Factors associated with utilization of HIV testing services in Integrated Counseling and Testing Centers (ICTC) in India: How can behavior change communication increase use?

Background: To assess baseline use of HIV testing services in Integrated Counseling and Testing Centers (ICTC), a survey was conducted in 22 of 35 districts in Maharashtra, India for the development of a demand generation campaign for ICTC Services.

Methods: Using a two-stage sampling design, 870 respondents – 478 males and 392 females - 18-49 years living in rural (n=416) and urban (n=454) areas completed an interviewer-administered survey. Mean age of respondents was 27 years (Median 24); 92% attended school with 11 as median highest grade completed; average monthly household income of INR 6212 (Median INR 4000); 52.5% married; and 27% students, 5.5% unemployed, 17% housewives, 15% agricultural labor, 20% in business/self-employed. Mass Media and information, communication and technology (ICT) access was high.

Results: Only 9% (79) respondents ever used ICTC services although 59% (511) heard of them and 45% (389) knew government HIV testing /counseling services were free. Married respondents (P<.001), female (P<.01), those who attended school (p<.05), heard of HIV-testing (p<.01), were exposed to HIV-education print materials (p<.01), and perceived some personal risk of acquiring HIV (p<.01) were significantly more likely to use ICTC. No significant differences were found in age, religion, urban/rural residence, income, mass media and ICT access between users and non-users.

Conclusions: There is a significant gap between awareness and use of HIV testing services. Greater exposure to communication about HIV testing will have a positive effect on ICTC utilization; however, behavior change communication needs to address the usage gap and perceptions of personal risk.