Correlation between knowledge of HIV, attitudes and perceptions of HIV and a willingness to test for HIV at a regional hospital in KwaZulu-Natal, South Africa

Background: With millions of South Africans infected with human immunodeficiency virus (HIV) and less than 10of the population aware of their HIV status; HIV counselling and testing (HCT) is the first step in any attempt to reduce the number of new infections. For those who test negative; HCT personalises the risks and reinforces preventative messages whilst for those who are positive; it is the gateway to accessing counselling and care. The Health Belief Model postulates that knowledge and attitude influence behaviour. The aim of this study was to determine whether knowledge of HIV and the attitude of patients referred for HCT correlated with a willingness to test for HIV. Methods: One hundred and seventy two patients referred for HCT were randomly selected over a three month period. Data were collected by a research assistant using the modified standardised World Health Organization (WHO)-Global AIDS Project (GAP) questionnaire.Results: Ninety per cent of the participants demonstrated sound knowledge of HIV; acquired immune deficiency syndrome (AIDS) and HCT. Despite the 90of the participants with sound knowledge only 71.5of the participants tested for HIV. There was no statistically significant difference in knowledge between those who tested and those who did not test for HIV. Twenty five per cent of those who refused to test stated that they had already made up their mind not to test for HIV before the counselling session. Conclusions: Despite excellent knowledge of HIV; a significant number of patients referred for HCT do not test for HIV

Using Structural Equation Modelling (SEM) to Predict Use of Voluntary Counselling and Testing (VCT) Services among Adults in Zambia

Background :Voluntary counseling and testing (VCT) has become a cornerstone intervention in the fight ; against HIV .Current evidence suggests that it is cost- effective in changing behaviour and preventing HIV infection .A number of studies have demonstrated some of the factors which are associated with both intention and actual use of VCT services. However; studies which show various factors combine to influence intention and subsequently the use of VCT services are generally lacking .We employed structural Equation Modelling (SEM) to examine the relationship between factors involved in use of VCT services. Method the AMOS program version 6 was used for our data analysis and data from a population based survey in Zambia (2003) was used to fit the model. Results the proposed model fitted well for the population. Fitness indices fell within assepted tanges; GFI=0.998; AGFI=0.994 and RMSEA= 0.025.The model fitted well accross age group (young/older participations) ; residence (rural/urban) and sex( male and female participants) .All standardized regression weight were significant at 95 confidence level except for regression weight between self-rated health and willingness. Psychological distress was positively associated with health use; depression; self-rated risk and willingness (intention; but negatively associated with self-rated health .willgness (intention) was positively associated with participation in VCT. Conclusion SEM was successfully used to explore how various determinants interact to influence the use of VCT services and most of our theoretical assumptions were supported by empirical finding .Self -rated health was a key explanatory parameter for psychological distress and the intention to use VCT services