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JOURNAL OF RESEARCH IN NATIONAL DEVELOPMENT VOLUME 7 NO 2, DECEMBER, 2009

KNOWLEDGE AND ATTITUDE TO HIV VOLUNTARY COUNSELLING AND TESTING AMONG STUDENTS IN TERTIARY INSTITUTIONS IN DELTA STATE, NIGERIA

Chris Ewhrudjakpor
Department of Sociology/Psychology, Delta State University, Abraka, Nigeria
E-mail: acadchris@yahoo.com

Abstract
The objectives of the study are to (i) assess knowledge of HIV (ii) assess attitudes toward HIV VCT and (iii) determine the relationship between knowledge of HIV and attitudes towards HIV VCT. 2815 students of tertiary educational institutions in Delta State were randomly drawn through a multi-stage sampling technique. With the aid of a structured questionnaire consisting of three sections; respondents’ socio-demographics, knowledge of HIV, and attitude scale towards HIV VCT, data was gathered. The data was statistically analysed using simple percentages and  Pearson product – moment correlation. The results show that (i) respondents had good knowledge of HIV (ii) attitudes towards HIV VCT was negative and (iii) respondents knowledge did not significantly correlates with negative attitudes towards HIV VCT. These results were discussed in the light of past studies related to this study and the subject matter of knowledge – Attitude of HIV VCT. The findings were situated in the health belief model. It was recommended among others, that legislation be passed to ensure compulsory HIV VCT as part of General studies in the schools curriculum. The mass media add campaigns of HIV VCT to the already known A-B-C model of HIV/VCT in Delta State.

Keywords: Nigeria, human immune deficiency virus, voluntary counselling and testing, students


Introduction
There has been growing concern for HIV voluntary counselling and testing services that foster risk-reduction behaviour based on knowledge of HIV status and link to government institutions with care and support services. The arguments put forward are that (i) individuals have a right to know their infection status to protect themselves and others from infection (ii) VCT may enable people to cope with the anxiety associated with the uncertainty of not knowing one’s HIV status, (iii) early detection of HIV may improve the medical, social, and psychological support for HIV infected persons, and (iv) HIV VCT has been shown to promote safer sex (De Zoysa, et al. 1995;Akpede,et.al 2002;Ekanem and Gbadegesin,2004;Kamb,et.al,1998;Okonta and Oseji,2006;and Okpala,et.al,2009)

Human Immune Virus (HIV) is a retrovirus that sets in motion the course of Acquired Immune Deficiency Syndrome (AIDS). Median HIV prevalence in Nigeria has steadily increased from 1.8% in 1991 to 5.8% in 2001, the range of HIV prevalence from 85 sites across the 36 states and Federal capital Territory was from 0.8% to 16.4%. 21 out of 85 sites were rural, where HIV prevalence ranged from 2.2% to 16%. The sites with the highest prevalence in the 2001 sentinel survey were rural (Utulu, 2006; UNAIDS, 2006).

In 2001, HIV prevalence among the 15 – 19 year old attendees tested was 5.9%, among the 20 -24 years olds the rate was 6.0% and among the 25-29 olds, 6.3%. In the major urban areas, HIV prevalence among clinic attendees has increased from 1% in 1991 to nearly 5% in 1999; in 1999 HIV prevalence ranged from 3% to 8% (Utulu, 2006). The most strategic form of care and support for people generally is counselling and testing as preventive measures of HIV/AIDS. This study is aimed at profiling knowledge of HIV/AIDS and psychosocial factors impeding positive attitudes to voluntary counselling and testing (VCT) of the most vulnerable group-young people in the fight against HIV and AIDS in Nigeria.

 

Statement of the problem
Utulu (2006) reports that the declaration of commitments, which resulted from the United Nations General Assembly Special Session (UNGASS) on HIV/AIDS in June 2001, highlighted the pressing need for countries to either develop or scale up voluntary HIV

 counselling and testing (VCT) services. It noted that participating nations commitment

“to ensure that  a wide range of prevention programmes is available in all countries, including expanded access to voluntary and confidential counselling and testing by 2005”

Voluntary HIV counselling and testing is the process by which an individual undergoes counselling to enable him/her to make an informed choice about being tested for the human immunodeficiency virus (HIV). This decision must be entirely the choice of the individual and he or she must be assured that the process will be confidential.

