Research Paper on youths and factors that hinder their access to HIV/AIDS services as a case scenario of Kalingalinga Compound of Lusaka District.

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THE UNIVERSITY OF ZAMBIA
SCHOOL OF HUMANITIES AND SOCIAL SCIENCES
POPULATION STUDIES DEPARTMENT
TOPIC
FACTORS THAT MAY HINDER YOUTHS FROM THE
UTILISATION OF HIV VOLUNTARY COUNSELLING AND
TESTING SERVICES IN KALINGALINGA
BY
MWIINDE, MOONO (11030275)
Report prepared in partial fulfillment of a Bachelor of Arts
Degree in Demography
Supervisor: Mr. Andrew Banda
© JULY 2015

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DECLARATION
I declare that (Factors that may hinder youths from the utilisation of HIV voluntarycounselling
and testing services. A case study of Kalingalinga compound) is my own work and that all the
sources that I have used or quoted throughout the study have been indicated and acknowledged
by means of complete references.
NAME SIGNATURE DATE
MWIINDE MOONO (11030275) ...………………….. ……………………..
SUPERVISOR
NAME SIGNATURE DATE
MR. BANDA ANDREW …………………… ………………………

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DEDICATION
This report is dedicated to my beloved father Mr. Gosline M Mwiinde, who has
been my source of motivation throughout my four years study. To my dearest
mother Annie H Mwiinde, your wise words led me to my path of success. To my
sisters (Ester, Beauty, Betty, Choolwe, Mubila and Namwiinga) and brother my
lone brother Lwaano, your look up to me and encouragement helped me maintain
my focus I really appreciate. Gratitude also goes to the Lord Almighty who’s
always been the driver throughout my journey of academics.

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ACKNOWLEDGEMENTS
Firstly, I wish to thank my Almighty Father in Heaven and the Lord Jesus Christ for being with
me and granting me grace, guidance and strength throughout my studies.
Secondly I would also like to show my gratitude to the entire Department of Population Studies
at UNZA for various aspects which directly or indirectly contributed to the preparation of the
report.
I am greatly indebted to Mr. A. Banda, my supervisor for his intelligent, guidance,
encouragement, support and patience at all stages of this research. Without his invaluable input,
it would not have been possible for me to have completed this paper work.
Finally my special thanks goes to my Dad and Mum, Mr. and Mrs. MWIINDE for their
guidance and support both financially and emotionally. Lastly but not the least I would like to
thank my sisters and brother for being there when needed and also my friends who gave me a
hand wherever necessary and my sweetheart charity for the support.

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Contents
LIST OF ACRONYMS............................................................................................................... 6
LIST OF TABLES...................................................................................................................... 7
ABSTRACT.............................................................................................................................. 10
CHAPTER ONE....................................................................................................................... 11
1.0 BACKGROUND ............................................................................................................. 11
1.1 STATEMENT OF THE PROBLEM ............................................................................... 12
1.2 STUDY RATIONALE..................................................................................................... 13
1.3 RESEARCH OBJECTIVES............................................................................................ 14
1.3.1 GENERAL OBJECTIVE;......................................................................................... 14
1.3.2 SPECIFIC OBJECTIVES;........................................................................................ 14
CHAPTER TWO...................................................................................................................... 15
2.0 LITERATURE REVIEW................................................................................................ 15
2.0.1 THEORETICAL FRAMEWORK:........................................................................... 15
2.1 HYPOTHESES................................................................................................................ 19
2.2 IDENTIFICATION AND MEASUREMENTS OF VARIABLES ................................... 20
2.2.1 IDENTIFICATION OF THE VARIABLES:............................................................. 20
2.2.2 DEFINITION OF VARIABLES: .............................................................................. 20
CHAPTER THREE.................................................................................................................. 22
3.1 METHODOLOGY.......................................................................................................... 22
3.1.1 AREA OF STUDY: ................................................................................................... 22
3.1.2 RESEARCH DESIGN:.............................................................................................. 22
3.1.3 DESCRIPTION OF THE POPULATION: ............................................................... 22
3.1.4 SAMPLE SIZE: ........................................................................................................ 22
3.1.5 SAMPLING DESIGN AND PROCEDURE:............................................................. 22
3.1.6 RESEARCH INSTRUMENTS OR TOOLS:............................................................. 23
3.1.7 DATA COLLECTION:............................................................................................. 23
3.1.8 DATA ANALYSIS:................................................................................................... 23
3.2 ETHICAL CONSIDERATION:...................................................................................... 24
3.3 LIMITATIONS:.............................................................................................................. 24
CHAPTER FOUR .................................................................................................................... 25
4.1 FINDINGS ...................................................................................................................... 25
RESULTS............................................................................................................................. 25
4.1.0 Overview................................................................................................................... 25
4.1.1 BACKGROUND PROFILE OF THE PARTICIPANTS........................................... 25
4.1.2 KNOWLEDGE AND AVAILABILITY OF HTC SERVICES.................................. 29

