An Assessment of HIV Counselling and Testing (HCT) Service Utilization in Nigeria: A Binary Logistic Regression Approach
International Journal of HIV/AIDS Prevention, Education and Behavioural Science
Volume 5, Issue 1, June 2019, Pages: 26-36
Received: Feb. 13, 2019;
Accepted: Mar. 15, 2019;
Published: Apr. 8, 2019
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Onemayin Kolawole Jospeh, Department of Mathematics and Statistics, Federal Polytechnic, Ado Ekiti, Nigeria
Halid Omobolaji Yusuf, Department of Statistics, Ekiti State University, Ado-Ekiti, Nigeria
Obafemi Oluwafemi Samuel, Department of Mathematics and Statistics, Federal Polytechnic, Ado Ekiti, Nigeria
Adetunji Ademola Abiodun, Department of Statistics, Federal Polytechnic, Ile-Oluji, Nigeria
HIV infection remains the most challenging health and development crisis in the last two decades as it continues to create health and socio-economic challenges in many parts of Nigeria and the world at large. HIV counselling and testing (HCT) can identify infection in early stages as it involves analysis of body fluids for the presence of antigens or antibodies produced in response to HIV and these are key to controlling the HIV epidemics. As a result, certain factors are considered in this study as deterrents to HCT service utilization in Nigeria applying the k-order binary logistic regression model using a structured questionnaire developed by the research team in some selected states in South-West of Nigeria. The socio-demographic details of respondents reveals that out of 788 people (out of 800 administered questionnaires) that were interviewed, 452 (57.4%) have had HCT while 336 (42.6%) never had HCT. Age15-19 (the adolescent) with 68.1% are the groups with the highest respondents with HCT uptake. The chi-square test of independence also reveals that age, gender, religion, and marital status are not related with HCT uptake while ethnic, educational status, place of residence are associated with decision on HCT uptake. The binary logistic regression of HCT uptake on the investigated socio-demographic details of respondents reveals the age group (50 and above) has the highest odds of up-taking HCT while those in the group 25-29 years has the least. Male respondents have a slightly higher odds compared to female and the Yoruba ethnic group are the most likely to utilize HCT. Results also revealed that traditionalist are the most likely to utilize HCT (1.635) with the Christianity (with 1.000) being the least. Those who are single/never married has a non-significant highest odds (1.092) among the marital status considered while those who are separated/divorced has the least (0.712). The odds of utilizing HCT is least among those with no formal education. People with Primary education are about three times more likely to take HCT compared to those with no formal education. Rural settlers are about three times (2.818) more likely to uptake HCT in comparison with those who reside in urban centres. Finally, employment status of respondents is insignificant to HCT uptake, although the odds in favour of those that are schooling is highest (1.175), followed by those that are self-employed (1.013).
Onemayin Kolawole Jospeh,
Halid Omobolaji Yusuf,
Obafemi Oluwafemi Samuel,
Adetunji Ademola Abiodun,
An Assessment of HIV Counselling and Testing (HCT) Service Utilization in Nigeria: A Binary Logistic Regression Approach, International Journal of HIV/AIDS Prevention, Education and Behavioural Science.
Vol. 5, No. 1,
2019, pp. 26-36.
UNAIDS (2010a). Report on the global AIDS Epidemic.
UNAIDS AIDS Epidemic update (2007). Joint UN Programme in HIV/AIDS and World Health Organization, 2007.
UNAIDS (20017a) ‘AIDSinfo’ [Accessed November, 2018]
Yamano T. and Jayne T. S. (2004). “Measuring the Impacts of Working-age Adult Death on Rural Households in Kenya,” World Development, vol. 32: 91-119.
UNAIDS (2010) 2010 Outlook Report. Joint UN Programme in HIV/AIDS 2009. Accessed at www.unaids.org on 04/02/2019
FMH (Federal Ministry of Health) (2012). Nigeria: HIV/AIDS Country Report, pp. 1 -60.
Yahaya L. A, Jimoh, A. A. G and Balogun O. R. (2010). Factors hindering acceptance of HIV and AIDS Voluntary Counselling and Testing (VCT) among youths in Kwara State, Nigeria. Journal of AIDS and HIV Research Vol. 2(7), pp. 138-143.
Marks G, Crepaz N, Senterfitt J. W, Janssen RS. (2005). Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: implications for HIV prevention programs. J AIDS; 39: 446–53.
UNAIDS (2002). Summary of the Declaration of Commitment on HIV/AIDS.
Obermeyer C. M. and Osborn M. (2007). The utilization of testing and counselling for HIV: a review of the social and behavioural evidence, American Journal of Public Health 97(10):1762-74. 2007
WHO (2012). Statement on HIV Testing and Counselling: WHO, UNAIDS re-affirm opposition to mandatory HIV testing, [Accessed February, 2019].
Olugbenga-Bello A. I., Oladele E. A., Adeomi A. A. and Ajala A. (2012). Perception about HIV testing among women attending antenatal clinics at Primary Health Centres in Osogbo, Southwest, Nigeria, Journal of AIDS and HIV Research Vol. 4(4), pp. 105-112, April 2012.
