Factors Influencing Utilization of Voluntary Counseling and Testing Services among Kenya Ports Authority Employees in Mombasa, Kenya

Abstract

Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) remains a problem of public health importance worldwide. About 36.9 million people were living with HIV and AIDS by the end of 2014. The greatest burden of the epidemic with about 25.8 million people living with HIV was in Sub-Saharan Africa which also accounted for 66% of the global total of new HIV infections. In Kenya, HIV burden stands at approximately 1.6 million. Early access to testing and treatment would facilitate containing the pandemic by 2020 and end AIDS epidemic by 2030 (UNAIDS, 2014). Voluntary Counseling and Testing (VCT) aids stigma reduction and also allows for early uptake of services such as counseling for positive living, social support, legal advice and future planning. The objective of this study was to determine factors influencing utilization of voluntary counseling and testing services among Kenya Ports Authority employees in Mombasa. The study participants were drawn from the 8 divisions in KPA using probability proportion to size sampling method (PPS). Respondents within divisions were then randomly selected. Quantitative data was collected using pre-tested structured questionnaires which were administered to 385 respondents. Data was analyzed using the Statistical Package for Social Sciences Version 16 (SPSS 16). Descriptive statistic was used to analyze quantitative data. Marital status was significantly associated with VCT uptake among KPA employees (p=0.015). However there was no significant association between age, education and religion of the respondents and VCT uptake. Majority (91.2%) of the respondents reported having had an HIV test and the main reason was to know their status. However, only 24.4% respondents were tested for HIV in KPA VCT centre. Although many respondents took the HIV test more than once (68.8%), some declined due to no apparent reason, felt it not necessary, feared positive results or thought there was no cure for AIDS. However, those who were tested received feedback promptly (80%) and communicated the test results to their partners (74.9%), although majority did not accompany their partners (56.6%). Accompanying a partner (p=0.017) was significantly xix associated with VCT uptake. The respondents agreed that ARVs improved immunity and prolonged life (85.4%) however majority felt uncomfortable being tested for HIV by someone they knew (63.4%). Fewer females (37.6%) disclosed their HIV results compared to males (62.4%) and more male (66.9%) than female (33.1%) respondents used condoms during sex. The study further indicated that there was a marginal relationship between VCT uptake and the aspect of being denied recruitment or promotion because of HIV status (odds ratio at 95% CI: 0.982, 2.886; p=0.057). Multiple regression analysis was conducted to determine the relationship between dependent and independent variables which showed that all the variables had positive level of significant (p<0.05). In conclusion, fewer employees reported to have ever been tested for HIV in KPA VCT in spite of less stigma and discrimination and VCT centres being at the workplace. More so, fewer employees preferred being tested by a person known to them while some declined the HIV test because of fear of positive HIV results. The main reasons for majority of employees not to accompany their partners to VCT were fear of being denied conjugal rights, being divorced or abandoned. This was also the main reason why fewer females than males reported having used condom during sex, in spite of benefits, and for more males disclosing their HIV status to their partners. Hence, new innovative methods need to be devised in order to motivate employees to utilize the VCT services in KPA. These include provision of VCT services for 24 hours, inclusion of external providers on rotational basis and initiation of programmes that will de-stigmatize HIV and AIDS at the workplace. Couple counseling should be encouraged so as to increase the level of HIV disclosure, especially among females. Females should be empowered so that they can negotiate for safer sex.