VCT services are meant for all (literate and illiterate people). It is a key component of both HIV prevention and treatment programmes but in Nigeria, HIV/VCT is not taken seriously due to fear of stigmatization and discrimination (Myers, et al, 1993; Meiberg, et al, 2008; WHO, 1994; Boyd, et al, 1990; UNAIDS, 2004; Ewhrudjakpor, 2006d).

In recent years, voluntary HIV testing in combination with pre and post test counselling has become increasingly important in national and international prevention and care efforts. Knowledge of serostatus through VCT can be motivating force for     HIV positive and negative people alike to adopt safer sexual behaviour, which enables seropositive people to prevent their sexual partners from getting infected and  those who test seronegative to remain negative. This intervention also facilitates access to prevention services for seronegative people and is a key entry point to care and support services for those  who are HIV infected. For instance, knowledge of seropositive of a pregnant  mother will reduce mother to child transmission of HIV, secondly, interventions through VCT will prevent opportunistic infections such as tuberculosis, prophylaxis and others. This will help HIV positive people live longer, healthier and satisfied lives.

This study is therefore designed to profile students knowledge of HIV/AIDS and their attitude towards voluntary counselling and testing (VCT) for HIV in Nigeria. This is against the backdrop of cultural, social, familial, bureaucratic and technological problems associated with counselling and testing for HIV as documented in earlier studies (Dorr, et. al; 1999; Flowers, et al, 2003; Fortenberry, et al 2002; Kalichman, et. al, 2003; Day, et al, 2003; and Peltzer, et. al, 2003;Popoola,2005).

Many studies (Kidanu, et al, 2001; Parker, et al, 2003; Crocker, et. al, 1998; Bos, et. al, 2001; Simbayi, et al, 2007; Malcolm, et.al, 1998; and Meiberg, et. al, 2008) have described the HIV/AIDs epidemic as an epidemic of ignorance, fear and denial leading to stigmatization of and discrimination against people living with HIV/AIDs and their family members.

Therefore, the objectives of this study are (i) to assess the present state of knowledge and (ii) attitude towards voluntary counselling and testing among undergraduates in Delta State tertiary educational institutions (iii) to determine the relationship between knowledge and attitude towards HIV VCT.

The Health Belief Model
This model relates theories of decision making to an individual perceived ability to make choice of alternative health behaviours (Rosenstock, 1974). Health belief model (HBM) is based upon the ideal that it is the world as it is perceived that determine individuals action. According to this model, individuals will act to avoid health problems, but they first need to believe that the probability that an individual will act to improve his or her health is determined by the individual’s perception of the benefits of and the barriers to alternative health behaviours.

The HBM is based on the fact that an adult will take a health – related action (that is go for HIV voluntary counselling and testing as in this study) if that person feels that a negative health condition HIV/AIDS can avoided or be known

and then manage it socio-psychologically and medically.

Methodology
Area of study
Delta State was created on August 27, 1991 out of the defunct Bendel State, in the south – south geopolitical region of Nigeria. The State lies roughly between longitudes 5o00’ and 6o00’ East of the Greenwich Meridian and Latitudes 5o00’ and 6o30’ North of the equator. The 2006 census figure is 4,098, 391 consisting of 2,074,306 males and 2,024,085 females (Federal Republic of Nigeria Official Gazette, 2007). There are twenty five local government councils in three politically designated senatorial districts occupied by five main ethnicities (Izon, Isoko, Itsekiri, Urhobo and Igbo including Ukwuani) and 14 tertiary educational institutions (Inside Delta State, 2004). The State has healthcare facilities in primary, secondary and tertiary levels. That is, numerous primary health care centres (PHCs), 44 secondary health institutions and a teaching hospital. These facilities reach perhaps 10% of the population (Mostly in cities and towns). Life expectancy is 52 years (Udonwa, et al, 2004). HIV/AIDS prevalence rate in the south-south geo-political zone where Delta State is a member is 7.7% as at 2003 (Utulu, 2006).

Sample size/ sampling technique
The study was conducted with 2815 students sampled from 14 government owned tertiary institutions in the state. This group is a sexually active target population and is relatively easy to reach and responsive in academic matters. Specifically the multi-stage cluster sampling technique was used to select the respondents. Out of the 3000 questionnaires distributed, only 2815 or 93.83% were recovered and accepted for statistical analysis.

