Who is more willing to Test for HIV? A Comparison of Community and School-Based Youth in Port Harcourt, Southern Nigeria

Introduction: Young people bear a significant HIV/AIDS burden worldwide. Yet most do not know their HIV status or voluntarily test for HIV. This study compared willingness to test for HIV between community and school-based youth aged 10-24 years in Port Harcourt, south-south Nigeria, and the influence of selected socio-demographic and HIV/AIDS-related factors. Methods: A comparative cross-sectional study was conducted in March 2006 in Azubie, a peri-urban community, and the College of Arts and Science in Port Harcourt. Multi-staged sampling was conducted; data was collected using pre-tested, structured questionnaires, analysed using Epi-Info v6.04d. Results: Participants were 219 community and 201 college youths. Mean ages differed, 18.2 ± 3.9 years versus 20.1 ± 2.1 years (t-test p<0.01). Sex distributions were similar but educational status varied with 9.6% community youth having college-level education. Awareness of HIV/AIDS was lower among community than college youth: 85.4% versus 96.9% (χ2 =16.59, p<0.01). Also VCT awareness differed: community, 5.0% versus college, 14.9% (χ2 =11.09, p<0.01). More of the community youth, 76.2% (95% CI=69.8-81.8) indicated willingness to voluntarily test for HIV compared with 56.7% (95% CI=49.1-64.0) among school youth. The commonest reason given was desire to confirm HIV status. Age, sex, marital status, and awareness of VCT were not associated with willingness to test. However, educational level (χ2 =45.61, p<0.01), HIV awareness (χ2 =23.86, p<0.01) and history of previous HIV testing (χ2 =4.5, p=0.03) were associated with willingness to test. Conclusion: A high level of willingness to test was observed, particularly among community-based youth who exhibited relatively less awareness and previous uptake of VCT. A scale-up of VCT services at community-level would increase opportunities for such young people to translate intent into actual decision to test. For school-based youth, who by default have greater exposure to HIV/AIDS interventions, opportunities should be maximized by reaching them with high-impact behaviour change interventions such as HIV Risk Assessment and VCT.