Knowledge, atitudes and aceptabilty to provider-initated HIV testing and counseling: patients’ perspectives in Moshi and Rombo Districts, Tanzania

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Provider-initated HIV testing and counseling (PITC) is referred to as routine testing in a clinical setting as part of a standard programme of medical services. PITC is initated in order to avoid missed oportunities for people to get tested for HIV. While advocated as a strategy, there is dearth of information on patients’ views on PITC in a number of districts in Tanzania. The objective of this study was to asses the knowledge, attitude and acceptabilty to PITC services among patients attending health care facilties in rural and urban settings in Kilimanjaro region A total of 12 focus group discussions (FGDs) were conducted with 9 (73 female and 26 male) patients enrolled into out- patient clinics in 8 (2 hospitals and 6 primary care centers) health facilities in Moshi Urban and Rombo districts in northern Tanzania. The study explored on knowledge, attitudes and acceptabilty of PITC, perceived benefits and barriers of PITC, and ethical issues related to PITC. Interviews were audio taped, transcribed, translated, and analyzed using Non-numerical Unstructured Data Indexing and Theorizing (NUDIST) software. Knowledge about PITC services was generally low. Compared to men, women had a more positive attitude towards PITC services, because of its ability to identify and treat undiagnosed HIV cases. HIV stigma was regarded as a major barrier to patients’ uptake of PITC. Institutional factors such as lack of supplies and human resources were identifed as barriers to succesfull provision of PITC. In conclusion, the findings highlight both oportunities and potential barriers in the succesfull uptake of PITC, and underscore the importance of informed consent, counseling and confidentiality and the need for specifc strategies on advocacy for the service.