Assessment of the enabling and barrier factors for reciept of couple HIV counselling and testing in Rakai district health facilities.

Abstract

INTRODUCTION: Discordant marriages are one of the world’s high risk groups for HIV transmission. Rakai district in Uganda has 55.9% HIV sero discordance rate. Married people who come with their partners for CHCT which would help identify the unknown sero discordant couples are as low as 3%. The objective of this study was to assess the enabling and barrier factors for CHCT among married people receiving HCT services in Rakai district health facilities. The information obtained could assist the DHT strengthen strategies to increase CHCT. METHODS: This was an unmatched case control study among married people who come for HCT in Rakai health facilities. We recruited 80 cases and 160 controls. All the couples who came for HCT in the selected health facilities were requested to participate in the study since couples are few. Qualitative data was captured through FGDs and KI interviews. Quantitative data was analysed using EPI-INFO, SPSS. Frequencies, means and Odds ratios, confidence intervals, p-values were computed. Data was presented in text and tabular form. Qualitative data was analyzed using a master sheet. RESULTS: The enabling factors for CHCT were: age difference more than 10 years between spouses (AOR=5.07, 95%C1=1.07-15.05), political leaders’ mobilization (AOR=5.03, 95%C1=1.97-14.22), Communication between spouses (AOR=39.77, 95%C1=6.82-23.82), Friends (AOR=3.90 95%C1=1.63-9.32) and referral for PMTCT/ family planning (AOR=10.32, 95%C1= 1.10-96.43). The barrier factors for CHCT in this study were; perceived lack of privacy for CHCT (AOR=0.04, 95%C1=0.01-0.17), Fear of discordant results. REDOMMENDATION: All political leaders in Rakai should encourage married people to come for CHCT, the DHT and all HIV/AIDS service providers should; intensify continuous mobilization with messages targeted at couples through radio talk shows and other channels, ensure that privacy for CHCT is provided in health facilities, ensure strong social support networks supporting post test dominant spouses in order to save their marriages and families from collapsing by setting up and supporting post test couple clubs, encourage communication between spouses about HIV/AIDS through radio, drama show campaigns and any other communication channels.