this study aimed at assessing the knowledge, attitude and practice of University students towards VCT service in North West Ethiopia.