Abstract

Background: In 2011, Uganda had a national HIV prevalence of 6.7%. Between 2008 and 2009, there was an upsurge in HIV in Gulu District from 9.4% to 16.0% with Gulu Municipality at 22.1%. Similarly, in 2020, the prevalence of HIV in Gulu District persistently remained high at 14.0%, much higher than the national average at 6.0%. The objective of this study was to assess knowledge, attitudes, hindrances, and practices on voluntary HIV counselling and testing (VCT) and determine factors associated with VCT practices among adults seeking treatment at the outpatient department of Gulu Regional Referral Hospital.

Methods: A cross-sectional study was conducted with 384 participants. Simple random sampling was used to recruit participants. Knowledge and practices on VCT were determined using knowledge ratings and attitudes using a modified Likert scale. A questionnaire with an internal validity of Cronbach’s α=0.71 was used. Ethical approval was obtained, and SPSS was used for data analysis at univariate, bivariate and multivariable logistic regression. A p-value less than 0.05 were considered significant.

Results: The most significant findings were that knowledge and attitude significantly affect VCT practices among adults in Gulu Hospital. Most participants had adequate knowledge (297/379, 78.4%), the most common source of VCT information was radio (236/372, 63.4%) and few from parents (30/372, 8.1%). 158/380(41.6%) had strongly positive attitudes however, 4/10(40.0%) believed knowing HIV status was not beneficial because of fear of stigma, 299/380(78.7%) had good practices,13/45(28.9%) did not undertake VCT due to ignorant on the importance, 9/45(20.0%) feared positive results, and 5/45(11.0%) for far-off service centers. Among those who discouraged others, 15/45 (83.0%) did it for no reason, while 2/45 (11.0%) believed it was a risky and painful process. Knowledge and attitude on VCT practices had an adjusted R square of 0.421, p<0.001. The independent predictors of VCT practices in a multivariable regression analysis was knowledge (β=0.478, t=10.374, p<0.001) and attitudes (β=0.257, t=5.570, p<0.001).

Conclusion: Knowledge and attitudes significantly influenced VCT practices among adults attending outpatient services at Gulu Hospital. The independent determinants of VCT practices were knowledge and attitudes. However, HIV stigma, fear of positive results and divorce/separation were the most deterring factors on VCT practices among participants.

Keywords: VCT; HIV; Knowledge; Attitudes; Practices; Hinderances; Gulu Regional Referral Hospital; Stigma