COLLEGE OF HEALTH SCIENCESSCHOOL OF PUBLIC HEALTH

UTILIZATION OF VOLUNTARY COUNSELING AND TESTING

AND ASSOCIATED FACTORS AMONG WOLDIA TEACHERS
COLLEGE STUDENTS, NORTH WOLLO ZONE, AMHARA
REGIONAL STATE, ETHIOPIA.

BY; SOLOMON NEGA

DANIEL BIRHANU

ENATENESH WORKU

ARESEARCH PROPOSAL SUBMITED TO SCHOOL OF PUBLIC HEALTH

COLLAGE OF HEALTH SCIENSE IN PARTIAL FULLFILLMENT OF THE
REQUAIMENT FOR BACHLOR OF DEGREE IN PUBLIC HEALTH

WOLDIA, ETHIOPIA

January, 2023

WOLDIA UNIVERSITY
 COLLEGE OF HEALTH SCIENCES

SCHOOL OF PUBLIC HEALTH

Name of Investigators Name ID

1. SOLOMON NEGA WDU112908
2. DANIEL BIRHANU WDU112859
3. ENATENESH WORKU WDU112864

Name of Advisors 1. Mr. MISGANAW GUADIE (BSc, MPH)

2. Mrs. YEMISRACH BELETE (BSc, MPH)

Full title of the research project Utilization of voluntary counseling and testing and associated
factors among Woldia teachers college students, North Wollo
Zone, Amhara regional state, Ethiopia, 2022/23

Duration of project December to March 2022/23

Study area Woldia teachers college, North Wollo Zone, Amhara regional
state, Ethiopia, 2022/23

Total cost of the project 8,954.00 Birr

Address of investigators 1. SOLOMON NEGA +251928189087

2. DANIEL BIRHANU +251953602203
3. ENATENESH WORKU +251935981384

Email: solnegayit@gmail.com
Acknowledgment

First, we would like to express our deepest appreciation to Woldia University and school of
Public health for providing us such an opportunity. We are also very grateful to express our
deepest thanks to our advisor Mr. Misganaw Guadie (BSc, MPH) and Mrs. Yemisrach Belete
(BSc, MPH) for their dedicated effort, constructive criticism, encouragement, valuable
comments and advices that enabled the production of this research proposal.

We would also like to acknowledge all our friends who contribute their part during the whole
process of this work.

Lastly, but not least our gratitude extend to our family for their supporting entire of our life

i
Table of content

Contents
Acknowledgment..............................................................................................................................i

Table of content...............................................................................................................................ii

List of tables...................................................................................................................................iv

List of figures...................................................................................................................................v

Abbreviations and Acronyms.........................................................................................................vi

Summary........................................................................................................................................vii

1. Introduction..............................................................................................................................1

1.1 Background Information...................................................................................................1

1.2 Statement of the problem..................................................................................................2

1.3 Significance of the study...................................................................................................3

2. Literature review......................................................................................................................4

2.1 Utilization of voluntary counseling and testing of HIV....................................................4

2.2 Factors associated with Utilization of voluntary counseling and testing of HIV.............5

2.3 Conceptual framework......................................................................................................9

3. Objective................................................................................................................................10

3.1 General objective............................................................................................................10

3.2 Specific objective............................................................................................................10

4. Methods and Materials...........................................................................................................11

4.1 Study area........................................................................................................................11

4.2 Study period....................................................................................................................11

4.3 Study design....................................................................................................................11

4.4. Population.......................................................................................................................11

ii
 4.4.1 Source population....................................................................................................11

4.4.2 Study population......................................................................................................11

4.4.3 Study unit.................................................................................................................11

4.5 Inclusion and exclusion criteria......................................................................................12

4.5.1 Inclusive criteria......................................................................................................12

4.5.2 Exclusive criteria.....................................................................................................12

4.6 Sample size determination and sampling technique.......................................................12

4.6.1 Sample size determination.......................................................................................12

4.6.2 Sampling technique.................................................................................................13

4.7 Study variables................................................................................................................15

4.7.1 Dependent variables.................................................................................................15

4.7.2 Independent variables..............................................................................................15

4.8 Operational definition.....................................................................................................15

4.9 Data collection method, tool and personnel....................................................................15

4.10 Data quality assurance....................................................................................................15

4.11 Data management and analysis.......................................................................................16

4.12 Ethical consideration.......................................................................................................16

4.13 Dissemination of results..................................................................................................16

5. Work plan...............................................................................................................................17

6. Budget....................................................................................................................................18

7. References..............................................................................................................................19

Annex 1: Consent form and English version of questioner...........................................................22

Annex 2: Amharic version of the questioner.................................................................................28

Annex 3: Declaration.....................................................................................................................34

iii
List of tables
Table 1: Work plan for the assessment of VCT utilization and associated factors among Woldia
teachers college, 2022/23...............................................................................................................17
Table 2: Budget for the assessment of VCT utilization and associated factors among Woldia
teachers college, 2022/23...............................................................................................................18

iv
List of figures
Figure 1: Conceptual framework on utilization of VCT and associated factors developed from
literatures (6, 7, 10, 16-28), 2023....................................................................................................9
Figure 2: Diagrammatic presentation of sampling technique for the assessment of VCT
utilization and associated factors among Woldia teachers college, 2022/23.................................14

v
Abbreviations and Acronyms

AIDS: Acquired Immunodeficiency Syndrome

ART: Antiretroviral Therapy

BSc: Bachelor of Science

EDHS: Ethiopia Demographic and Health Survey

HIV: Human Immunodeficiency Virus

HIVST: HIV self-testing

HPE: Health and Physical Education

ICT: Information Communication Technology

MPH: Master of Public Health

SPSS: statistical package for the social science

SRS: Simple Random Sampling

UNAIDS: Joint United Nations Program on HIV/AIDS

VCT: Voluntary Counseling and Testing

WHO: World Health Organization

vi
Summary

Introduction: HIV prevention initiatives are based on HIV testing, which has also been
marketed as a crucial initial step in the detection, treatment, and prevention of human
immunodeficiency virus infection. Many studies conducted in different setting identified that
different factors were associated with seeking HIV testing. But a little is known about utilization
of voluntary counseling and testing and associated factors among students of Woldia teachers
college. .

