Only 25% of individuals aged 15-49 in the African Region know their HIV sero-status. In the Cape Coast Metropolitan Area of Ghana, just 3.2% of men and 6.7% of women aged 15-49 had been tested within the past 12 months and knew their status at the time of the 2008 Demographic and Health Survey. At 9.6%, the Cape Coast sentinel site reported the highest prevalence of HIV in the country in 2011. The Central Region as a whole saw an increase in prevalence from 1.7% to 3.7% from 2010 to 2011. The main objective of this study was to determine factors influencing HIV testing and counseling uptake in the Cape Coast Metropolitan Area.
A population based cross-sectional study was carried out among 75 males and 145 females aged 15-49 in the study area. Multi-stage cluster sampling was used to obtain this population-representative sample in 12 enumeration areas throughout the Metropolitan. The random walk method was utilized in sampled enumeration areas to obtain study participants. Trained research assistants verbally administered the survey questionnaire.
From the study, more females than males (33.1% versus 24.0%) had been tested for HIV within the past 12 months and received their results. The primary reason among both sexes for failure to test was fear of stigmatization (63.6% and 72.1%), followed closely by fear of test results (54.6% and 60.3%). For male respondents, HTC uptake was 12.44 (1.83, 91.24) times higher in individuals that had traveled 5 or more times within the past twelve months in comparison to no travel at all. Uptake was 90% (aOR=0.1029, 95% CI= 0.01, 0.72) lower in individuals that believed HTC uptake could lead to an early death.
For females, testing was lower among those that had only attended some secondary high school (aOR=0.0766, 95% CI=0.0098, 0.5968), believed HTC could lead to an early death (aOR=0.2480, 95% CI=0.0653, 0.9412), and had not has sexual intercourse within the past 12 months (aOR=0.025, 95% CI= 0.001,0.6195). Females that were not currently working as students, traders, or civil servants were 35 times more likely (CI=2.4680, 516.07) to have been tested than those currently attending school.