Acceptability of provider initiated HIV testing and counseling (PITC) among tuberculosis patients in private health facilities in the Amhara Region, Ethiopia

Background: Ethiopia's tuberculosis (TB) control program utilizes directly observed therapy-short course (DOTS) in private health facilities. To benefit from available care and treatment options, TB patients should first be counseled and tested for HIV. Providers are advised to initiate testing and counseling for their TB patients. Methods: The USAID-funded Private Health Sector Program (PHSP) conducted a facility-based cross-sectional study to assess the acceptability of provider initiated testing and counseling (PITC) and factors influencing its uptake among TB patients in public-private mix-DOTS sites. In March 2010, data was collected from 412 TB patients at 19 private health facilities in the Amhara Region. Odds ratios and logistic regression analyses were employed to identify the factors influencing PITC uptake and measure the degree of association between socio-demographic, knowledge, and perceived barriers. Results: Acceptability of PITC was 66.2%. Reported barriers for low acceptability of PITC included: previously tested (66.0%), inability to pay (56.3%), fear of stigma and discrimination (44.7%), unable to cope with a positive result (20.4%), and fear of partner's reaction (18.4%). Respondents aware of the availability of PITC were 4 times more likely to accept PITC (AOR: 4.01, with 95% CI: 1.63-9.84) than those who were unaware. Conclusions: Several barriers hinder the acceptability of PITC. Awareness campaigns for PITC should be conducted to improve utilization. Free access to HIV rapid test kits and price negotiation with private clinics to make HIV testing services more affordable will also improve private clinic PITC service utilization.