Predictive ability of the health belief model in HIV testing and counselling uptake among youth aged 15-24 in La-Nkwantanang-Madina Municipality, Ghana.

Background: Majority of new Human Immunodeficiency Virus (HIV)-positive persons in Ghana are aged 15-24. HIV prevalence among persons aged 15-24 years, a proxy for new infections, remained stable at 1.5% for 2017 and 2018, making it a significant public health concern. Yet only 26.4% of females and 8.6% of males aged 15-24 years know their HIV status. This study determined the predictive ability of the Health Belief Model (HBM) in HIV testing and counselling (HTC) uptake among youth (15-24 years) in the La-Nkwantanang Madina Municipality, Ghana.

Methods: A cross-sectional design was adopted for the study, using a multistage sampling method to select 415 youth aged 15-24. Data were collected using a structured interviewer-administered questionnaire, and analysed using binomial logistic regression with STATA software version 16.0 at p < 0.05 significance level and at 95% confidence interval.

Results: HTC uptake was 29.2%. Perceived susceptibility, perceived barriers, and perceived self-efficacy predicted HTC uptake. Youths with a high-risk perception for contracting HIV [OR = 3.03; 95% CI = 1.46, 6.30, p = 0.003], who perceived that they can contract HIV if not protected [OR = 3.69; 95% CI = 1.47, 9.22, p = 0.005], and worry about getting HIV [OR = 3.03, 95% CI = 1.61, 5.69, p < 0.001] (perceived susceptibility) were more likely to uptake HTC. Youths who had no trust issues with health workers [OR = 3.53; 95% CI = 1.46, 8.53, p = 0.005] and those who were not afraid of positive HIV test results [OR = 5.29; 95% CI = 2.66, 10.51, p,0.001] (perceived barriers) were more likely to uptake HTC. Youths who had no difficulties in turning up for appointments (perceived self-efficacy) had higher odds of HTC uptake [OR = 11.89, 95% CI = 6.73, 20.98, P < 0.001]. For the modifying factors, being married [OR = 2.96; 95% CI = 1.65-5.33], and having knowledge of HTC [OR = 9.10; 95% CI = 2.16-38.3], significantly influenced HTC uptake.

Conclusion: Health promotion interventions to increase HTC uptake should focus on heightening the perception of susceptibility to HIV, reducing the barriers to HTC uptake, and increasing the self-efficacy for HTC uptake. The interventions should also target the significant modifying factors.