Voluntary counseling and testing (VCT) for HIV/AIDS: a study of the knowledge, awareness and willingness to pay for VCT among students in tertiary institutions in Enugu State Nigeria.

OBJECTIVE: To examine the level of awareness of youths to voluntary counseling and testing and willingness to pay for this service, and to explore reasons for underutilization of this service.

METHODS: A cross sectional study was carried out among undergraduate students of two tertiary institutions in Enugu Nigeria using pre-tested interviewer administered questionnaire. Information was collected from 250 respondents per institution. Analysis was done using SPSS computer software package.

RESULTS: Most of the respondents (64%) have heard about VCT and 70.6% of the students obtained their information from the mass media (P<0.05) while a minority (3.8%) heard from families. 76.6% of respondents believe VCT can provide useful information on HIV/AIDS and VCT is obtainable mainly in teaching hospitals (78.5%) and to a lesser extent in government hospitals (9.8%) and NGOs (8.8%), while being almost non existent in private hospitals (2.9%). 81% of the respondents did not attend VCT while only 19% attended. The reasons for non attendance were that majority of the students (45.7%) were unaware of the services (P<0.05), indifferent to VCT (20.0%), (12.8%) felt it was costly and (13.3%) were afraid of discovering their HIV status. About 50% of the respondents were willing to pay for VCT and the mean willingness to pay was $3.2 (N370). Out of those willing to pay, 46% of them are willing to pay ($2.6) N300 while 34% and 20% are willing to pay $3.4 (N400) and $4.3 (N500), respectively (P<0.05). Among those not willing to pay, 67.6% of them think it should be free (P<0.05). Males and people with higher knowledge of VCT stated higher WTP values than females and those with less knowledge of VCT. Log OLS also showed that a higher level in the University was positively related to WTP.

CONCLUSION: The high knowledge of VCT does not reflect on the attendance at VCT clinics. Respondents seem ignorant about where the services can be obtained and they believe VCT should be free or adequately subsidized. The cost of VCT is much higher than the mean WTP and governments should take this into consideration when subsidies are being considered. More VCT centers should be created and widely publicized in various communities.