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4.1.3 CURRENTLY USING OR EVER USED AND THE EXPERIENCE........................ 32
CHAPTER FIVE...................................................................................................................... 39
5.0 DISCUSSION OF FINDINGS......................................................................................... 39
5.1 OVERVIEW.................................................................................................................... 39
5.2 OVERVIEW OF MAIN FINDINGS................................................................................ 39
5.2.1 Knowledge and Availability of HTC services............................................................. 39
5.2.2 Currently using or ever used and the experience....................................................... 40
5.2.3 School attendance and VCT Use................................................................................ 40
5.2.4 Employmentstatus and never gone for VCT,............................................................ 41
5.3 CONCLUSION................................................................................................................ 41
5.4 RECOMMENDATIONS................................................................................................. 42
APPENDIX............................................................................................................................... 44

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LIST OF ACRONYMS
AIDS – Acquired Immuno-Deficiency Syndrome
ANC – Antenatal Care
ANOVA – Analysis Of Variance
FBO – Faith Based Organisations
GDP – Gross Domestic Product
HIV - Human Immuno-suppressive Virus
HTC – HIV Testing and Counselling
NGO - Non-Governmental Organisation
PMTCT – Prevention of Mother-To-Child Transmission of HIV
UNAIDS - United Nations Joint Programme on HIV/AIDS
VCT – Voluntary Counselling and Testing
WHO - World Health Organisation

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LIST OF TABLE
Table 1……………..Age
Table 2……………..Sex
Table 3…………….Marital status
Table 4…………….School attendance
Table 5…………….Education Level Attained
Table 6…………..…Employment Status
Table 7…………..... Ever Heard About HTC
Table 8……………..Where you heard about VCT from
Table 9………….......Awareness Programs
Table 10…………….Where they offer VCT
Table 11…………….Distance from VCT centre
Table 12…………….Do you pay for VCT
Table 13…………….How long do you wait for results
Table 14…………….Never gone for VCT
Table 15…………….Reason for failure to access VCT
Table 16……………..Cross Tabulation 1
Table 17……………..Cross Tabulation 2
Table 18……………..Cross Tabulation 3
Table 19…….………..Cross Tabulation 4

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LIST OF FIGURES
Figure 1………………………Marital Status
Figure 2………………………Education Attainment
Figure 3………………………Heard about VCT
Figure 4………………………Ever gone for VCT
Figure 5………………………Effects of waiting for results

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ABSTRACT
In the study, the design used was an analytical design. This study or design was used because
the research sought to find out factors that might hinder the utilization of HIV Counseling and
Testing services among the youths of Kalingalinga compound in Lusaka.
The researcher used semi-structured individual questionnaires to collect data which comprises
of open ended questions. In addition, relevant documents such as reports and statistics from the
local clinic were used.
The researcher employed both qualitative and quantitative methods in the collection and
analysis of data, though quantitative method was more dominant.
The researcher carried out a comprehensive literature review which determines the works other
researchers had done in the field or area of Voluntary Counselling and Testing worldwide.

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CHAPTER ONE
1.0 BACKGROUND
HIV counseling and testing (HTC) programs have demonstrated their ability to increase safe
sexual behavior and use of care and support services among youths. By helping clients learn
their HIV status and creating a personalized HIV risk reduction plan, HTC can provide the
information and support necessary to change risky behaviors that could lead to HIV infection
or re-infection. Counseling, both before and after the test, and a risk reduction plan are the key
features that distinguish VCT from other HIV testing services.
HTC has become a widely advocated HIV/AIDS prevention strategy for the human race
because clients get to interact and comprehend to the highest level by one on one conversation
with questions. Most clients of HTC services are in their mid to the late twenties. Sixty percent
of all new HIV infections in sub-Saharan Africa, however, occur among young people between
the ages of 10 to 24 because few young people use any health services for reasons not known,
using HTC as a strategy to reduce risk behaviors among young people appears to be more
challenging than it would be among adults (Horizons, 2001: 08).
HIV Voluntary Counseling and Testing (HTC) programs play an important role in helping
clients adopt HIV preventive behaviors and identifying people who need follow-up treatment
and support services. Societal assumptions concerning gender may also affect the access that
youths have to contraception. This may be due to the assumption that contraception is a female
issue, thus excluding men from responsibility or participation. Consequently, while some
females may have little power and choice regarding contraceptives, they end up bearing most
of the responsibility for their use (Alan Guttmacher Institute, 1998).
Agencies engaged in humanitarian efforts to prevent the further spread of HIV have
emphasized the importance of voluntary counseling and testing (HTC), and most high
prevalence countries, Zambia in particular now has facilities that offer free testing.
Despite the massive campaign by the government, Non-Governmental Organizations (NGOs),
Faith Based Organizations (FBOs), Civil society organizations and many more to promote the
utilization of HIV counseling and testing services, it is disappointing that there is low utilization
of these services among the youths of Kalingalinga.
Hence a research will be conducted in Kalingalinga to assess the factors that hinder the
utilization of the HIV counseling and testing services offered among the youths of the area.

