Sexual risk behavior and uptake of HIV counseling and testing among youth in Metropolitan Kumasi, Ghana

ABSTRACT

Research on HIV counselling and testing (HCT) has proliferated in Ghana but limited evidence exists about the uptake of HCT among a large population that has been shown to engage in HIV risk-related behavior in Metropolitan Kumasi. With retrospective cross-sectional data from a representative sample of sexually active young people, multivariate logistic regression models examine the variables associated with HCT uptake in Kumasi. Among 906 participants (male 51% and female 49%, with a mean age ±SD, 25 ± 6), 22% had utilized HCT in the last six months despite the higher knowledge of HCT (84%) mainly through mass media (65%) and health providers (27%). Besides, less than 20% of the sample intended to undergo HCT services. Multivariate logistic regression analysis showed that female gender (adjusted odds ratio [aOR] = 1.830; 95% CI: 1.280–47.831; p < 0.001), being single (aOR = 3.032; 95% CI: 1.413–6.485; p = 0.040), having sexual intercourse with irregular partner (aOR = 5.597; 95% CI: 1.776–17.638; p = 0.018), practiced unprotected sex (aOR = 2.614; 95% CI: 1.821–6.472; p = 0.002), having multiple sex partners (aOR = 2.902; 95% CI: 1.405–7.226; p < 0.001) and being aware of HCT services (OR = 3.488; 95% CI: 1.256–5.929; p < 0.005) were associated with HCT uptake. These findings are germane for health policy and planning interventions seeking to address the barriers to HCT uptake among youth who are at greater risk of HIV infection.

KEYWORDS:

• Ghana
• health policy
• HIV counseling and testing uptake
• public health
• risky sexual behavior
• vulnerable group
• youth

Acknowledgments

The authors wish to thank the participants who generously participated in this study in the various sub-metropolitan areas. We acknowledge the excellent efforts of our research assistants during the data collection. The three anonymous and amiable reviewers of this journal are appreciated for offering courteous comments and suggestions to improve the original version of this paper.

Author disclosure statement

No competing financial and other conflict of interests exist.

Notes

WHO definition for a generalized epidemic is when the official HIV prevalence is 1% or greater in the general population.

The exchange rate between the U.S. dollar ($) and Ghana Cedis (GH¢) (i.e., $1 = GH¢4) as of the time of data analysis (August 2016).