Factors Associated with Utilization of Voluntary Counselling and Testing Services among Boda Boda Operators in Ndhiwa Constituency, Homa Bay County, Kenya

Abstract

Voluntary Counselling and Testing (VCT) is one of the initiatives used to deliver HIV/AIDS preventive information. It enhances access to antiretrovirals (ARVs), HIV patient care and support as well as behaviour change. In spite of these benefits, its utilization is still low in Kenya’s most rural areas like Ndhiwa constituency which has high HIV prevalence. This low VCT utilization exposes the public, including Boda Boda operators to lose on benefits of VCT services. This is likely to put the transport sector in Ndhiwa Constituency, provided mainly by Boda Boda business, at risk of low activity owing to dangers of HIV infection. The objective of this study was to determine level of utilization of HIV-VCT services (testing for HIV at VCT centre) and factors associated with VCT utilization among Boda Boda operators in Ndhiwa constituency. In this cross-sectional study, pre-tested questionnaires were administered to 231 operators while in-depth interviews were conducted for four selected key informants. Data were entered and analysed in SPSS Version 16.0. Descriptive statistics using frequencies and proportions were used to determine levels of VCT utilization and VCT awareness. Odds ratio at significance level p value <0.05 was determined to establish factors associated with VCT uptake among the operators. Factors that showed association were entered into logistic regression analysis to control for effect of confounding in establishing predictors of VCT utilization. Qualitative data were analyzed through the scrutiny of words or phrases mentioned by the interviewees on thematic areas based on the variables and literature review. Majority of the operators were males (91.3 %), 52.4% were married while 47.6% were single. The ages of the participants ranged from 15-57 years with the mean of 27.2 years. Most operators were within the age groups of 20-24 and 25-29 years at 31.2 % and 33.8% respectively. With respect to religion, majority were Seventh Day Adventists (37.7%). The participants who attained primary level of education were 48.1% while those with secondary education were 44.2% and only 7% had post secondary education. Majority of the participants came from the terminus of Magina market centre (25.5%). Level of utilization of VCT services among the Boda Boda operators was 72.1% while 96% of them were aware of existence of at least one VCT site within the constituency. Key informants also mentioned high VCT utilization and awareness among the participants. Factors that showed significant association to VCT utilization at both bivariate and multivariate analysis were gender (AOR=4.529, 95% CI: 1.753-11.687), visiting a VCT centre with a partner (AOR=16.39, 95% CI: 3.012-27.986) and assurance of confidentially in HIV test results (AOR =4.79, 95% CI: 2.033-8.907). Going to a VCT centre in which the operator was known (AOR=0.152, 95% CI: 0.034-0.221) and fear of being seen at VCT centre (AOR=0.551, 95% CI: 0.307-0.988) were likely to hold over the operators from HIV testing. In conclusion there is high level of VCT service utilization and awareness among the Boda Boda operators. VCT utilization uptake among the operators is influenced by gender, assurance of confidentiality of the HIV test results, going to a VCT with a partner, fear of being seen at a VCT centre and going to a VCT in which the operator is known. Interactive programmes between the operators and the immediate society on VCT services that encourage the transfer of the high level HIV/VCT awareness of the operators to the general public should be developed. Couple counselling and testing, provision of specialised training and development of peer educators as well as development of programmes that de-stigmatize HIV/AIDS by the relevant ministries of health together with other development partners in the health sector will increase utilization of VCT services among the operators and the immediate society.