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1.1 STATEMENT OF THE PROBLEM
The study aimed at identifying factors that might hinder the utilization of HIV counseling and
testing (HTC) services among Kalingalinga youths.
The Zambian Voluntary Counseling and Testing Services began to be established in 1999, and
by mid- year 2003 the country had at least 101 VCT centers. Between October 1999 and May
2003, almost 386,000 clients visited a VCT center, and more than 266,000 of these were tested.
The overall HIV prevalence rate of those who were tested was 34 percent (Huddart 2004). A
majority of “youth” or “young people,” which refers to those aged 15-24 years, who engaged
in unsafe sex or other risky behaviors, were at risk of HIV infection. This age group accounted
for more than 50 percent of all HIV infections worldwide. Preventing HIV among youth is
particularly urgent in Zambia, where young people comprise more than 30 percent of the total
population and general HIV prevalence rates exceed 10 percent. In Zambia, young women had
HIV prevalence rate in 1999 of 15.86 to 18.68, while young men had a prevalence rate of 7.08
to 9.32 (Boswell 2002:1).
Given these statistics, the problem of increasing HIV infection rates among young people in
Zambia needs to be addressed, and the utilization of HTC services would be an effective way
to meet these needs for they have the information out of counselling that leads to the causes of
the rise in HIV cases. In Zambia, HIV counselling and testing (HTC) is considered a priority
public health intervention for prevention of HIV transmission as it raises awareness about risks
and motivates behavior change to reduce health risks. Therefore, if factors that may hinder
youths shun the exercise of utilization of HTC services are not taken care of then there would
be an increase in the HIV cases and therefore a reduction in Economic activities causing
underdevelopment.
Through its impacts on the labor force, households and enterprises, AIDS has played a more
significant role in the reversal of human development than any other single factor. One aspect
of this development reversal has been the damage that the epidemic has done to the economy,
which, in turn, has made it more difficult for countries to respond to the crisis. One way in
which HIV and AIDS affects the economy is by reducing the labor supply through increased
mortality and illness. Amongst those who are able to work, productivity is likely to decline as
a result of HIV-related illness. Government income also declines, as tax revenues fall and
governments are pressurized to increase their spending to deal with the expanding HIV
epidemic. The impact that HIV and AIDS has had on the economies of African countries
Zambia inclusive is difficult to measure. It is thought that the impact of AIDS on the gross

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domestic product (GDP) of the worst affected countries is a loss of around 1.5% per year; this
means that after 25 years the economy would be 31% smaller than it would otherwise have
been (http://www.avert.org/aids-impact-africa.htm).
The ability of a country to diversify its industrial base, expand exports and attract foreign
investment are integral to economic progress of a country. By making labor more expensive
and reducing profits, HIV and AIDS limits the ability of a country to attract industries that
depend on low-cost labor and makes investment of a country’s businesses less desirable. HIV
and AIDS therefore threaten the foundations of economic development of a country.
Although both international and domestic efforts to overcome the crisis have been strengthened
in recent years, there is little sign of the epidemic diminishing. The people of sub-Saharan
Africa will continue to feel the effects of HIV and AIDS for many years to come. Therefore, it
is clear that as much as possible needs to be done to minimize this impact. Therefore, the
purpose of this study is to assess factors that may hinder youths from accessing HIV counseling
and testing services in Kalingalinga.
1.2 STUDY RATIONALE
A research of this nature will systematically document the reasons that may hinder youths of
Kalingalinga from accessing and using HTC services. Moreover, the factors that influence
Kalingalinga youths’ decision to access HTC services for these challenges are relatively
unknown. Not only will the research benefit the academic interest but also improve the nation
economy through developing knowledgeable people on the HIV/AIDS. It will add to the
literature on youths understanding the importance of HTC services to reduce their involvement
in risky behavior in as much as HIV/AIDS is concerned. It is also hoped that the
recommendations that will be made shall be used by policy formulators to come up with the
measures that will help improve on how HTC services should be conducted. It is for this reason
that the access to HTC services among Kalingalinga youths should be of interest to both
researchers and HTC service providers.

