Factors influencing the uptake of Voluntary HIV Counseling and Testing

29 Background: Voluntary HIV counseling and testing (VCT) is a key strategy towards 30 HIV prevention yet, the uptake of VCT services among young people remains low. 31 This study determined the factors that influence the uptake of VCT among secondary 32 school students in Arusha City, Tanzania. 33 Methodology: A cross sectional study using quantitative methods was conducted. A 34 multi-stage sampling method was applied to randomly select the secondary schools. 35 Stratification, random and systematic sampling techniques were used to identify the 36 study participants. Interviews were conducted using structured questionnaires. Data 37 analysis was done using statistical package for social sciences version 16. Analytical 38 statistics were done using odds ratio to measure strength of association between VCT 39 uptake and independent variables. Association with p-value < 0.05 was considered 40 significant. Binary logistic regression was used to identify predictors of VCT uptake. 41 42 Results: Of 400 study participants, 50.5% were male and 49.5% were female. 93.5% 43 of the respondents were aware of the VCT services, 79.1% had high knowledge on 44 VCT services and 75.9% had positive attitude towards VCT services. On VCT 45 uptake, only 29.3% had ever tested. VCT uptake was found to be significantly 46 predicted by age (p=0.003), sex (p<0.001), religion (p<0.001), exposure to VCT 47 information from a VCT centre (p<0.001) and type of school ownership (p<0.013). 48 49 Conclusion: Despite high knowledge on VCT services, the uptake of VCT among 50 secondary school students was found to be low. The uptake of VCT was mainly 51 found to be influenced by fear of HIV test results, knowledge and attitude on VCT 52 services, age, education, engagement in sexual relationships, stigma and distance to 53 the VCT centre. Integration of youth friendly VCT services in secondary schools 54 would increase VCT uptake among secondary school students. Support and care 55 received after knowing the test results should be clearly communicated as it helps 56 motivate more young people towards VCT uptake and reduce stigma among them. 57