Acceptability and Barriers to Uptake of HIV Testing and Counseling among Students of Tertiary Institutions in Owo Ondo State Nigeria

Download Article

Authors : Ebenezer Obi Daniel


HIV/AIDS epidemics have reached an alarming rates globally and most especially in Sub-Sahara Africa with adverse political, economic and social implications. Nigeria is one of the countries with prevalence rate of greater than 4%, and a prevalence of 1.2% and 2.9% in males and females in the age group 15-24 years respectively (UNAIDS/WHO, 2008). Various preventive strategies have been employed to curb the spread of HIV infection because there is presently no cure. Abstinence, avoidance of multiple sexual partners, condom use, voluntary counseling and testing (VCT), and treatment of HIV-infected individuals form the cornerstone of HIV prevention. Despite these challenges, the patronage of Voluntary Counseling and Testing (VCT) by youths and other vulnerable groups in Nigeria was reported to be very low by previous studies. This study therefore evaluates the acceptance and barriers to uptake of HIV testing and counseling among students of tertiary institutions in Owo, Ondo State Nigeria.

A total 330 undergraduates from two institutions; Rufus Giwa Polytechnic and Achievers’ University were interviewed in May, 2013. Stratified and systematic random sampling techniques were adopted and a combination of close-ended and open-ended questionnaires were used as instruments for data collection.

Majority (90.2%) of the respondents to this study knew that HIV is the cause of HIV/AIDS, but their overall knowledge of HIV infection is not impressive as over half (54.4%) of them had poor knowledge of HIV/AIDS. This is in spite of the fact that 57.1 percent of them reported anti-HIV campaign programs in their institutions within a period of twelve months preceding this study. Data analysis further indicated that 50% of respondents from both institutions had had at least one session of HIV testing, however; only 40.2% of respondents underwent HIV voluntary counseling and testing prior to their test. This differential uptake of HIV testing was found to be statistically significant at p<0.01. Most of the respondents (40.3%) that have never had HIV test reported lack of access to a screening facility as a major obstacle to having an HIV test done. In a similar vein, respondents that had no intention of having HIV test reported fear of a positive test result (30.9%), not sexually active (24.7%), denial of risk (17.3%) and fear of stigma and discrimination (16%) as reasons why they have never considered HIV testing. Gender of

respondents had no effect on subjects’ willingness to have VCT as 48.1% and 53.6% of males and females respectively who are yet to have VCT reported lack of willingness to test.

Statistical significant association were found between previous HIV testing and respondents’ age group, institutions of learning as well as their overall knowledge of HIV at p<0.05.

More HIV awareness programs and screening facilities should be made available in institutions of higher learning as well as their host communities in order to improve knowledge of HIV/AIDS among undergraduates and also increase their uptake of HIV counseling and testing in order to halt and reduce the spread of HIV infection among this age group. 


[1.]             Adeyi O (2006), AIDS in Nigeria; A nation on the threshold (Harvard University Press, Harvard series on population and International Health)

[2.]             Akande A (1994). AUDS-related beliefs and behavior of students: evidence from two countries (Zimbabwe and Nigeria) International Journal of Adolescents and Youths. 4: 285-303.

[3.]             Buve A. (2001) The spread and effect of HIV-1 infection in Sub-Saharan Africa. Lancet 2002; 359:17

[4.]             Bygbjerg IC. (1983). AIDS in a Danish surgeon (Zaire, 1976). Lancet; 1:925

[5.]             Centre for Disease Control uptake. (1988). Serologic testing for anti-body to HIV. MMWR; 36:883-40

[6.]             Clavel F, Guetard, Brun-Vezinet F. (1986). Isolation of a new human retrovirus from West Africa patients with AIDS. Science; 233:343-6

[7.]             De Wit JBF, Adam PCG. (2008). To test or not to test : Psychological barriers to HIV testing in high-income countries. HIV medicine, 9 (Suppl. 2):20-22.

[8.]             Downing M. (2001). Drugs users talk about HIV testing: Motivating and deterring factors. AIDS care, 2001, 13(5):561-577

[9.]             Federal Ministry of Health (FMOH 2001) A Technical report on 2001 National

[10.]   HIV/Syphilis Seroprevalence Sentinel Survey among pregnant women attending antenatal clinics in Nigeria, Abuja: NASCP, Nigeria.

[11.]   Federal Miniatry of Health (FMOH 2004) A Technical report on 2003 National HIV/Syphilis seroprevalence sentinel survey among pregnant women attending antenatal clinics in Nigeria. Abuja. National AIDS/STIs Control program, Nigeria.

[12.]   Fatusi A.O (2004) Study of African Universities’ response to HIV/AIDS: The Nigerian Universities; Report of study submitted to the Association of African Universities, Ghana.