Objective: This study aims to assess utilization of voluntary counseling and testing and
associated factors among Woldia teachers training college students, North Wollo Zone, Amhara
regional state, Ethiopia, 2022/23.

Method: Institution based cross sectional study will be conducted on 249 randomly selected
Woldia teachers training college students. Self-administered structured questionnaire will be
used to collect the data. The collected data will be coded, analyzed and summarized using
descriptive statistics of frequency and percentage.

Work plan: The study will be conducted from December to March 2022/23.

Total Budget: To complete the study about 8954 (eight thousand nine hundred fifty four) Birr
will be required.

vii
 1. Introduction

1.1 Background Information

World AIDS day was celebrated which aimed to stress on inequalities which are the major
obstacle for progression of ending AIDS(1). The option to realize equity of service and ends
AIDS by 2030 include; allocation of resources to countries, working on gender equity, inclusion
of key population and concerning on combating of AIDS on children. The other emphasized
point of world AIDS day 2022 was providing access to HIV testing, prevention and treatment on
equitable manner to end AIDS by 2030(2, 3).

In an effort to prevent and manage HIV/AIDS, the World Health Organization (WHO) and the
Joint United Nations Program on HIV/AIDS proposed the HIV voluntary counseling and testing
(VCT) strategy in 1994 (4). VCT provided an opportunity for both a primary prevention and
secondary prevention as it encompasses counseling before and after HIV testing (5).

HIV prevention initiatives are based on HIV testing, which has also been marketed as a crucial
initial step in the detection, treatment, and prevention of human immunodeficiency virus
infection (6). It is widely acknowledged as an effective and required tool for HIV prevention and
treatment on a global scale (7).

In many parts of the world, HIV/AIDS is a significant problem for public health. To reach the
UNAIDS 90-90-90 targets of identifying 90% of HIV-positive people, starting 90% of those
diagnosed on ART, and achieving viral suppression in 90% of those on ART, finding HIV-
positive people and enrolling them in care is essential. No one should be denied access to HIV
testing services in order to achieve the first objective (8).

At least 90% of HIV-positive individuals must undergo at least one test; several African nations
are working toward or have established this target (9). In its efforts to prevent and control
HIV/AIDS in the nation, Ethiopia has also been promoting HIV voluntary counseling and testing
(VCT) as a significant tool. However, there is still a low level of VCT service usage (6, 10).

1
1.2 Statement of the problem

Approximately 85% of people with HIV globally knew their HIV status in 2021. The remaining
15% (about 5.9 million people) did not know they had HIV and still needed access to HIV
testing services(11).

Only 10% of HIV-positive individuals in Africa were thought to be aware of their status in 2005.
In contrast, estimates from over 15 years ago indicate that 81% of HIV-positive individuals in
Africa now are aware of their condition(12).

In Ethiopia, 69% of women and 84% of men are aware of where to get an HIV test, while 40%
of women and 43% of men have ever gotten the results of an HIV test. Spread of HIV in
Ethiopia has seen reduction over the past years with a prevalence rate standing at 0.93% for
2021even though the prevalence of HIV shows some reduction, there is still a lack of proper
attention at all levels(13)

HIV testing coverage in the Amhara region was substantially lower (2%) in 2005 and increased
to 37% in 2011. The coverage of HIV testing uptake in the region demonstrates significant
increase; however, it is still lower(14).

Many studies conducted in different setting identified that different factors were associated with
seeking HIV testing. But a little is known about utilization of voluntary counseling and testing
and associated factors among students of Woldia teachers college.
Therefore, the study will be aimed at assess utilization and the major factors affecting VCT
service among students of Woldia teachers college.

2
1.3 Significance of the study

HIV/AIDS epidemic is problematic among college students because of their vulnerability.

Increased utilization of HIV testing among students has a paramount importance to reduce HIV
related mortality and morbidity. The study will be encouraged individuals to utilize HIV testing
as they are participating on such issue. The findings of the study will be helpful to expand and
improve the service of VCT, contributing to the HIV/AIDS prevention and control programs in
Woldia teachers college.

3
 2. Literature review

2.1 Utilization of voluntary counseling and testing of HIV

More than 40% of adults in Sub-Saharan Africa are unaware of their HIV status. HIV self-testing
(HIVST) is a novel approach with a potential to increase uptake of HIV testing and linkage to
care for people who test HIV positive (15).
A cross-sectional study conducted in Sudan, Kartum showed that from a total of 192 students
about 9% of the students took the HIV test, and 62% expressed their willingness to uptake VCT
in the future(16).
Another study in Kenya showed that 91.2% of the respondents reported having had an HIV test,
and the main reason was to know their status. And 68% took the HIV test more than once(17).
According to the current study, 34.9% of Ethiopian youths were assessed to have a VCT uptake
prevalence overall. Youths living in Dire-Dawa Special District were the most likely to be tested
for HIV, with 55.9% of them having so, followed by those in Gambella and Addis Abeba, with
54.7 and 51.6% of them testing, respectively. Youths in the Somali region had the lowest testing
rate, with only 13.2% of them being examined for the disease(10).
A cross-sectional study conducted in Mizan-Tepi university students showed that VCT
utilization was 42.5%(7). The study, conducted in Arsi-Negele district, showed that the
magnitude of VCT service uptake is 58.7%(18). Another study in Merawi Preparatory School
Students in Merawi Town, West Gojjam revealed 31.5% had undergone VCT for HIV (19).
A cross-sectional study conducted in Gondar revealed that 81.7% of participants were aware of
the use of voluntary counseling and testing services. However, 48.3% of people really use
voluntary counseling and testing(20). Similarly, a study in Gondar among youths suggested that;
71% were aware of VCT services. But, 37.8% had used VCT services (21). Another study in
Mizan-Aman Town, Southwest Ethiopia among youths showed that utilization of VCT was
42.4% (22). And also a study in southwest Ethiopia among university students suggested that
63.0% of the students disagreed that VCT in the campus is not functional and not giving service
appropriately. 93.4% were knowledgeable about VCT and 78.8% had positive attitude VCT. But,
only 36.7% had practiced VCT(23). The study in Wolkite University showed that 65.7% had

4
ever undergone VCT, while only 29.6% have had VCT. Among those who had tested, 35.2% and
23.1% had undergone VCT at government institutions and private clinics respectively(24).

