Challenges with non-uptake of home-based HIV screening among siblings of HIV positive children in Calabar, Nigeria

Abstract

Background: Knowledge of HIV status is critical to expanding access to HIV treatment, care and support in a timely manner. Household members of HIV positive persons often are also infected but unaware of their HIV status with consequent diagnosis and treatment gaps. Targeting siblings of index HIV infected children is an important approach of improving identification and enrolment into care. Homebased HIV counselling and testing (HBHCT) has been identified as an acceptable model to complement Provider initiated counselling and testing (PITC) efforts.This study was therefore conducted to assess the uptake of HBHTC among siblings of HIV positive children in Calabar.
Methods: This cross-sectional descriptive study was conducted in two health facilities in Calabar. Siblings of HIV positive children were traced to their homes and HIV test was done using the home-based HIV counselling and testing model. Reasons for non-acceptance of HIV test at home were documented. Data was collected and analyzed using SPSS version 21 and p-value <0.05 was considered significant.
Results: Out of 401 children recruited into the study, 314(78.3%) accepted home testing while 87 (21.7%) were tested at the health facility giving an uptake of 78.3% among siblings of HIV positive children. The reasons given for non-acceptance of home-based HIV test were; fear of stigmatization 87 (100%), fear of HIV status disclosure by 54(38.3%) and previous testing for HIV 80(92%). None statistically significantly predicted uptake of home-based HIV testing.
Conclusion: Home-based HIV testing among siblings of HIV positive  children in Calabar has a high acceptability. However, fear of stigma, HIV status disclosure and previous HIV test were responsible for non-uptake.

Keywords: HIV, Home-based HIV testing, Sibling, Stigma, Disclosure, Non-acceptance, Uptake