Instrument
The researcher used a structured questionnaire schedule consisting of three sections namely:  Section “A”:Socio-demographic information on sex, age, and faculty of study; Section B :  Knowledge about HIV VCT. This contained eight factors impacting HIV and VCT. The response here were weighted ranging from 10 to 0,2 to 0. The total maximum score is 80 with an average score of 40. Section C: Attitudes towards HIV VCT. The technique of summated ratings (Likert, 1932) was used to construct the attitude scale. The 22 questions were framed in simple and clear sentences. The questions included positive and negative aspects of HIV VCT. Thus 11 positive and 11 negative statements  were assigned a scale value of 1,2,0,3,4,5 representing these options, which the student have to choose one, namely; “strongly disagree”, “disagree”,  “undecided”, “agree” and “strongly agree” respectively. The average positive attitude score per respondent was 55.

Validity and reliability of instrument
The 22 statements generated were pre-tested and yielded test retest reliability of r = 0.86. Also, with a known – group method of construct validation, the researcher found a validity score; t = 13.02; d.f, 11, p< .05; r = 0.89; df, 10,p<.05 known group of seropositive and seronegative people in Delta State.

Procedure for data collection
A multi-stage sampling technique was used to select the respondents. Out of the 14 tertiary institutions, 2815 student were drawn from seven faculties using simple random sampling. In each of the institution a proportional number of questionnaire was used, specifically in the ratio of 4:3:2:1 in respect of University, Colleges of Education, Polytechnics and Schools of Nursing and Midwifery. The questionnaires were administered through the departments’ Administrative officer after been debriefed on anonymity distribution and retrieval techniques. This exercise lasted five months (January – May of 2009). The administrative staffs used were given some token financial assistance to pay for any miscellaneous expense. Finally, out of the 3000 questionnaires given to the administrative staffs, 2815 was retrieved and were suitable for statistical analysis.

Statistical design
The cross-sectional design was employed in the data analysis. That is knowledge of HIV VCT was tied to attitudes towards actual testing. Therefore, apart from simple percentages used to describe socio-demographics of respondents, the Pearson’s product – moment correlation was used to analyze the cross-sectional design of knowledge and attitudes about HIV VCT. Here,

knowledge is the independent variable (X) and attitudes, the dependent variable (Y). It was expected that, good knowledge  of HIV VCT will encourage positive attitude towards testing.

Results
After statistical analysis of data collected, results were presented (Table 1-4).

Table 1: Summary of socio-demographics with corresponding knowledge and attitude scores of respondents (N.2815)


Socio-demographics Variables

Male

 

Female

 

Knowledge

 

Attitude

 

 

No
1132

%
40.21

No
1683

%
59.79

Male

Female

Male

Female

Age

 

 

 

 

 

 

 

 

15 < 20

103

9.10

129

7.66

9270

6181

2575

39995

20< 25

790

69.79

937

55.67

94800

164560

8964

10496

25<30

201

17.76

594

35.29

34170

195116

3653

9842

30 <35

38

3.35

23

1.37

11780

294010

246

422

Mean Age

23.16

 

21.02

 

 

 

 

 

Faculty of Study

 

 

 

 

 

 

 

 

Arts

201

17.76

606

36.01

41002

58226

3110

5601

Education

246

21.73

309

18.36

3665

613100

2256

3100

Law

46

4.06

18

1.07

2684

5107

106

204

Medicine

104

9.19

122

7.25

194906

199881

646

965

Science

186

16.43

164

9.74

161002

176664

4116

6885

Social Science

233

20.58

309

1836

98951

120041

399

524

Technology

116

10.25

155

9.21

86792

110566

2100

2819

Ethnic Group

 

 

 

 

 

 

 

 

Urhobo

601

53.09

733

43.55

165981

98521

12845

14791

Itsekiri

92

8.13

121

7.19

9886

16454

902

1090

Isoko

103

9.10

238

14.14

18311

19466

169

565

Izon

89

7.86

67

3.98

8642

198851

264

360

Ibo (Ukwuani)

247

21.82

524

31.13

263421

299562

989

1425

Source: Fieldwork 2009

Table 2:  Summary of respondents knowledge factors and attitude scores towards HIV VCT (N= 2815)


Knowledge Factors

Respondents

 

Knowledge Scores

Attitude Scores

 

No

%

 

 

*Source(s) of Information

 

 

 

 

Media

1609

57.16

9663569

1,264,410

Know of Sufferer

32

1.14

8614

3101

Friends

811

28.81

10064

1210

Workshop/Seminar

46

1.63

9215

1822

Reading Boots/Poster

14

0.50

496

1312

Never Heard of HIV

00

0.00

00

00

* Cause(s)