2.2 Factors associated with Utilization of voluntary counseling and testing of HIV
A. Socio-demographic factors

Sex: A cross-sectional study done at Mizan-Tepi University, found a positive correlation

between female sex and the use of VCT. Similar to this, a study done at Wolkite University
revealed that using VCT was negatively correlated with being a male. Additionally, a study done
in Mizan-Aman Town revealed that women were more likely to use VCT. Similar data from the
2016 EDHS revealed that VCT uptake was negatively associated with being a man (7, 10, 22,
24).

Year of study: According to a cross sectional study conducted in Gondar city showed that being
2nd year of study was positively associated with VCT utilization. Similarly a study conducted in
Wolkite University revealed that 1st year students were negatively associated with utilization of
VCT (21, 24)

Age: According to a study done in the town of Gondar, increased age was positively related to
the use of VCT. Mizan-Tepi University found that people between the ages of 21 and 22 were
more likely to have VCT. Another study in the Arsi-Negele district revealed that those under 35
were more eager to get tested for HIV and that VCT use was positively correlated with age
group. While a research in Ethiopia of women aged 15 to 49 demonstrated that the use of VCT
was inversely correlated with age higher than 45(6, 7, 20).

Religion: According to data from the 2016 EDHS utilizing multilevel analysis, orthodox
Christians used VCT more frequently than other religious groups. However, a Mizan-Tepi
University study found that the use of VCT was positively correlated with being orthodox and
Protestant(7, 10).

Marital status: According to a cross sectional study conducted in Gondar city having partner
was positively associated with utilization of VCT. A cross sectional study conducted in Ethiopia
among women aged 15-49 showed that married women were more likely utilized VCT. Similarly

5
evidence from 2016 EDHS using multilevel modeling showed that being married was positively
associated with VCT uptake (6, 10, 21).

B. Social and culture

Stigma and discrimination: According to a cross-sectional study done with in Arsi-Negele

district, using VCT was negatively correlated with feeling stigmatized and discriminated against
after getting an HIV test. Similar to this, a study among university students in Southern Ethiopia
revealed that stigma was positively related to the use of VCT. A study among primary school
teachers in southwest Ethiopia suggests that stigma and discrimination, particularly toward
family members, was a barrier to the utilization of VCT (18, 23, 25).

Fear of positive result: A cross sectional study conducted in Sudan Khartoum showed that fear
of positive result was negatively associated with VCT utilization. Similarly a study conducted in
Kenya Mombasa showed that perceiving positive result was negatively associated with
utilization of VCT. This was supported by a study conducted in Southern Ethiopia among
University students (16, 17, 23).

Peer group: According to a cross-sectional study done in the city of Gondar, having a friend
who uses VCT is highly associated with using VCT. Similar research from Bahidar University
showed that individuals were more willing to use VCT if they had friends who had had it.
Additionally, a study carried out in Southern Ethiopia revealed that access to peer-to-peer
education was favorably related to the use of VCT. A study that was carried in Arbaminch Town
among students in preparatory schools provided more support for this (21, 26-28).

Having boy/girlfriend: A cross-sectional study done in the city of Gondar revealed that having a
boyfriend or girlfriend increased the likelihood of using VCT. Similar to this, a study done at
Bahirdar University revealed that relationship was favorably correlated with using VCT.
Additionally, a study done at Wolkite University, Mizan-Tepi University, and Merawi Town
suggested that dating was positively correlated with using VCT (7, 19, 21, 24, 26).

Discussion with parents: According to a cross-sectional study done in Merawi Town, students
who discussed to their parents about HIV were more likely to use VCT. In a similar vein, a study
conducted in the town of Gondar found that students who had discussed to their parents about

6
VCT were more willing to use VCT. Additionally, a study conducted in Bahirdar University
showed that using VCT was significantly associated with discussing to parents about HIV/AIDS
(19, 20, 26).

C. Knowledge and perception

Knowledge about VCT and HIV/AIDS: According to a recent study in Southern Ethiopia,
using VCT was highly associated with having knowledge of SRH issue. Additionally, data from
the 2016 EDHS using multilevel analysis showed a favorable relationship between the use of
VCT and having a moderate to high degree of knowledge about HIV. Similar to this, a study
carried out in Mizan-Aman Town found that using VCT was strongly linked with knowledge of
HIV/AIDS. Additionally, a study done in Merawi Town revealed that the use of VCT was
positively associated with having good knowledge of VCT (10, 16, 22, 24, 27).

HIV risk perception: According to a cross sectional study conducted in Sudan Khartoum
showed that individuals who considered themselves at risk of HIV infection or who had
experienced sexual intercourse were positively associated with VCT utilization. It was supported
by evidence from 2016 EDHS using multilevel modeling. Similarly a study conducted in Gondar
city showed knowing infected/dead individual with HIV/AIDS was positively associated with
utilization of VCT. Whereas a study conducted in Southern Ethiopia among University students
showed that being sure of not having HIV was negatively associated with VCT utilization (10,
16, 21, 23).

D. Health service factor

Knowing the place where VCT is given: According to a cross sectional study conducted in
Gondar city knowing the place where VCT is given was positively associated with utilization of
VCT. Similarly, a study conducted in Sudan Khartoum showed that knowing the place where
VCT is given was strongly linked with utilization of VCT. It was supported by a study conducted
in Gambia (16, 21, 29).

