244485 Acceptability of provider initiated HIV testing and counseling (PITC) among tuberculosis patients in private health facilities in the Amhara Region, Ethiopia

Monday, October 31, 2011

Mohammed Dawd Negash, Bsc, MPH , Private Health Sector Program, Abt. Associates Inc., Addis Ababa, Ethiopia
Temesgen Assefa Alemu, MPH , Private Health Sector Program, Abt Associates, Addis Ababa, Ethiopia
Abenet Leykun, MPH , Private Health Sector Program, Abt Associates, Addis Ababa, 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.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Protection of the public in relation to communicable diseases including prevention or control

Learning Objectives:
Determine acceptability of provider initiated testing and counseling (PITC) among tuberculosis patients. Identify factors influencing the uptake of PITC services among tuberculosis patients.

Keywords: HIV/AIDS, TB

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am Mobile HlV counseling and testing Program Coordinator working on HCT programmatic activities under the USAID Private Health Sector Program which includes Voluntary Counseling and Testing (VCT) and Provider Initiated Counseling and Testing (PlCT).
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.