 

 

 

 

Unprotected Sex

2645

93.96

8593042

2,311,230

Witches

21

0.75

335

864

Innoculation

1961

69.66

1689

1415

Germs

641

22.77

2454

3369

Curse

146

5.19

1200

2576

Poverty

896

31.83

16898

21456

Blood Transfusion

1064

37.80

236145

3615

Hereditary

13

0.46

610

492

* Signs and Symptoms

 

 

 

 

Weight loss

1884

66.93

5615602

165712

Frequency fever

1963

69.73

19810

142906

Frequency Diarrhea

2006

71.26

21829

123681

Blindness

00

0.00

00

00

Loss of Appetite

896

31.83

8914

965

Persistent Caught

1404

49.87

27752

1066

Stomach Ache

891

31.65

1009

9642

* Consequences

 

 

 

 

Social Stigma

2815

100

9856330

2639614

Death

1961

69.66

39561

8445

Feeling of inferiority

2699

95.88

18989

7630

No Change

00

0.00

00

00

Rejection by Friends

1998

70.98

17800

8992

Protection

35

1.24

211

404

Good Health

00

0.00

00

00

* Ethnic Beliefs

 

 

 

 

Normal ill health

00

0.00

00

00

Evil Doer

1968

69.91

12520

891

Witch/Wizard

610

21.67

8900

742

Ostracized

1860

66.07

16752

1902

Curability

 

 

 

 

Curable

26

0.93

961

1104

Incurable

2729

96.94

49697

321064

Do not Know

60

2.13

433

239

* Barriers

 

 

 

 

Traditional values

2716

96.48

561664

168145

Friends

1819

64.62

321001

151024

Family Members

965

34.28

8910

1290

Social Stigma

2815

100

9856330

2689614

* Response of Family

 

 

 

 

Neglect

2806

99.68

8657721

2528152

Prayers

106

3.76

892

2149

Psychosocial Supports

31

1.10

396

814

Traditional Medicine

865

30.73

1050

1004

Orthodox Medicine

1906

67.71

396564

236599

Do not know

39

1.38

217

314

*N.B: Respondents chose more than one item among the options of the variables.
Source: Fieldwork 2009

Table 3: SPSS output summarizing the Pearson Product Moment Correlation analysis on the relationship between Respondents Knowledge of HIV and Attitudes towards VCT (N = 2815)

 

 

Attitude

Source(s) Information

Cause(s)

Signs and Symptoms

Consequences

Ethnic beliefs

Curability

Barriers

Response of Family

 

 

Y

X1

X2

X3

X4

X5

X6

X7

X8

Pearson correlation

 

1.000

.181

.106

.102

.169

.104

.166

.186

.162

Source(s) of Information

X1

.181

1.000

.107

.119

.172

.114

.164

.181

.101

Cause(s)

X2

.106

.107

1.000

.144

.111

.164

.101

.192

.102

Signs/symptoms

X3

.102

.119

.141

1.000

.114

.144

.102

.122

.129

Consequences

X4

.169

.172

.117

.149

1.000

.114

.164

.101

.111

Ethnic beliefs

X5

.104

.114

.164

.114

.101

1.000

.110

.140

.133

Curability

X6

.116

.164

.145

.144

.194

.119

1.000

1.29

.168

Barriers

X7

.186

.181

.116

.104

.166

.142

.142

1.000

.109

Response of faculty

X8

.162

.101

.164

.110

.192

.104

.121

.166

1.000

Sig. (Two tailed test)

Y

000

000

000

000

000

000

000

000

000

Source (s) of Information

X1

000

 

000

000

000

000

000

000

000

Cause(s)

X2

000

000

 

000

000

000

000

000

000

Signs/symptoms

X3

000

000

000

 

000

000

000

000

000

Consequences

X4

000

000

000

000

 

000

000

000

000

Ethnic beliefs

X5

000

000

000

000

000

 

000

000

000

Curability

X6

000

000

000

000

000

000

 

000

000

Barriers

X7

000

000

000

000

000

000

000

 

000

Response of family

X8

000

000

000

000

000

000

000

000

 

N

Y

2815

2815

2815

2815

2815

2815

2815

2815

2815

 

X1

2815

2815

2815

2815

2815

2815

2815

2815

2815

 

X2

2815

2815

2815

2815

2815

2815

2815

2815

2815

 

X3

2815

2815

2815

2815

2815

2815

2815

2815

2815

 