Access to media: According to evidence from 2016 EDHS using multilevel modeling showed
that having frequent access to media was positively associated with VCT utilization. Similarly a

7
study conducted in Mizan-Tepi University showed that individual who had access to media were
positively associated with utilization of VCT(7, 10).

E. Behavioral factors
According to the study conducted in Ethiopia among youth girls, alcohol drinkers were more
likely to initiated sexual intercourse early. This made them at risk of HIV infection. As a result,
health service utilization including VCT increase. Similarly, a study conducted in Woldia Town
among secondary school students showed that alcohol drinking and chat chewing were positively
associated with VCT uptake(20, 30).

8
2.3 Conceptual framework

Socio
demographic
factors

 Age
 Sex
 Marital status
 Religion
Social and cultural
 Year of study
 Stigma and
Health service factors discrimination
 Fear
 Access to media  Peer groups
VCT utilization
 Knowing the place  Having boy/girl
friend
of VCT
 Discussed with
parents on the issue
of VCT
Behavioral factors

 Alcoholic
 Chat chewing Knowledge/perception

 Knowledge about
VCT
 Knowledge about
HIV/AIDS
 HIV risk perception

Figure 1: Conceptual framework on utilization of VCT and associated factors developed from
literatures (6, 7, 10, 16-28), 2023.

9
 3. Objective

3.1 General objective

To assess utilization of voluntary counseling and testing and associated factors among Woldia
teachers college students, North Wollo Zone, Amhara regional state, Ethiopia, 2022/23.

3.2 Specific objective

 To determine the prevalence of voluntary counseling and testing utilization among

Woldia teachers training college students.
 To identify associated factors of voluntary counseling and testing utilization among
Woldia teachers training college students.

10
 4. Methods and Materials

4.1 Study area

The study will be conducted in Woldia teachers college in Woldia town, Amhara region,
Ethiopia. Woldia is the capital of the North Wollo Zone which is located at about 360km from
Bahir Dar and 520km away from Addis Ababa on the high way from Addis Ababa to
Mekelle(31) . Woldia is administratively structured by seven kebeles. The only Government
owned college found in the town is Woldia teachers college. There are nine departments which
are delivered in this college. Those include; Amharic, English, Mathematics, General science,
Social study, Information communication technology (ICT), Statistics, Citizenship, and health
and physical education. There are 601 students who are attending regular classes.

4.2 Study period

The study will be conducted in January 26-30 / 2023.

4.3 Study design

Institution based cross sectional study will be used.

4.4. Population

4.4.1 Source population

All students of Woldia teachers’ college.

4.4.2 Study population

The study population will be regular students who will be randomly selected from students of
Woldia teachers college during data collection according to the sampling technique.

4.4.3 Study unit

Each respondent from selected students based on sampling technique will be a study unit.

11
4.5 Inclusion and exclusion criteria

4.5.1 Inclusive criteria

All regular students of Woldia teachers college will be illegible to be included in the study.

4.5.2 Exclusive criteria

Students being seriously ill, and attending non regular class will be excluded. Similarly, students
who are absent three times or more during our visit will be excluded.

4.6 Sample size determination and sampling technique

4.6.1 Sample size determination

The sample size will be determined using a formula for estimation of single population
proportion with the assumption of 95 % confidence interval, a margin error of 5 % and taking
37.5 % utilization of VCT service [18]. To compensate the non-response rate, 10 % of the
determined sample will be added up on the calculated sample size. The final sample size will be
calculated using
n = Z2p (1-p) / d2 Where n=minimal sample size
p = proportions of students who utilized premarital
q = 1-p
d= marginal error
z= 1.96(95% confidence interval)

n= (1.96)2× 0.375(1-0.375) =361

(0.05)2
Since the total population were less than 10,000 adjustments was made by the following formula
¿
nf= 1+ ¿ Where nf = final sample size ni = minimal sample size N = total population
N
361
361 = 226 Non respondent=10 % nf = 249
1+
601

Total sample size will be 249.

12
 4.6.2 Sampling technique
We will be used stratified sampling followed by simple random sampling technique. The list of
students will be obtained from the college’s registrar office and considering students with the
same department as a homogenous group, they were stratified in to nine clusters as Amharic,
English, Mathematics, General science, Social study, Information communication technology
(ICT), Statistics, Citizenship, and health and physical education. Then number of study
participants for each stratum will be allocated proportionally and samples will be selected by
simple random sampling technique.
In = Ni x n = where In = sample size of one stratum
N Ni = Population size for one stratum
N = Total students
n = Total sample size

Accordingly;
58 x 249 63 x 249
Amharic Ni= 58, ¿= =24 ICT Ni= 63, ¿= =26
601 601
54 x 249 68 x 249
English Ni= 54, ¿= =22
HPE Ni= 68, ¿= =28
601 601
80 x 249 65 x 249
Mathematics Ni= 80, ¿= =33
Statistics Ni= 65, ¿= =27
601 601
110 x 249 53 x 249
General science Ni= 110, ¿= =46
Citizenship Ni= 53, ¿= =22
601 601
50 x 249
Social study Ni= 50, ¿= =21
601

13
 Total regular students=
601

Distribution by department

Amh Eng Maths G.Sci Socia ICT HPE Stat Citizen

58 54 80 110 50 63 68 65 53

24 22 33 Proportional
46 21
allocation 26 28 27 22

SRS

249

Figure 2: Diagrammatic presentation of sampling technique for the assessment of VCT

utilization and associated factors among Woldia teachers college, 2022/23

14
4.7 Study variables

4.7.1 Dependent variables

 VCT utilization
4.7.2 Independent variables
Socio demographic factors: Age, sex, marital status, religion, year of study

Social and cultural: Stigma and discrimination, fear, peer groups, having boy/girl friend,
discussed with parents on the issue of VCT

Knowledge/perception; Knowledge about VCT, knowledge about HIV/AIDS, HIV risk

perception

Health service factors: Access to media, knowing the place of VCT

Behavioral factors: Alcoholic, chat chewing

4.8 Operational definition

Knowledgeable -Those who answered greater than 50% of knowledge question(21).