Mgosha, P., C., Kweka E., J., Mahande A., M., Barongo L., R., Shekalaghe S., Nkya H., M., Lowassa A., Mahande M., J. (2009). Evaluation of utilization and attitude to voluntary counselling and testing among health care professional students in Kilimanjaro region, Tanzania. BMC Public Health, 9:128.
Witzel T. C, Lora W., Lees S., and Desmond N. (2017). Uptake contexts and perceived impacts of HIV testing and counselling among adults in East and Southern Africa: A meta-ethnographic review. PLoS ONE 12(2): e0170588. https://doi.org/10.1371/journal.pone.0170588.
Matovu J. K. B. and Makumbi F. E. (2007). Expanding access to voluntary HIV counselling and testing in sub-Saharan Africa: alternative approaches for improving uptake, 2001–2007. Trop Med Int Health. 2007; 12(11): 1315–1322. pmid:17949401
UNAIDS (2017b) Data Book.
UNAIDS (2017c) ‘Ending AIDS: Progress towards the 90-90-90 targets.
UNAIDS (2017d) ‘Data Book’.
NACA (2017) ‘National Strategic Framework on HIV and AIDS: 2017 -2021.
National Bureau of Statistics (NBS) and United Nations Children’s Fund (UNICEF) (2017) ‘Multiple Indicator Cluster Survey 2016-17, Survey Findings Report’
NACA (2015) ‘Nigeria GARPR 2015’.
Bond V. A. (2010). “It is not an easy decision on HIV, especially in Zambia”: opting for silence, limited disclosure and implicit understanding to retain a wider identity. AIDS Care. 2010. 22: s6–s13.
Ibrahim M., Ipadeola O., Adebayo S. and Fatusi A. (2013). Socio-demographic Determinants of HIV Counseling and Testing Uptake among Young People in Nigeria, International Journal of Prevention and Treatment, 2(3), pp. 23-31. doi: 10.5923/j.ijpt.20130203.01
Azuogu B. N., Ogbonnaya L. U., Alo C. N. (2011). HIV voluntary Counselling and testing practices among military personnel and civilian residents in a military cantonment in South-Eastern Nigeria. HIV/AIDS-Research and Palliative Care, pp. 107-116
DeGraft-Johnson J., Paz-Soldan V., Kasote, A. and Tsui A. O. (2005). HIV voluntary counseling and testing service preferences in a rural Malawi population. AIDS and Behavior, 9(4), 475-484.
Bwambale F. M., Ssali S. N., Byaruhanga S., Kalyango J. N., Karamagi C. A. (2008). Voluntary HIV counselling and testing among men in rural western Uganda: implications for HIV prevention, BMC Public Health. 2008 Jul 30;8:263. doi: 10.1186/1471-2458-8-263.
Adejumo A. O. and Adetunji A. A. (2013): Application of Ordinal Logistic Regression in the Study of Students’ Performance, Journal of Mathematical Theory and Modelling, 3(11), pp 10 – 19.
Kleinbaum, D. G. and Klein, M. (2010) Modeling Strategy Guidelines. In: Logistic Regression, Part of the Series Statistics for Biology and Health, Springer, Berlin, 165-202. http://dx.doi.org/10.1007/978-1-4419-1742-3_6.
Park H. (2013). An Introduction to Logistic Regression: From Basic Concepts to Interpretation with Particular Attention to Nursing Domain, J Korean AcadNurs 43(2), pp. 154-164.
Cox D. R. (1972). “Regression Models and Life Tables (with Discussion).” Journal of the Royal Statistical Society, Series B 34:187 – 220.
Fahrmeir L. and Tutz G.(2001). Multivariate Statistical Modelling based on Generalized Linear Models (3rd edition), Springer: New York.
Hosmer D. and Lemeshow S. (2001). Applied Logistic Regression (second edition), john Wiley & Sons: New York. ISBN: 0471208264 / 0-471-20826-4.
Ogunleye S. O. and Fagbohun A. B. (2009). “A Logit Regression Analysis of some Tuberculosis Data”, International Journal of Numerical Mathematics Vol 4(1) pp. 1-14.
Mohlabane N., Tutshana B., Peltzer K. and Mwisongo A. (2016). Barriers and facilitators associated with HIV testing uptake in South African health facilities offering HIV Counselling and Testing, Health SA Gesondheid 21 (2016) pp. 86-95.
Halid O. Y. and Akinnitire F. I. (2013). A Logit Regression Analysis of Homeowners in Nigeria, The Global Journal of Science Frontier Research, 13(3).
Shisana O., Rehle T., Simbayi L., Parker W. and Jooste S. (2009). South African National Hiv Prevalence, Incidence, Behaviour and Communication Survey, 2008 HSRC Press, South Africa.
Menna T., Ali A., and Worku A. (2015). Factors associated with HIV counseling and testing and correlations with sexual behavior of teachers in primary and secondary schools in Addis Ababa, Ethiopia, HIV/AIDS - Research and Palliative Care 2015:7 197–208.
Amu E. O., Ijadunola K. T., Bamidele J. O. and Odu O. O. (2013). Barriers to and determinants of HIV counselling and testing among adults in Ayedaade local government area, Osun State, Nigeria, Journal of Medical Sciences, 13(8) PP 803-808.