Evaluation of uptake and attitude to voluntary counseling and testing among health care professional students in Kilimanjaro region, Tanzania

Mgosha P Charles 2 Eliningaya J Kweka 1 Aneth M Mahande 1 Longin R Barongo 4 Seif Shekalaghe 0 Hassan M Nkya 3 Asanterabi Lowassa 3 Michael J Mahande 0 0 KCM College of Tumaini University, Community Health Department , PO Box 2240, Moshi , Tanzania 1 Tropical Pesticides Research Institute, Division of Livestock and Human Disease vector control , PO Box 3024, Arusha , Tanzania 2 Ministry of Health and Social Welfare, National AIDS Control Programme division , PO Box 11857, Dar es Salaam , Tanzania 3 Tanzania Wildlife Research Institute, Research Department , PO Box 661, Arusha Tanzania 4 National University of Rwanda, Research Department , BP 117, Butare , Rwanda Background: Voluntary counseling and testing (VCT) is a corner stone for successful implementation of prevention, care and support services among HIV negative and positive individuals. VCT is also perceived to be an effective strategy in risk reduction among sexually active young people.. This study aimed to assess the acceptability of VCT and its actual uptake among young health care professional students at KCM College of Tumaini University and Allied health schools. Methods: This was a cross-sectional study. A structured questionnaire was used among health care professional students aged 18-25 years who were enrolled in degrees, diplomas and certificates courses at Kilimanjaro Christian Medical College and all other Allied health schools Results: A total of 309 students were recruited, among these 197 (63.8%) were females. All respondents were aware of the benefits of VCT. Only 107 (34.6%) of students have had VCT done previously. About 59 (19.1%) of the students had negative for health care professional to attend VCT. Risk perception among the students was low (37.2%) even though they were found to have higher risk behaviors that predispose them to get HIV infection. Conclusion: Awareness of VCT services and willingness to test is high among students; however its uptake is low. In order to promote these services, a comprehensive training module on VCT needs to be included in their training curricula. In particular, more emphasis should focus on the benefits of VCT and to help the students to internalize the risk of HIV so that they can take preventive measures. - Background Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) is a killer disease affecting all age groups from infants to old people [1]. HIV/AIDS has killed more than 3 million adults and children in the year 2005 and it is estimated that 5 million adults and children acquired the infection to make the number of adult and children with HIV/AIDS to be 42 million worldwide [2]. Sub-Saharan Africa remains the most affected region in the world with an estimate of 22.5 million people living with HIV. Approximately 1.7 million new infections occurred in sub-Saharan Africa in the year 2007 [1]. Ten million young people aged 1524 years and almost 3 million children under 15 years are living with HIV [1]. Sub-Saharan Africa is the region with the highest overall HIV sero-prevalence, especially among adults (1549 years) population. However this varies between countries, ranging from less than 2% to above 15%. For example, in Somalia and Gambia the prevalence is below 2%. In other countries HIV prevalence varies; Zambia (20%), Botswana (38.8%), Lesotho (31.5%), Swaziland (33.4%), Central African Republic (12.4%), Nigeria (5.8%), Kenya (15%) and Uganda is (5%) [1]. Tanzania was estimated to have about 2.2 million adults living with HIV/AIDS, among which 15% are in 1524 year age groups and 60% of all new infection occurs in this age group. The overall prevalence of HIV infection among blood donors in 2004 was 7.7% while that in the Ante-natal clinic was 8.4% [3]. Currently, there is no cure or vaccine for HIV/AIDS; however, the provision of Antiretro viral drugs and positive prevention strategies helps to prolong life for those who are already infected. Many countries have been trying to take many different approaches in an attempt to slow the spread of HIV infection and minimize its impact on the individual, family and society. Among these strategies include; voluntary counseling and testing (VCT), provider initiated counseling and testing (PICT), diagnosis of HIV in infants and young children, family care and partner testing and counseling based on index care, condom promotion and provision, detection and management of sexually transmitted infections, safer sex and risk reduction counseling, male circumcision, targeted interventions for sex workers and men who have sex with men (homosexual practice). Others include; occupational and non occupational post exposure prophylaxis, family planning and counseling, antiretroviral medicines for preventing HIV infection in infants, treatment, care, support for pregnant HIV positive women, infant feeding counseling and support, prevention of HIV from mothers to children and prevention of HIV (and tuberculosis) transmission in health care settings (Infection control), blood safety, safe injections and use of standard precautions. All these strategies emphasizes on behavior change and risk reduction behavior which both adult and youth have shown to have positive response to VCT [4] In Tanzania voluntary counseling and testing activities started in 1997, by the end of April 2008 about 5,319,247 clients were counseled and tested for HIV in 1643 HIV voluntary counseling and testing centers in the country [5]. Health care professional students are not spared with the increased HIV infections because majority of them fall under the age group which are at risk of HIV infection and occupational exposure [6]. In addition, the public expect the medical professionals to be seen as a role model in health care seeking behaviour including VCT. It was the objective of this study to assess the acceptability of VCT among the vulnerable group of health care professional students (1825 years) at KCM College of Tumaini University and other health allied schools in the campus in Moshi town. The information that generated from this study for will be useful to health policy makers in developing HIV/AIDS interventions, curriculum development and provision of youth friendly services Study Area The study was conducted at KCM College and other affiliated allied Health Schools at Kilimanjaro Christian Medical Centre. The Kilimanjaro Christian Medical College is incorporated in the Kilimanjaro Christian Medical Center, a research and teaching hospital. It is one among the fourreferral hospitals in the country being situated in Moshi urban district, which is one of the six districts of Kilimanjaro region in North Eastern part of Tanzania. There are about eight voluntary counseling and testing centers in Moshi Municipality, most of them located in town, and these includes, Kinshai, Langani, KCMC-Mbuyuni, Mawenzi Hospital, Rainbow, Pasua Health Center, KCMC and "KIWAKKUKI". KIWAKKUKI is a female non governmen (...truncated)