VCT utilization: If participants in the study who ever use Voluntary HIV testing service at least
once(19).

4.9 Data collection method, tool and personnel

Self-administered structured questionnaire which will be adapted from literatures(19, 32) will be
used to collect the data. The questionnaire will be prepared in English and then it will be
translated to Amharic version. Data collectors will be 3 health professional public health
students.

4.10 Data quality assurance

The quality of data will be ensured through close supervision by our advisor and by each other’s,
reviewing each of completed data. And also pretest will be conducted on 5% randomly selected
students.

15
4.1 Data management and analysis
The data gathered from study participants will be cleaned and checked for its completeness then
coded and entered in to computer software using statistical package for social science (SPSS)
version 27. Bivariate and multivariable binary logistic regression will be utilized for assessing
statistical significance of association between dependent and independent variables. P-value less
than 0.05 will be considered as a level of significance. Finally, data will be presented in tables,
graphs, frequency percentage of different variables.

4.12 Ethical consideration

Permission for doing the research will be requested using a letter from College of health science,
School of public health. The objective of the study will be described & informed verbal consent
will be obtained from the study participants prior to data collection. Participants will be informed
about their full right not to be participating at all or to stop at any time while the data collection
is going on. Study participants will be also informed that all data obtain from them will be kept
confidential by using codes instead of any personal identifiers.

4.13 Dissemination of results

The result of the study will be presented and submitted to school of public health, college health
science, Woldia University. Additionally, the study finding will be distributed for the college,
and zonal health department. Online dissemination will also be considered.

16
 5. Work plan
Table 1: Work plan for the assessment of VCT utilization and associated factors among Woldia
teachers college, 2022/23

December January February March

S.N Activity RB 01- 2

25 6-
3
0

1. Preparation and PI
submission of first draft
proposal

2. Submission of second PI
draft and final proposal

3. Submission of third draft PI

4. Resource securing IRB

obtaining ethical
clearance

5. Data collection PI

6. Data entry and cleaning PI

7. Analysis PI

8. Thesis write up and PI

submission of first draft

9. Second draft submission PI

10. Advice and comment Ad

11. Thesis defense PI

Key; RB=Responsible body, PI= Principal investigators, IRB= Institutional review board,
Ad= advisors

17
 6. Budget
Table 2: Budget for the assessment of VCT utilization and associated factors among Woldia
teachers college, 2022/23.

I. Supply cost
S.N Item Unit Quantity Cost per unit Total(Birr)
1. Printing paper Pack 2 1000 2000
2. Questionnaire Each 1750 2 3500
duplication
3. Note book Each 4 100 400
4. Pen Each 4 25 100
Supply total 6000
II. Personnel cost
S.N Description Rate of Number Total Remark
payment
Data 100 Birr/day 3 for 3 day 900 Data
collectors collection
Supervisor 200 Birr/day 1 for 3 day 600 Supervision
Personnel 1500
cost total
III. Transportation
Public Round trip No. of Price per trip Total
transport individuals in
each trip
4 4 40 Birr 640
Transportati 640
on total
Sum total 8140
Contingency 814
Grand total 8954

18
 7. References
1. WHO. World AIDS day 2022 [
2. HIV/AIDS JUNPo. World AIDS Day report 2022 Geneva2022 [881-97].
3. World AIDS Day 2022: UCL (University College London); 2022 [
4. Armstrong-Mensah EA, Tetteh AK, Ofori E, Ekhosuehi O. Voluntary counseling and
testing, antiretroviral therapy access, and HIV-related stigma: global progress and
challenges. International Journal of Environmental Research and Public Health.
2022;19(11):6597.
5. Derebew B, Mola M, Kalyankar VB, Padwal ND, Chauhan NM, Humbe AS, et al.
Determination of knowledge, attitude and practice of voluntary counseling testing on HIV
among youths from Tepi Town, Ethiopia. PEC Innovation. 2023;2:100102.
6. Erena AN, Shen G, Lei P. Factors affecting HIV counselling and testing among Ethiopian
women aged 15–49. BMC Infectious Diseases. 2019;19(1):1-12.
7. Adulo LA, Hassen SS, Kontuab AM. Utilization of Voluntary Counseling and Testing
Experience among Mizan-Tepi University Students in Southwestern Ethiopia. AIDS
Research and Treatment. 2022;2022.
8. Kiplagat J, Huschke S. HIV testing and counselling experiences: a qualitative study of older
adults living with HIV in western Kenya. BMC geriatrics. 2018;18(1):1-10.
9. Li Z, Hsiao Y, Godwin J, Martin BD, Wakefield J, Clark SJ, et al. Changes in the spatial
distribution of the under-five mortality rate: Small-area analysis of 122 DHS surveys in 262
subregions of 35 countries in Africa. PloS one. 2019;14(1):e0210645.
10. Nigatu M, Kabeta T, Taye A, Belina M. HIV voluntary counseling and testing uptake and
associated factors among Ethiopian youths: evidence from the 2016 EDHS using multilevel
modeling. BMC Infectious Diseases. 2021;21(1):1-11.
11. Global Statistics 2022 [Available from: https://www.hiv.gov/hiv-basics/overview/data-and-
trends/global-statistics.
12. National consolidated guidelines for comprehensive HIV prevention. Ethiopia2018.
13. agency Cs. Ethiopian demographic and health survey, . Addis Ababa, Ethiopia2016.