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1.3 RESEARCH OBJECTIVES
1.3.1 GENERAL OBJECTIVE;
 To investigate the factors that may hinder the youths from utilization of HIV voluntary
Counseling and testing services in Kalingalinga.
1.3.2 SPECIFIC OBJECTIVES;
 To investigate if lack of knowledge about geographic location of HTC services and
centers prevents youths from accessing the services.
 To find out if the delay in releasing test results has an influence on youths’ access to
HTC services.
 To find out if inconvenient hours and poor service provision of office by the service
providers hinder youths from accessing HTC services.
 To determine the impact of age of a service provider on the utilization of HTC services
by the youths.
 To examine whether the beliefs and prevalence of stigma among fellow youths affects
the access to HTC services.

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CHAPTER TWO
2.0 LITERATURE REVIEW
This section begins with a brief discussion regarding the possible theoretical frameworks that
could describe the poor accessibility to HIV counseling and testing services. An overview of
the specific conceptual framework guiding this study is then presented, followed by a more
detailed literature review of the key components framework and its applicability to youthful
populations.
2.0.1 THEORETICAL FRAMEWORK:
There are several theories concerning the utilization of services that could be applied to the
poor accessibility to HIV counseling and testing services among youths. These include among
others; the gap analysis by Berry (Bordley, 1992:2), and the utility theory by Thaler, abid.
Based on the theories above, the theory of concern is the gap analysis. Bordley states that,
"Service quality as perceived by consumers stems from a comparison of what they feel service
firms should offer (i.e., from their expectations) with their perception of the performance of
firm providing the services. Perceived service quality is therefore viewed as the degree and
direction of discrepancy between consumer’s perceptions and expectations. In the service
quality literature, expectations are viewed as desires and wants of consumers, that is, what they
feel a service provider should offer rather than would offer". Gap analysis defines service
quality in terms of the gap between what the service should provide and the customer’s
perception of what the service actually provides. It assumes the smaller the gap, the higher the
quality of service.
In the study, people are motivated by the quality of service offered by the service providers,
meaning if the services are poor people will be less willing to access them. Further, other factors
that motivates people are expectations and perceived benefits. If people do not see any benefits
from seeking a particular service, they will be reluctant to access that service.
Overview of Literature Review:
In 2003, the UNAIDS carried out a research in a number of countries and it was estimated that
only 0.2% of adults in low- and middle-income countries received voluntary HIV counseling
and testing services. People fail to be tested for HIV for many reasons: lack of access to testing
services, fear of stigma and discrimination, fear the test will be positive, and lack of access to
treatment. These facts mean thousands of opportunities for increased access to treatment, care,

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support and prevention have been, and are being, missed. In light of the need for individuals to
have earlier access to treatment, care, support and prevention, UNAIDS and WHO are
supporting a major expansion of access to HIV testing and counseling through the scaling up
of client-initiated testing and counseling services and through the expansion of provider-
initiated testing and counseling services in health care settings. Such efforts are not only
necessary to improve the health of individuals, they are also necessary to achieve universal
access to prevention, treatment, care and support and to mount effective responses against HIV.
One research was carried out to assess the possible reasons that might cause people refuse to
go for HIV Testing at Public Hospital-Based Antenatal Care Clinics in Afar, Amhara, and
Tigray regions in Ethiopia. The data collected on activities for the prevention of mother-to-
child transmission of HIV (PMTCT) from Amhara, Tigray, and Afar revealed that only a small
proportion of pregnant women who were offered HIV counseling and testing in hospital-based
PMTCT settings in 2005 and 2006 accepted the services. Those women who did not accept
services represent a considerable number of missed opportunities to prevent HIV disease. The
research used qualitative methods to seek a greater understanding of how women experience
and overcome barriers to HIV counseling and testing at PMTCT sites. Using a purposeful
sampling strategy, the study selected six public hospitals that offer PMTCT services, yet have
a history of low PMTCT uptake despite high numbers of clients seeking antenatal care (ANC)
and a high HIV and AIDS disease burden. Two additional sites with known high PMTCT
uptake were selected as comparison sites. The study used three different methods of qualitative
data collection, these included; (1) In-depth, semi-structured interviews of pregnant women
who accepted testing, pregnant women who refused testing, and PMTCT counselors; (2) Focus
group discussions of women attending ANC, and (3) Direct observation of counseling sessions
and patient flow. Quantitative data was also gathered from ANC and PMTCT registers at the
sites. The research was expected to elucidate women's individual experiences of PMTCT
services, highlighting their decision-making processes with regard to HIV testing. It was found
out that specific qualities of PMTCT service delivery were more important in explaining uptake
of HIV testing within the context of PMTCT services than intrinsic characteristics of ANC
attendees. Pregnant women understood the risk that accepting an HIV test might pose to their
relationships with their husbands and other family members, especially if their test results were
positive. Despite these risks, they were willing to be tested, especially when an opt-out
approach, meaning that HIV testing is a routine part of ANC is used (Coates, 1998).

