Barriers to Utilization of Institutional Voluntary HIV Testing and Counseling Services Among Students Aged 18-24 in Selected Kenyan Public Universities

Abstract

Kenya is home to an estimated 1.7 million people living with HIV/AIDS. Globally, young people aged 15-24 are a highly vulnerable population with respect to HIV/AIDS infection and transmission. According to the Kenya AIDS Indicator survey (KAIS, 2012), HIV prevalence in the age group 15-24 stood at 2.2%. HIV testing and counseling services play a critical role as an entry point to care and treatment. However, utilization of HIV testing and counseling services among the youth in Kenya has been reportedly low, a trend with negative implications on HIV transmission and treatment outcomes. The main aim of the study was to determine the barriers to utilization of institution-based voluntary counseling and testing (VCT) services among students aged 18-24 in selected public universities in Kenya. The specific objectives were to determine the individual level and facility level factors impeding utilization of institutional voluntary counseling and testing services for HIV among students and assess the associations between various socio-demographic factors and service utilization in institutional VCT facilities. This research adopted a descriptive cross-sectional study design where primarily, data was collected using semi-structured questionnaires and through focus group discussions held with the students in the three public universities; Kenyatta University, University of Nairobi and Jomo Kenyatta University of Agriculture and Technology public Universities. Multi-stage sampling technique was used to reach a student sample size of 305 spread across the three study sites. Results from the study indicated that utilization of institutional VCT services stood at a low of 45% from a population where 84.4% were aware of the presence of these services on their campuses. Accessibility to test site, testing hours, fear to be seen at site and fear of test result were identified as the most commonly reported barriers to service utilization. Additionally, age category (p=0.02) and marital status (p=0.029) proved to be significantly associated with utilization of VCT services among students. Students from the Health-related departments were more likely to test (OR=1.38) than those from non-health related departments. This study recommends that gender and age-specific specific strategies should be put in place to contribute to improving utilization of services. More so, VCT facilities that reflect the most desired characteristics such as accessibility and flexible testing hours should be used. Further research should also focus on the persisting risky sexual behaviors among university students despite the high knowledge they have on HIV/AIDS.