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14. Gashu KD, Meshesha M, Molla M. HIV Counseling And Testing Uptake among Adults in
Amhara Region; North West Ethiopia. East African Journal of Public Health.
2015;12(1):956-63.
15. Njau B, Covin C, Lisasi E, Damian D, Mushi D, Boulle A, et al. A systematic review of
qualitative evidence on factors enabling and deterring uptake of HIV self-testing in Africa.
BMC public health. 2019;19(1):1-16.
16. Abdalla AM, Abusalih HH. Factors Affecting HIV Voluntary Counseling and Testing
Uptake among Usndergraduate Students of Khartoum, Sudan. The Open AIDS Journal.
2021;15(1).
17. Wangui J, Kikuvi G, Msanzu J. Factors influencing utilization of Voluntary Counseling and
Testing Services among Kenya Ports Authority employees in Mombasa, Kenya. Global
Journal of Health Sciences. 2016;1(1):27-41.
18. Nuri R. Voluntary Counseling and Testing Utilization and Associated Factors Among
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Public Health. 2017;6(3):00169.
19. Abdissa D, Tazebew M, Gerbi A. Prevalence of Voluntary Counseling and Testing
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20. Demeke GB, Alazbih NM. Assessment of factors affecting voluntary counseling and testing
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Ethiopia. 2019.
21. Alem AT, Sisay MM, Alemayehu AM. Factors Affecting Voluntary HIV/AIDS Counseling
and Testing Service Utilization Among Youth in Gondar City, Northwest Ethiopia.
HIV/AIDS (Auckland, NZ). 2020;12:667.
22. Zewude MW, Gebremedhin T, Gole AG. Assessment of Intension to Voluntary HIV
Counseling and Testing Utilization and Associated Factors Among Youth Living in Mizan
Aman Town, South-West Ethiopia By Health Belief Model, A Cross Sectional Study.
Assessment. 2020;66.
23. Ermeko T, Kebede D, Lette A. Knowledge, attitude and practice towards voluntary
counseling and testing service among University Students, Southern Ethiopia. Microbiol
Res J Int. 2019;1.

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24. Abdu AO, Teshome G, Melese DM, Girma A, Daniel K, Agizie A. Knowledge, attitude,
practice and associated factors of voluntary counseling and testing for HIV/AIDS among
Wolkite university students in Ethiopia. 2017.
25. Sheki B. Exploring the Determining Factors for Utilization of VCT Service among Primary
School Teachers in South-West Ethiopia. J Obstet Gynecol Womens Health. 2019;2(1):1-
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26. Fikadie G, Bedimo M, Alamrew Z. Prevalence of voluntary counseling and testing
utilization and its associated factors among Bahirdar University students. Advances in
Preventive Medicine. 2019;2014.
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comparative cross-sectional study. BMC public health. 2022;22(1):1-17.
28. Nnko S, Kuringe E, Nyato D, Drake M, Casalini C, Shao A, et al. Determinants of access to
HIV testing and counselling services among female sex workers in sub-Saharan Africa: a
systematic. 2019.
29. Deynu M, Agyemang K, Anokye N. Factors Associated with HIV Testing among
Reproductive Women Aged 15–49 Years in the Gambia: Analysis of the 2019–2020
Gambian Demographic and Health Survey. International Journal of Environmental Research
and Public Health. 2022;19(8):4860.
30. Aragie TG, Abate BB. Utilization of Reproductive Health Services and Associated Factors
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Environmental and Public Health. 2021;2021.
31. ICF CSACEa. Ethiopia Demographic and Health Survey 2016. Addis Ababa, Ethiopia2016.
32. OBIAJULU AC. KNOWLEDGE, ATTITUDE AND PRACTICE OF VOLUNTARY
COUNSELING AND TESTING (VCT) FOR HIV/AIDS AMONGST THE HEALTH
PROFESSIONALS IN UMPUMULO HOSPITAL, MAPUMULO, ILEMBE DISTRICT,
KWAZULU-NATAL PROVINCE. 2008.

21
Annex 1: Consent form and English version of questioner
Dear Respondent, How are you? My name is _______________. I and my colleagues, currently
we are a graduating students at Woldia University, College of Health Sciences, school of Public
health. We are conducting a research entitled “utilization of voluntary counseling and testing and
associated factors among Woldia teachers training college students, North Wollo zone, Amhara
regional state, Ethiopia,2022”. The main purpose of the study is to collect information necessary
to assess utilization of voluntary counseling and testing and associated factors and in order to
identify the gap to recommend possible solutions. To attain this purpose your honest and genuine
participation is very important and highly appreciable. Therefore, kindly request you to fill this
questionnaire as accurately and carefully as possible. Please be assured that all the information
gathered will be kept strictly confidential and your name does not need to written in any page of
the questionnaire. Only the researcher has the access of the information and used it for the study
purpose only. You have a full right not to participate in this study.

Are you willing to participate?

Yes__________________ No_________________

This questionnaire is prepared to study Assessment of utilization of voluntary counseling and

testing and associated factors among Woldia teachers training college students, North Wollo,
2022.

Instruction

-Circle your choice from the given alternative

-Write appropriate answer for open ended question on space provided

-please don’t write you name

22
PART 1 SOCIO DEMOGRAPHIC CHARACTERISTICS

No Questions Response Skip

1. Age ------------Years

2. Sex 1. Male

2. Female

3. Religion 1. Orthodox

2. Muslim

3. Protestant

4. Catholic

5. Others

4. Marital status 1. Married

2. Single

3. Divorced

4. Widow

5. Educational status 1. 1st year

2. 2nd year

3. 3rd year

PART 2 KNOWLEDGE QUESTION CONCERNING HIV AIDS

Question True (√) False (×)

1. HIV could be transmitted by

Pregnant- women to unborn baby

23
 2. HIV could be transmitted by

Breast- milk to infant.

3. HIV could be transmitted by

Sharing of razors or tooth-brush

4. Abstinence prevent

sexual l- transmission of HIV

5. Condom could prevent

sexual transmission of HIV

6. A person could be a carrier of

HIV without having AIDS.

7. Mosquitoes could transmit

the HIV

8. HIV and AIDS is the same thing.

9. There is a cure for AIDS

10. HIV could be transmitted by

sharing contaminated sharp material

PART 3 KNOWLEDGE QUESTION CONCERNING ON VCT

Question Yes(√) No(×)

11. Have you ever heard about VCT?

12. Do you know HIV testing is given

with counseling?

13. Do you know HIV testing is

conducted voluntarily?

14. Do you know the place where VCT is

24
 conducted?

15. Is VCT important for the prevention

and control of HIV?

