Amsterdam 2015
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| Abstract #2282 - Teen spirit: Adolescents and HIV | ||||
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Session: 46.7: Teen spirit: Adolescents and HIV (Parallel) on Friday @ 09.00-10.30 in C104 Chaired by Tonya Thurman, John Miller Authors: Presenting Author: Mr Michael Strauss - University of KwaZulu-Natal, South Africa |
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| Additional Authors: | ||||
| Aim: A key strategy of the South African national response to HIV is the scale up of both supply and demand of HIV counselling and testing (HCT) to 80% in the 15-49 year age group. The 2010/11 national HCT campaign was successful in reaching over 13 million people and an integrated school health policy, introduced in 2012 has been developed to guide the rolling out of youth friendly health services including provision of HCT. This study aims to identify barriers and facilitators of HCT among high school learners, and inform the design of integrated HCT service packages in schools. | ||||
| Method / Issue: A discrete choice experiment (DCE) was used to examine the preferences of high school learners regarding the attributes of HCT service packages on offer. 270 learners randomly ed from rural schools in the Vulindlela sub-district of Umgungundlovu, KwaZulu-Natal participated in the DCE. Fixed effects logit models were used for analysis of data to estimate the main effects of the attributes of HCT as well as socio-demographic interaction terms. The DCE design was informed by an exploratory qualitative study, which included 18 focus group discussions examining the perceptions and experiences of learners regarding HCT. | ||||
| Results / Comments: In comparison to the free mobile HCT services offered in the area, money was found to have the strongest effect of any attribute on preferences for an HCT, with a fee of $2 reducing the odds of learners choosing an HCT service package (odds ratio OR 0.387, p < 0.001) and an incentive to the value of $10 increasing preferences for HCT services (OR 2.213, p < 0.001). Confidentiality issues were found to be a major concern for learners considering HCT services. The odds of choosing an HCT service package decreased significantly when conducted by a nurse the learners knew (OR 0.656, p < 0.001) and when group counselling was offered (OR 0.819, p = 0.002). This was similarly the case if no counselling was offered (OR 0.689, p < 0.001). Compared to the standard finger prick rapid test used for initial HIV screening, offering either a mouth swab test (OR 0.711, p < 0.001) or an intravenous blood draw test (OR 0.801, p < 0.001) significantly decreased the odds of choosing an HCT service. | ||||
| Discussion: In the context of current plans in South Africa for both HCT scale-up and the integration of HCT into existing adolescent friendly and adolescent targeted health services such as the integrated school health policy, this study provides valuable insights into the preferences of young people and their drivers of choice for HCT services. Policy makers and HCT service providers must ensure confidentiality be maintained in the design of services. Monetary incentives for testing may be a way of increasing demand and any costs to learners associated with undergoing HCT will be a significant barrier. The importance of programmes designed to reduce social stigmas and improve education and knowledge dissemination around HCT and HIV are vital in creating demand for HCT and changing attitudes among young people. | ||||
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