RESUMO
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