Factors Associated with Index HIV Client Testing at Care and Treatment Clinics in Ilemela Municipal Council

Abstract

Background: Early HIV testing and diagnosis are paramount for increasing case identification and prevention of spread of HIV. Capitalizing on index clients who are already enrolled into care can be an entry point for identifying those undiagnosed. Index testing with fidelity started since 2017 however, uptake remain low. Objective: To determine factors associated with index client HIV counselling and testing at Care and Treatment Clinics (CTC) in Ilemela Municipal Council. Methodology: A cross-sectional study was conducted among HIV clients receiving care and treatment services within six CTCs in Ilemela Municipal Council between August and September 2018. Participants were randomly selected and interviewed through face to face to collect data on structural and individual factors associated with index testing using closed ended questionnaire. Ethical approval was obtained from Muhimbili University of Health and Allied Sciences ethics committee. Descriptive analysis was used to summarize the data, bi-variate and multi-variate logistic regression was used to determine individual and structural factors associated with successful index testing. Data management, manipulation and analysis was done using Stata version 15. Results: Out of 352 eligible clients, 321(91%) agreed to participate in study with mean age of 37.9 (standard deviation of 9.7) years. Female clients accounted for 55.8 %; while married clients were 70.7%. Majority of the clients had primary education (65.7%) and 25.9% doing business while 21.2% were farmers. About 77.3% of respondents reported to have knowledge about index testing with 85.6% reporting healthcare providers were their main source of information. Being married [aOR: 3.01,95%CI: 1.33 - 3.12)]; a peasant [aOR: 3.28, (95%CI: 1.40 – 7.72)]; housewives [aOR: 3.79, (95%CI: 1.42 – 10.15)]; having adequate knowledge about index testing [aOR: 2.22, (95%CI: 1.16 – 4.25)]; having a positive attitude towards Index testing [aOR: 3.74, (95%CI: 2.07 – 6.74)];clients who used health care workers for notification [aOR: 1.61, (95%CI: 1.08 – 4.16)]clients who were assisted with partner notification [aOR: 2.92, (95%CI: 1.34 – 6.39)] ; clients given priority when brought index [aOR: 3.43, (95%CI: 1.67 – 7.04)] and supplies [aOR: 0.35, (95% CI:0.14 – 0.87] were associated with higher odds of successful index testing. Conclusion: Marital status, main economic activity, knowledge and positive attitude towards index testing, methods used to notify index contactsgiving them priority at testing point, and supplies were associated with successful index testing.