PART 4 PRACTICES OF VOLUNTARY CONSELING AND TESTING

16. Have you ever had HIV test 1. Yes If No skip to 24

voluntarily?
2. No

17. Did you receive the result? 1. Yes

2. No

18. Why were you tested for HIV? 1. Requested by

health professional
after I had illness

2. I was at risk of
acquiring the
disease

3. Need to know my
HIV status for
different reason,
like marriage, to
have a child, risky
behavior.

4. Having boy/girl
friend

5. Requested by
migration
committee (for
visa)

6. Others (specify)

19. If you never tested for HIV/ AIDS 1. Fear of result

what are factors that prevented you

25
 from having HIV tested? 2. Never had sex

3. Stigma associated
with HIV/AIDS

4. Do not want to
have test yet

5. I don’t know the

place where VCT is
given.

6. No access to media

7. Peer influence

20. Do you want to have HIV test in the 1. Yes If No skip to 28

future?
2. No

21. Why you want to have HIV testing 1. To know my status

and plan according
depending on the
result

2. Distrust of partner

3. Pregnancy

4. Being married

5. Exposure to HIV
risk

6. Having symptoms
of HIV/ AIDS

7. Other (specify)

22. If you want to be tested where would 1. Government health

it be the most convenient? institute

2. Private health
institution

26
 3. Non-government
VCT test center

4. Other (specify)

23. Have you ever discussed about VCT 1. Yes

with your parents?
2. No

24. Have you ever smoked? 3. Yes

4. No

25. Have you ever drunk excessive 1. Yes

alcohol?
2. No

27
Annex 2: Amharic version of the questioner.
በወልድያ መምህራን ኮሌጅ ተማሪዎች ላይ በፈቃደኝነት ላይ የተመሰረተ የኤችአይ ቪምርመራና
የምክር አገልግሎት አጠቃቀምና ተያያዥ ጉዳዬች ግምገማ ላይ ጥናት ለማድረግ የተዘጋጀ የስምምነት
ቅጽ እና ጥያቄ፣ሰሜን ወሎ፣2015 ዓ.ም

ውድ ተጠሪ፣ እንዴት ነህ? ስሜ _______________። እኔ እና ባልደረቦቼ፣ በአሁኑ ጊዜ በወልድያ

ዩኒቨርሲቲ፣ የጤና ሳይንስ ኮሌጅ፣ የህብረተሰብ ጤና ትምህርት ክፍል ተመራቂ ተማሪዎች ነን።
በወልድያ መምህራን ኮሌጅ ተማሪዎች፣ በሰሜን ወሎ ዞን፣ በአማራ ክልል፣ በ 2015 ዓ.ም "በበጎ
ፈቃደኝነት ላይ የተመሰረተ የኤችአይቪ ምርመራና የምክር አገልግሎት ላይ ተጽእኖ የሚያሳድሩ
ጉዳዮች" በሚል ርዕስ ጥናት እያደረግን ነው። የጥናቱ ዋና ዓላማ የበጎፈ ቃድ የምክር እና የምርመራ
አጠቃቀምን እና ተያያዥ ጉዳዮችን ለመገምገም እና ክፍተቱን በመለየት መፍትሄዎችን ለመስጠት
አስፈላጊ መረጃዎችን መሰብሰብ ነው። ይህንን ዓላማ ለማሳካት የእናንተ ታማኝ እና እውነተኛ
ተሳትፎ በጣም አስፈላጊ እና በጣም የሚደነቅ ነው። ስለዚህ ይህንን መጠይቅ በተቻለ መጠን በትክክል
እና በጥንቃቄ እንዲሞሉ በአክብሮት እንጠይቃለን። እባክዎ ሁሉም የተሰበሰቡ መረጃዎች በጥብቅ
በሚስጥር እንደሚጠበቁ እና ስምዎ በማንኛውም የመጠይቁ ገጽ ላይ መፃፍ እንደማያስፈልገው
እርግጠኛ ይሁኑ። መረጃውን ያገኘው ተመራማሪው ብቻ ነው እና ለጥናት ዓላማ ብቻ
ይጠቀምበታል። በዚህ ጥናት ላይ ላለመሳተፍ ሙሉ መብት አለህ/ሽ።

ለመሳተፍ ፈቃደኛ ነህ/ሽ?

አዎ

አይ_________________

ይህ መጠይቅ የተዘጋጀው የወልድያ መምህራን ኮሌጅ ተማሪዎች በፈቃደኝነት ላይ የተመሰረተ

የኤችአይቪ ምርመራና የምክር አገልግሎት አጠቃቀምና ተያያዥ ጉዳዬች ግምገማ ላይ ለማጥናት
ነው።

መመሪያ

- ከተሰጠው አማራጭ ምርጫዎን ክብ ያድርጉ

- ክፍት ለሆነ ጥያቄ በተሰጠው ቦታ ላይ ተገቢውን መልስ ይፃፉ

28
 - እባክዎን ስምዎን አይጻፉ

ክፍል አንድ - ሶሺዮ - ዲሞግራፊክ ጉዳዬች

ተ.ቁ ጥያቄ መልስ ይለፉ

1. ዕድሜ ……………….አመት

2. ጾታ 1. ወንድ

2. ሴት

3. ሃይማኖት 1. ኦርቶዶክስ

2. ሙስሊም

3. ፕሮቴስታንት

4. ካቶሊክ

5. ሌሎች

4. የጋብቻ ሁኔታ 1. ያገባ

2. ያላገባ

3. ፍቺ

4. ባል ወይም ሚስት የሞተበት

5. የትምህርት ደረጃ 1. 1 ኛ አመት

2. 2 ኛ አመት

3. 3 ኛ አመት

ክፍል II- ኤችአይ ቪ ኤድስን የሚመለከት የእውቀት ጥያቄ

29
 ጥያቄ እውነት(√) ሀሰት(×)