X4

2815

2815

2815

2815

2815

2815

2815

2815

2815

 

X5

2815

2815

2815

2815

2815

2815

2815

2815

2815

 

X6

2815

2815

2815

2815

2815

2815

2815

2815

2815

 

X7

2815

2815

2815

2815

2815

2815

2815

2815

2815

 

X8

2815

2815

2815

2815

2815

2815

2815

2815

2815

Source: Fieldwork, 2009

Table 4: Summary of Pearson Product – Moment Correlation Showing the relationship between Respondents Total Knowledge Factors of HIV and their Attitudes towards VCT (N= 2815)

Psychosocial Variables

Total Score

Mean Score

S.D

df

R value calculated

r. critical value

Knowledge of HIV

99645884

35398.18

291.64

 

2813

 

0.123

 

.195

Attitude towards VCT

8256042

70

   2932.87

83.35

 

 

 

(r= 0.123; d:f = 2813; p > .05)

Source: Fieldwork, 2009

Findings
i)          Knowledge of HIV was good
ii)         Attitude towards VCT was negative
iii)        There was no relationship between good knowledge of HIV and negative attitude towards VCT.

*          These findings were derived from statistical analysis contained in tables one to four and are discussed in the context of related studies retrieved and the health belief model.

Discussion
This study was aimed at three basic objectives, that is (i) to assess the present state of knowledge and (ii) attitude towards voluntary counselling and testing (VCT) and (iii) to determine the relationship between knowledge of HIV and attitude towards VCT. The study was conducted in Delta State among students drawn from 14 government owned tertiary institutions. Table one contains 2815 students consisting of 1132 (40.21%) males and 1683 (59.79%) females with mean ages of 23.16 and 21.02 years respectively, representation of the five ethnic groups and seven occupational courses of study. They were randomly sampled through multi-stage sampling technique using a structured questionnaire consisting of three sections: socio-demographics, knowledge of HIV questionnaire and attitude scale towards VCT. The data generated were subjected to statistical analysis with the aid of simple percentages and Pearson product – moment correlation. The results are shown in tables one to four.

The first objective of this study was fulfilled, that knowledge of HIV was good. In table one, knowledge scores relating to socio-demographics of respondents was tabulated. It shows unanimously that these students have good knowledge of HIV  considering the huge score over the average knowledge score of 720 (that is 40 per person) as contained in the instrument scoring under methods in this study. Meanwhile in table one, knowledge scores ranged from 2684 from Male Law Students to 299562 from Ibo and Ukwuani female students. In addition, table two also summed the factors of knowledge on HIV, and it again supports the earlier results in table one. For instance, on the source of knowledge, the media had 57.16% as the commonest source of knowledge on HIV. On causes of HIV, unprotected sex had 93.96% positive responses, on consequence; social stigma had 100%, and others, this  goes to further support knowledge scores derived in table one. This finding corroborates earlier studies (Myers, et al, 1993; Okonta, and Oseji, 2006; Akpede, et al; 2002; Utulu, 2006; Popoola, 2005; Boyd, et al, 1990; UNAIDs, 2006; Ewhrudjakpor, 2006d; kidanu, et. al. 2001; Parker, et. al, 2003).

This study’s second objective to assess the corresponding attitudes of students VCT to knowledge of HIV showed that it was negative. In other words, despite good knowledge of  HIV, the respondents had low attitudinal scores portraying negative attitudes. This was based on the study’s ‘attitude scale’ scoring that had 55 per respondent as minimum positive score. The result (table 1) showed that attitude scores ranged from 106 among Male Law students to 14791 from Urhobo female students. This translated to an individual attitude score averages of; 2.30 to 24.61 as against the study’s positive attitude average of 55 per respondent. This shows a significantly negative attitude towards HIV VCT in Delta State of Nigeria. Table two which shows summarization of attitude scores according to knowledge factors confirmed results contained in table one. For instance, on knowledge factors having media as the commonest source of information with knowledge scores of 9663569 averaging per respondent 6005, had attitudinal score of 1,264, 410 average per respondent 785.835, against the expected positive attitude scores of 88495. Also, on consequences, the attitudinal score was 2639614 average per respondent 937.695 far less than 88495 (the minimum possible positive score). These shows clearly significant negative attitudes towards HIV VCT. These results support findings in past studies (Akpede, et al, 2002; Okpala, et. al, 2009; UNAIDS, 2004; Kalichman and Simbayi, 2003; Peltzer, et. al, 2003 and Ekanem, and

 

Gbadegesin, 2004; Crocker, et. al, 1998; Bos, et. al, 2001).

