Factors associated with HIV counseling and testing behavior among undergraduates of universities and vocational technical training schools in Tbilisi, Georgia

BACKGROUND Stigmatizing attitude towards HIV/AIDS alongside other factors such as HIV knowledge, substance use, sexual behavior, and involvement in various social activities (e.g., internet use, exposure to media) may be related to likelihood of having HIV counseling and testing (HCT). Thus, we examined these associations among 18-24 year old post-secondary school students in Tbilisi, Georgia. METHODS We conducted a secondary data analysis of a 2010 cross-sectional survey of 1,879 secondary and post-secondary school students aged 15 to 24 years in Tbilisi, Georgia examining sociodemographics, substance use, sexual behavior, HIV-related knowledge and stigmatizing attitudes, and recreational activities in relation to lifetime HCT. A stratified two-stage cluster sample design was used by the parent study with universities selected with probabilities proportional to their size at the first stage, and with a random selection of students stratified by gender in each of the participating university at the second stage. RESULTS The vast majority (95.6%) of participants never received HCT. In the multivariate regression model, significant predictors of lifetime receipt of HCT included being married (p = 0.03), not having HIV stigmatized attitude (p = 0.03), more often reading fiction literature (p = 0.02), more often going out in the evenings (p = 0.03), and more often passing time with friends (p = 0.05). CONCLUSIONS Intervening on HIV stigmatizing attitudes may be a critical prevention or HCT promotion strategy among youth in Georgia. In order to better inform policy and programs, future research should examine contextual factors in secondary and post-secondary schools that impact HCT among Georgian youth. Specifically, factors impacting differential rates of HCT among males and females, the social stigma and knowledge related to HCT and HIV, and the impact of leisure time activity involvement on HCT should be examined further. In addition, interventions and policies that might impact attitudes toward HIV and HCT should be investigated and considered.