It is important to measure the coverage of VCT uptake among young people, not only because of their vulnerability to HIV, but also because they may experience some obstacles in accessing the VCT services [2]. According to the findings of this study, females were more likely to uptake Voluntary HIV Counseling and testing as compared to males. This might be due to the fact that females of 15–24 years old tend to start having sexual activity earlier as compared to males [2]. On the other hand, the low uptake of VCT by males may be due to the fact that males are not fully involving themselves in HIV prevention programs, making it hard for them to recognise the importance of knowing their HIV status as compared to females. This finding is similar to a study done in Ethiopia whereby VCT uptake was found to be higher among females as compared to males [9]. But also look similar to a finding in Western Uganda where by males were found to have low VCT uptake due to inadequate involvement in HIV prevention programs [10].
The rate of VCT uptake was found to be higher among those participants aged 18 years and above as compared to those who were aged below 18 years. This finding might be due to the fact that as the young people grow, they are exposed to VCT and HIV education which make them recognise the importance of knowing their health status. This finding is similar to the finding of a study conducted in Cameron whereby VCT uptake was found to increase with age [11]. However, this study differs with the finding of a Tanzania study by Sukari et al., [12] whose findings indicated that VCT uptake decreased with age. The authors argue that as age increases, young people become more sexually active thus hesitating to undergo HIV testing due to fear of the test results. However, this depends also on the age in which the sample started as respondents at extreme ages may have lower response to VCT uptake due to different reasons such as being sexually inactive, low VCT education and others.
The rate of VCT uptake was also found to increase with the level of education. This is because as the level of education increases, students are being exposed to more education on VCT services and HIV infection which provide them with more confidence of undergoing HIV test but also with some skills on how to avoid HIV infection. This finding is similar to a study conducted in Tanzania-Mwanza, whereby VCT uptake was found to increase with increase in the level of education [13]. This finding is also similar to a study done in Cameroon in which VCT uptake was found to increase with the level of education [11]. Other researchers got similar findings to a survey done in Tanzania whereby VCT uptake was found to increase with the level of education [3].
According to this study, the major proportion of the respondents were aware of the VCT services as majority of the respondents had heard about VCT services and the main source of VCT information was reported to be Media (TV and Radio). The findings look similar to a study conducted in Ethiopia in which the major proportion of the respondents were found to be aware of the VCT services with majority of the respondents (75.66%) mentioning TV and radio as their main source of VCT information [9]. This finding might be due to the fact that many of the participants either reside in town or near town areas where sources of information like media and internet services are easily accessible. In addition, health facilities are available and easily accessible in town, which provides the young people with more access to the VCT information through posters and leaflets in the facilities as well as direct health information from the health care providers. The finding of this study shows that, participants who had visited a health facility were more likely to test for HIV than those who had not visited. This might be due to the fact that people often go to a health facility when they already have a health problem, providing them with more chances of getting to know their health status through the health care providers.
The study found that less number of participants received VCT information from their schools compared to media and health facilities. This might be due to the fact that the VCT education programs are not fully given priority in schools enough to be included in the school programs or curriculums and also the frequency of being mentioned by the teachers during class sessions determines the level of VCT awareness among the students. A few respondents reported receiving VCT information from the parents, friends and worshiping places like church and others, implying that, in these key areas VCT services are not yet given priority though in real sense important areas such as worshiping places if given priority may help increase the VCT services awareness and hence improve HIV testing uptake among the young people. These findings also look similar to a study conducted in northern Tanzania among pregnant women whereby partners involvement, parents, and religion were among the factors found to be influencing VCT uptake [14].
The major proportion of the respondents had high knowledge about VCT services. These findings are similar to a study done in Ethiopia whereby the majority of the respondents were found to have adequate knowledge on VCT services [9]. This might also be due to exposure to VCT education among the students either in school or from other areas.
A major proportion of the respondents had positive attitude towards the VCT services. Similarly another study conducted in Ethiopia found that the majority of the respondents had positive attitude towards VCT services [15]. This was realised as majority of the respondents thought that undergoing VCT was of importance to all people and both HIV-positive and HIV-negative individuals get benefits from the HIV test results [16,17]. This is the correct thinking as those who receive the negative results will know how to protect themselves against HIV infections through abstinence, having one safe and faithful sexual partner and practicing safe sex, but also those who receive positive HIV results will know how to behave so as to prevent further transmission and start medication [18,19].
A significant number of the respondents believed that in order to make more progress in the fight against HIV transmission, VCT services are very important to be given priority in terms of the number of facilities offering the VCT service, quality service to be offered by knowledged care providers, good support to the HIV infected people, ensuring confidentiality and stigma reduction by providing education to the community members. Similar finding in a study conducted in Ethiopia by [9]. The fact that more than three quarter of the study respondents were willing to test for HIV indicates that the majority of the participants understand the importance of VCT services and therefore conducive environments and strategic plans for VCT services can attract more youth towards the service.
A significant number of respondents reported fear from anxiety and stress that may result after have came to know that they are HIV positive as among the main reasons towards low VCT uptake. Some respondents even reported that, if the results become HIV positive they would lose focus on their studies and all other future plans. However, this is due to the fact that they lack knowledge and confidence on how they are going to cope with either of the test results, but also they are not sure of the support and care that may be available for them after have tested and received the positive HIV test results. The findings are similar to a study conducted in Ethiopia, whereby fear from anxiety and stress was found to be among the main factors influenced VCT uptake among the young people [9].
Among the prominent reasons for poor response to VCT was fear of stigmatization from the family and community members. A significant number of the study participants said that, they don’t like to go for VCT as they fear from being stigmatized particularly when they are well labeled as HIV victims. This finding is similar to a study conducted in Tanzania-Mwanza, whereby poor response to VCT was associated with fear of stigma [13,20]. This finding also look similar to the one for a study done in Western Uganda, whereby a significant number of respondents reported fear from being stigmatized as being associated with low response to VCT [10]. Because of this young people may lack confidence to cooperate with different people for some key responsibilities and hence getting deprived of some important rights in the society.
A significant number of the study participants considered themselves at low risk of contacting HIV infection. This was realized as some of the respondents thought that it is not possible for them to contact HIV, while others reported to be trusting on their health and therefore they couldn’t find the importance of going for HIV test. Similar finding was observed in a study conducted in Guizhou province-China, whereby low response to VCT uptake was contributed by low risk perception of acquiring the disease [21,22]. Nevertheless, there are different ways one can acquire HIV and even protection with condoms sometimes may not offer hundred percent protection.
Distance to the VCT centre has been found to be among the factors that hindered the decision towards VCT uptake. Participants who reported to reside near the VCT centre were more likely to undergo HIV testing than those who reported to reside far. Among the reasons given included absence of VCT centre around their school premises, lack of knowledge about VCT and its location, lack of money to go for VCT as it involved some costs to reach the centre. But also a significant number of the respondents reported to be busy with no enough time to go for VCT services. Similarly, a study conducted in Tanzania-Mwanza, long distance was associated with low VCT uptake among the students [5,12]. Also a systematic review of published qualitative research in sub-Saharan Africa found that, direct and indirect costs were found to be associated with low uptake of VCT [23,24].