Determinants for Refusal of Provider Initiated HIV Testing and Counselling among Patients Attending Adult Outpatient Departments of Public Health Facilities in Woliso Town, South West Shoa Zone, Oromia, Ethiopia

Abstract

Background: Globally, HIV/AIDS is killing millions of people, and the epidemic is continuing to become a major public health problem in sub-Saharan Africa. The main justification for routine PITC is to increase the number of patients tested and thus the number of HIV-infected patients identified and linked to medical care and support services. Most people do not know whether they are HIV positive for a variety of reasons. However, PITC refusal rate tends to be high in OPD setting compared to other clinical service delivery areas. Objective: To assess determinants for refusal of PITC among clients attending adult OPD services in Public health facility of Woliso town, South West Shoa Zone, Oromia, Ethiopia, 2023 Methods: Facility based unmatched case control study supplemented by qualitative study was conducted from April 20 to May 20, 2023. A total of 396 clients were participated from two hospitals and two health centers. Data were collected using interviewer-administered structured questionnaire and entered into Epi-Info version 7.2, then exported to SPSS version 25 for processing and analysis. Descriptive statistics was used to describe the participant‟s characteristics. Binary & multiple logistic regressions were used to assess the association between dependent & independent variables. The magnitude of association between dependent & independent variables were measured by odds ratios along with 95% confidence interval. Finally the significance of association was declared by p-value < 0.05. The results were displayed by using text, table and graph. Finally, model of fitness was checked by using Hosmer and Lemeshow test goodness-of-fit. Qualitative part was done by FGD . Results: In this study 396 clients (132 cases and 264 controls) were completed the interview giving the response rate of 100%. Mass media (AOR7.8 (95%CI 4.70-12.12)), information about PITC from health workers AOR= 4.7(95%CI (2.70-8.20)) , trust sexual partner AOR=2.62(95%CI:(1.28-5.34)),previous test exprience (AOR=2.97(95% CI: (1.62-5.46)), perceive the benefits of HIV test (AOR= 2.76(95% CI: 1.25-6.07)) were significantly associated with determinants for refusal of PITC. Conclusion: Trust sexual partner, source of information about PITC from mass media and health workers and not perceived risk of HIV were major barriers for PITC refusal in our study.