Terefe Bewuketu, Techane Masresha Asmare, Assimamaw Nega Tezera, Kebede Adane
Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and HealthSciences, University of Gondar, Gondar, Ethiopia.
J Health Popul Nutr. 2024 Dec 19;43(1):221. doi: 10.1186/s41043-024-00718-w.
Individuals can learn their HIV status through voluntary HIV counseling and testing (VCT), which also serves as a crucial access point for prevention, treatment, care, and support programs. VCT has grown in significance as a component of HIV prevention and care in Ethiopia because of its viability and convenience for the wider community, as well as its ability to provide access to care, treatment, and support for those in need. However, studies on this topic are limited, particularly because the fidelity of Ethiopia's VCT program has not been evaluated or measured. Therefore, this study aimed to assess the current implementation status of VCT services and client satisfaction in public health facilities in Gondar City.
This cross-sectional study was conducted out from June to July 2022. This study involved 130 counselors and 423 VCT users. Information on physical facilities, client satisfaction, and counselor impressions of the services was gathered using a standardized and pre-tested questionnaire, observation checklists, and resource inventory checklists developed from Ethiopian national VCT guidelines, the World Health Organization, United Nations AIDS, and previous literature. In the bivariate and multiple logistic regression models, variables with p values ≤ 0.2 and < 0.05 were chosen as candidate variables and associated variables, respectively.
The overall implementation and facility readiness for VCT services was found to be 67%. The overall client satisfaction rate was 71% (95% CI: 69.7%, 72.7%). Age of participants from 25 to 30 years (AOR = 1.11, 95% CI, 1.02-1.21), 31-35 years (AOR = 2.03, 95% CI, 1.88-2.18), higher educational status (AOR = 1.18, 95% CI, 1.03-2.01), and comprehensive knowledge of HIV/AIDS (AOR = 2.42, 95% CI, 1.53,3.32) were positively associated with client satisfaction, whereas fear of confidentiality (AOR = 0.42, 95% CI, 0.20, 0.63) and longer waiting time (AOR = 0.09, 95% CI, 0.04, 0.15) were negatively associated with the outcome variable.
The implementation fidelity was evaluated to be low; however, client satisfaction was somewhat good. Based on the descriptive and analytical findings, providers' adherence to standards, strong communication with leaders, and the preservation of client confidentiality and privacy must be ensured by having VCT centers meet the necessary standards as outlined in the HTC guidelines to increase client uptake and satisfaction. To enhance the quality of the program, it is important to address clients' educational levels, improve participants' understanding of VCT, promote youth participation, and provide training to service providers.
个人可以通过自愿咨询检测（VCT）了解自己的艾滋病毒感染状况，VCT也是预防、治疗、护理和支持项目的关键接入点。在埃塞俄比亚，VCT作为艾滋病毒预防和护理的一个组成部分，其重要性日益凸显，因为它对更广泛的社区具有可行性和便利性，并且能够为有需要的人提供护理、治疗和支持。然而，关于这一主题的研究有限，特别是因为埃塞俄比亚VCT项目的保真度尚未得到评估或衡量。因此，本研究旨在评估贡德尔市公共卫生设施中VCT服务的当前实施状况和客户满意度。
本横断面研究于2022年6月至7月进行。本研究涉及130名咨询员和423名VCT使用者。使用从埃塞俄比亚国家VCT指南、世界卫生组织、联合国艾滋病规划署以及以往文献中制定的标准化且经过预测试的问卷、观察清单和资源清单，收集有关物理设施、客户满意度以及咨询员对服务的印象等信息。在双变量和多因素逻辑回归模型中，p值≤0.2和<0.05的变量分别被选为候选变量和相关变量。
发现VCT服务的总体实施情况和设施准备情况为67%。总体客户满意度为71%（95%可信区间：69.7%，72.7%）。年龄在25至30岁（调整后比值比[AOR]=1.11，95%可信区间，1.02 - 1.21）、31至35岁（AOR = 2.03，95%可信区间，1.88 - 2.18）的参与者、较高的教育水平（AOR = 1.18，95%可信区间，1.03 - 2.01）以及对艾滋病毒/艾滋病的全面了解（AOR = 2.42，95%可信区间，1.53，3.32）与客户满意度呈正相关，而对保密性的担忧（AOR = 0.42，95%可信区间，0.20，0.63）和较长的等待时间（AOR = 0.09，95%可信区间，0.04，0.15）与结果变量呈负相关。
评估得出实施保真度较低；然而，客户满意度还算不错。基于描述性和分析性结果，必须确保VCT中心符合HTC指南中概述的必要标准，以提高客户接受度和满意度，包括提供者遵守标准、与领导进行有力沟通以及保护客户的保密性和隐私。为提高项目质量，重要的是提高客户的教育水平、增进参与者对VCT的理解、促进青年参与并为服务提供者提供培训。