Furthermore, table three showed a re-confirmation of results contained in tables one and two using a computer application of the Statistical Package for Social Sciences (SPSS) version 14 Pearson product – moment correlation to analyze correspondences between each of the eight knowledge factors and attitudinal responses to HIV VCT. These results fulfil the third objective of this study, which is to determine the relationship between knowledge of HIV and attitudes towards HIV VCT. The inter – correlationship amongst these knowledge factors and attitude is unambiguously shown in table three.

In table three, there are three rows, the first row gives the coefficient of correlation of the eight  elements (X1-X8) against attitude which is 1.00. The second row gives the significance level .000 which practically chosen as .05 alpha level of the test, and the third row gives the total number of observations (2815 respondents) considered in the analysis. It is the breakdown of how each knowledge item reached significance when subjected to the chosen .05 alpha level which is 0.195 in the statistical table that translates to positive or negative attitudes towards HIV VCT.

Therefore, from results shown in the second row of table three, all eight knowledge factors did not reach significance or alpha level of .195. This literally interpreted, means that each of the eight HIV knowledge factors did not relate positively with attitudes towards HIV VCT. Confirming result contained in tables one and two earlier discussed. In addition, table three was summarized in table four which expressly relates all knowledge factors summed and sum total of attitudinal scores. Again, here, the results (r=0.123; d.f=2813; p> .05) showed the unambiguity of respondents negative attitudes towards HIV VCT. This result and finding provides solution to objective three, that despite good knowledge of HIV, respondents attitudes towards HIV VCT is significantly negative. It however corroborates earlier researches (Meiberg, et. al, 2008; Fortenberry, et al, 2002; Day, et. al, 2003; Kamb, et. al, 1998; and  De Zoysa, et al, 1995) in the literature.

Now in relating knowledge and attitude towards HIV VCT, there are barriers respondents face, which act significantly to block positive attitudes, in this study the most potent was traditional values and fear of social stigma with responses of 96.48% and 100% respectively. This finding situates in the Rosenstock (1974) model of health belief, that succinctly states, individuals act to avoid health problem based on perception of benefits and barriers to alternative (VCT) health behaviours. In this society, up until now, attitude towards people living with HIV/AIDS (PLWHA) is absolutely negative, hence fear to get VCT is real and alive as found in this study and supported by earlier researchers (WHO, 1994; Dorr, et. al, 1999; Flowers, et. al, 2003; and De Zoysa, et. al, 1995; Simbayi, et. al, 2007; Malcolm, et. al, 1998; Parker, et. al, 2003; and Kidanu, et. al, 2001) related to this subject matter in question.

 

Conclusion
This study used 2815 students drawn from 14 tertiary educational institutions in Delta State of Nigeria. The study was designed to assess knowledge of HIV, attitude towards HIV VCT and relationship between knowledge of HIV and attitudes towards HIV VCT. Data collected through the use of structured questionnaires were statistically analyzed and the results showed unequivocally that; (i) students have good knowledge of HIV, (ii) students have negative attitudes towards HIV VCT, and (iii) Students good knowledge of HIV does relate negatively to their attitudes towards HIV VCT.

These results were discussed in the light of past studies related to the subject matter of knowledge, attitude and HIV VCT. The findings were also explained situated in the Health Belief Model (HBM) of Rosenstock (1974). The author finally made recommendations in order to stem this negative trend and reverse negative attitudes.

Recommendations
There is growing concern and demand for HIV VCT services in order to stem the increasing rate of mortality from HIV. The most potent ways to get these done and reverse negative attitudes towards HIV VCT as revealed in this study’s findings is to legislate for compulsory VCT (i)

 

aspect of General Studies in the schools curricula (ii) before any form of attention to students in the institutions health facilities. Result of this test must remain confidential.

Also, HIV VCT centres be made readily accessible in every primary, secondary and tertiary health institutions in the state. Presently only a few secondary and tertiary health institutions have facilities to run the HIV VCT. This is not proper considering the wealth of Delta State (Udonwa, et. al, 2004). In addition, the mass media should be encouraged to intensify campaigns on HIV VCT, which is presently in the state still campaigns on the abstinence, behaviour and condom use (A-B-C) Model of HIV/AIDS(Popoola,2005).


References
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