Factors associated with HIV counseling and testing and correlations with sexual behavior of teachers in primary and secondary schools in Addis Ababa, Ethiopia

BACKGROUND The HIV/AIDS pandemic is a global crisis that affects the lives of millions of people. Although HIV counseling and testing (HCT) serves as the entry point for HIV prevention, treatment, and care, it remains a low priority in many settings. The aim of this study, therefore, was to assess the factors associated with HCT and their correlation with the sexual behavior of primary and secondary school teachers in Addis Ababa. METHODS A comparative cross-sectional study was conducted among primary and secondary school teachers in Addis Ababa, Ethiopia. A multistage sampling technique was used to select a representative sample of 1,136 teachers. HCT and sexual health behavior-related data were collected using a self-administered questionnaire. Binary logistic regression was employed to examine the relationships between HCT, sociodemographics, and risky sexual behavior-related variables. RESULTS Of the 1,136 eligible study participants, 1,034 (91.0%) teachers completed the self-administered anonymous questionnaire. The proportion of teachers who had ever tested for HIV was 739/1,034 (71.5%; 95% confidence interval [CI] 69.1-74.2). Multivariate logistic regression analyses showed that being male (adjusted odds ratio [AOR] 0.63; 95% CI 0.44-0.90) was associated with a 37% decrease in odds of being ever tested for HIV compared with being female. Married teachers were less likely to have had HIV testing (AOR 0.30; 95% CI 0.19-0.47) compared with unmarried teachers. Being aged ≥45 years (AOR 4.05; 95% CI 1.82-9.03), having high HCT-related knowledge (AOR 3.56; 95% CI 1.73-7.32), and having a perceived risk of HIV (AOR 1.43; 95% CI 1.04-1.96) were positively associated with HCT. Moreover, regarding the correlation of HCT with the sexual behavior of teachers, those teachers who never had HCT were more likely to have multiple sexual partners than those who had ever had HCT (AOR 1.85; 95% CI 1.08-3.15). In contrast, teachers who had ever been tested for HIV were less likely to have used condoms consistently than those who had never been tested (AOR 0.55; 95% CI 0.32-0.96). CONCLUSION No significant differences were observed between primary and secondary school teachers regarding factors associated with HCT and its correlation with sexual behavior. Gender, age, marital status, knowledge of HCT, and perceived risk were found to be factors associated with HCT uptake. Correlations between being faithful to a partner, inconsistent use of condoms, and HCT uptake of teachers were also observed. Thus, strengthening the current practice of HCT services in the education sector with due emphasis on the observed factors could play a pivotal role in bringing about positive changes in the sexual behavior of school community.