[13.]   Feyisetan B, Pebley A.R. (1989) Premarital sexuality in urban Nigeria. Studies in family planning; 20 (6): 343-354.

[14.]   Flowers P, Knussen C, Church S. (2003). Psychological factors associated with HIV testing amongst Scottish gay men. Psychology and Health, 18:739-752.

[15.]   Gallo R (1987). The AIDS virus. Sci Am; 256:46-56.

[16.]   Jurgens R, Betteridge G (2009). HIV testing and counseling for people who use drugs. Background paper. Geneva, WHO, UNODC, UNAIDS.

[17.]   Kelly M.J (2001) Synthesis report for the working group on higher education, Association for the Development of Education in Africa. Washington: World Bank; Challenging the Challenger: Understanding and expanding the response of universities in Africa to HIV/AIDS

[18.]   Katjavivi P.H, Otaala B. (2003) African higher education institution responding to the HIV/AIDS pandemic; Paper presented at the AAU conference of Rectors, Chancellors and of African Universities; Mauritius.

[19.]   Lauby. (2006) Decisional balance, perceived risk, and HIV testing practices. AIDS and Behavior, 10(1), 83-92.

[20.]   Mackenzie WR, Davis JP, Peterson DE. Multiple false positive serological test testa for HIV, N Engl J Med 1987: 317:238-41.

[21.]   Meyer KB, Panker SG. (1987). Screening for HIV. Can we afford the false positive rate? N Engl J Med: 317:238-41

[22.]   Mounier-Jack S, Nielsen S, Coker RJ. (2008). HIV testing strategy across European countries. HIV medicine, 9 (Suppl 2): 13-19.

[23.]   Nahmias AJ, Weiss J, Yao X, (1959). Evidence for Human infection with HTLV­III/LAV-like virus in central Africa. Lancet; 1:1279-80

[24.]   Obermeyer CM, Osbon M. (2007). The utilization of testing and counseling for HIV: A review of social and behavioral evidence. American Journal of Public Health, 97 (10: 1762-1774)

[25.]   Okonofua F.E. (1995) Factors associated with adolescent pregnancy in rural Nigeria. Journal of Youth and Adolescence . 24(4):419-438.

[26.]   Omoregie G.O (2002). Sexual behavior of tertiary institutions’ students using the PSI behavior change framework. Abuja: Society for Family Health.

[27.]   Orubuloye I.O, Caldwell J.C, Caldwell P (1991) Sexual networking in Ekiti district of Nigeria. Studies in Family Planning; 22(2):61-73.

[28.]   Patton G (2009). Global pattern of mortality in young people: a systematic analysis of population health data.

[29.]   Physician for Human Rights (2006) ‘Nigeria: Access to health care for people living with HIV and AIDS.

[30.]   Pronyk PM. (2002) Introduction of voluntary counseling and rapid testing for HIV in rural South Africa: From theory to practice. AIDS care, 14:859-865

[31.]   Rhame FS, Maki DG. (1989). The case of wider use of testing for HIV infection. N Engl J Med; 320:1248-54.

[32.]   Saxinger WC, Levine PHY, Dean A. (1985). Evidence for exposure to HTLV-III in Uganda before 1973. Science; 227:1036-8

[33.]   Semafumu E, Ngabirano T. (2006). Building on the success of STD programs to increase access to prevention and care for HIV/AIDS: The case for routine testing and counseling in STD patients. Paper presented at: President’s Emergency plan for AIDS Relief Implementers’ Meeting; Durban, South Africa.

[34.]   Serafim D, Ferraz D, Chequer P. (2006). Counselling in the use of anti-HIV rapid testing: The experience of the Brazillian AIDS Conference, in Toronto.

[35.]   STI AIDS Netherlands. (2004). A delicate balance, the state of affairs of HIV and other STIs in the Netherlands. Amsterdam.

[36.]   Telles PR, Westman S, Needle R. (2004). Assessing feasibility and acceptability of rapid HIV testing for injecting drug users in five Brazilian cities. International Conference on AIDS, 15: abstract no. E12030.

[37.]   UNAIDS (2006). Interim Country Report, United Kingdom, Geneva, (Country Progress Report Series).

[38.]   UNAIDS (2010). ‘UNAIDS report on the global AIDS epidemic’

[39.]   United Nations General Assembly Session (UNGAS) on HIV/AIDS (2001): DECLARATION ON COMMITMENT ON HIV/AIDS “Global Crisis-Global Action

[40.]   WHO, UNAIDS & UNICEF (2008). Towards universal access: scaling up HIV/AIDS intervention in the health sector. ‘Towards universal access: scaling up priority HIV/AIDS interventions in the health sector.

[41.]   WHO, UNAIDS & UNICEF (2010) ‘Towards universal access: scaling up priority HIV/AIDS interventions in the health sector.

[42.]   WHO HIV operational research instrument.