1. ኤችአይቪ በእርግዝና ወቅት ከእናት

ወደልጅ ሊተላለፍ ይችላል

2. ኤችአይቪ ጡት በማጥባት ጊዜ
ከእናት ወደልጅ ሊተላለፍ ይችላል

3. የጥርስ ቡርሽ በጋራ መጠቀም

ኤችአይቪ ሊያስተላልፍ ይችላል

4. መታቀብ ኤችአይቪን ይከላከላ

5. ኮንዶም መጠቀም ኤችአይቪን

ይከላከላል

6. አንድ ሰው ኤድስ ሳይኖረው

ኤችአይቪ በደሙ ሊኖር ይችላል

7. የወባ ትንኝ ኤችአይቪ

ልታስተላልፍ ትችላለች

8. ኤችአይቪ እና ኤድስ አንድ ናቸው

9. ኤችአይቪ መዳን የሚችል ነው

10. ስለታም ነገሮችን በጋራ መጠቀም

ኤችአይቪን ሊያስተላልፍ ይችላል

ክፍል III- በበፈቃደኝነት ላይ የተመሰረተ የኤችአይቪ ምርመራ እና የምክር አገልግሎት (VCT) ላይ

ያተኮረ የእውቀት ጥያቄ

አዎ (√) አይ (×)

11. ስለ VCT ሰምተው ያውቃሉ?

12. የኤችአይቪ ምርመራ በምክር

እንደሚሰጥ ያውቃሉ?

13. የኤችአይቪ ምርመራ የሚደረገው

በፈቃደኝነት እንደሆነ ያውቃሉ?

14. VCT የት እንደሚሰጥ ያውቃሉ?

15. VCT ኤችአይቪን ለመከላከል እና

30
 ለመቆጣጠር አስፈላጊ ነው?

ክፍል IV-በበፈቃደኝነት ላይ የተመሰረተ የኤችአይቪ ምርመራ እና የምክር አገልግሎት (VCT)

አጠቃቀም ላይ ያተኮሩ ጥያቄዎች

16. በፈቃደኝነት ላይ የተመሰረተ 1. አዎ መልስዎ አይ ከሆነ

የኤችአይቪ ምርመራ አድርገህ/ሽ ወደ 24 ይሂዱ
ታውቃለህ/ሽ? 2. አይ

17. ውጤቱን ተቀብለዋል? 1. አዎ

2. አይ

18. የኤችአይቪ ምርመራ ያደረጉበት 1. ከታመምኩ በኋላ በጤና

ምክንያት ምንድን ነው? ባለሙያ አነሳሽነት

2. በሽታውን የመያዝ አደጋ

ላይ ስለነበርሁ

3. በተለያዩ ምክንያቶች
የኤችአይቪ ሁኔታዬን
ማወቅ ስለነበረብኝ
(ለምሳሌ እንደ ጋብቻ፣
ልጅ ለመውለድ;
ተጋላጭነት)

4. ወንድ ወይም ሴት የፍቅር

ጓደኛ መኖር

5. በስደተኞች ኮሚቴ
የተጠየቀ (ለቪዛ)

6. ሌሎች (ይግለጹ)

19. ፈጽሞ የኤች አይ ቪ/ኤድስ 1. ውጤትን መፍራት

ምርመራ ካላደረግህ/ሽ የኤች አይ
2. ወሲብ ፈጽሜ አላውቅም
ቪ ምርመራ እንዳታደርግ/ጊ
ያገዱህ/ሽ ነገሮች ምንድን 3. ከኤችአይቪ/ኤድስጋር
ናቸው? የተያያዘ መገለል

4. እስካሁን የኤች አይ ቪ
ምርመራ ማድረግ

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 አልፈልግም

5. VCT የሚሰጥበትን ቦታ
አላውቅም

6. የመገናኛ ብዙሃን ተደራሽ

አለመሆን

7. ሚስጥራዊነትን መፍራት

8. የአቻ ተጽዕኖ

20. ወደፊት የኤችአይቪ ምርመራ 1. አዎ መልስዎ አይ ከሆነ

ማድረግ ትፈልጋለህ? ወደ 28 ይሂዱ
2. አይ

21. ለምን የኤችአይቪ ምርመራ 1. እንደ ውጤቱ መሰረት

ማድረግ ይፈልጋሉ? የእኔን ሁኔታ እና እቅድ
ለማወቅ

2. ከፍቅረኛ ወይም ከትዳር

አጋር ጋር አለመተማመን

3. እርግዝና

4. ስላገባሁ

5. ለኤችአይቪ የሚያጋልጥ
አደጋ ገጥሞኝ ስለነበረ

6. የኤችአይቪ/ኤድስ
ምልክቶች መኖር

7. ሌላ (ይግለጹ)

22. የኤችአይቪ ምርመራ ማድረግ 1. ከመንግስት ጤና ተቋም

ከፈለጉ የት ማድረግ ይመርጣሉ?
2. ከግል ጤና ተቋም

3. ከመንግስታዊያ ልሆነ
በበፈቃደኝነት ላይ
የተመሰረተ የኤችአይቪ
ምርመራ እና የምክር

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 አገልግሎት (VCT) ማዕከል

4. ሌላ (ይግለጹ)

23. ከወላጆችህ/ሽ ጋር ስለ VCT 1. አዎ

ተወያይተህ/ሽ ታውቃለህ/ሽ?
2. አይ

24. አጨስህ ታውቃለህ/ሽ? 3. አዎ

4. አይ

25. ከመጠን በላይ አልኮል ጠጥተህ/ሽ 1. አዎ

ታውቃለህ/ሽ?
2. አይ

ስለተሳተፉ እናመሰግናለን!!!

Annex 3: Declaration
We, the undersigned, public health students declare that this proposal is our original work in
partial fulfillment of the requirement for the bachelors of degree in Public Health.

Name Solomon Nega Daniel Birhanu Enatenesh Werku

Signature ………………. ……………… ………………….

Place of submission: School of Public Health, College of Health Sciences, Woldia University.

Date of Submission: ____________________________

Approved by Advisors

Name Signature

1. Mr. Misganaw Guadie (BSc, MPH) _____________________

2. Mrs. Yemisrach Belete (BSc, MPH) _____________________

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