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Another research was carried out in Europe to assess the general image on the HIV counseling
and testing. The research was based on a survey conducted among NGOs and institutions
working in the field of HIV and AIDS in Europe, including all members of the AIDS Action
Europe network. The survey questions were drafted by ARAS and distributed by e-mail. The
survey took place between January 1st and January 31st 2008. 32 survey responses were
received, from 18 countries, most of them from Eastern Europe. Results showed that some
countries faced barriers in accessing quality VCT services. These barriers were not only related
to discrimination of HIV infected people but also to the costs of HIV tests (5 tari/ how much
in Euro?). Moreover, respondents from 11 countries reported difficulties in accessing the
testing services, including information on these services. The study also identified practices
affecting human rights. The respondents from 5 countries stated that the counseling process
did not include informed consent from the client and 3 respondents reported to have no
knowledge about any legal provisions regarding the consent. However, the research had some
weakness in that it was not a precise representative, as it was based on an online questionnaire
sent to the representatives of NGOs working in HIV prevention (Bucharest, 2008).
Ladner (1996), did a research to examine whether HIV counseling and testing leads to
reductions in sexual risk behavior. The methodology was based on the meta-analysis which
included 27 published studies that provided sexual behavior outcome data, he assessed behavior
before and after counseling and testing, and provided details sufficient for the calculation of
effect sizes. The studies involved 19,597 participants. He found out that after counseling and
testing, HIV-positive participants and HIV-serodiscordant couples reduced unprotected
intercourse and increased condom use more than HIV-negative and untested participants. HIV-
negative participants did not modify their behavior more than untested participants.
Participants' age, volition for testing, and injection drug use treatment status, as well as the
sample seroprevalence and length of the follow-up, explained the variance in results.
Another research was carried out in Nairobi, Kenya, and Kampala and Masaka, Uganda, on
HIV counseling and testing among youth of ages 14 to 21. Researchers conducted focus group
discussions and in-depth interviews with youth, parents, service providers, and community
members and administered a survey among a convenience sample of young people. In Uganda,
the survey sample consisted of 135 youth who had taken an HIV test and 210 untested youth.
In Kenya, researchers interviewed 105 tested and 122 untested youth. After the study, it was
found out that there are a number of factors that deter youth from going for HIV counseling

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and testing, these included; The cost, stigma, lack of youth friendly services, fear of people
finding out, fear of positive results, inconvenient hours of service, distance of service, beliefs,
peer influence, provider attitude, waiting period for results, do not want to have test yet, still
thinking about it, do not feel at risk and never had sex. However, there is a weakness with the
methodology in that a convenience sample cannot be used to generalize to higher population
(Horizons, 2001).
In Malawi a study was carried out to see as to why people refuse to go for VCT, Malawi was
chosen to assess the deterrents of people to VCT because of relatively high prevalence rate, the
population is well aware of the risks of death from AIDS, VCT has been available since the
mid-1990s, and has expanded markedly since 2003 to government hospitals, and since 2004 to
rural areas. In the study, an explanatory research was utilized to examine the acceptability of
HIV testing from three rural districts in Malawi. The survey showed that a high proportion of
people would like to go to be tested of HIV while few people have utilized the available testing
services. further, after carrying out a door-to-door rapid blood testing for HIV as part of
longitudinal study in rural Malawi, the overwhelming majority agreed to be tested and to
receive their results, therefore, it was found out that Malawians are responsive to door-to-door
HIV testing for the following reasons; it is convenient, confidential, and the rapid blood testing
is credible ((CDC, 1994).
In a 1992 study based on interviews with 17 individual men, 15 individual women, and 15
couples from Dar es Salaam, Tanzania, the results were such that the greatest barriers to HIV
testing and test disclosure for women were decision-making and communication between
partners, partners' attitudes towards HIV testing, and the fear of partners' reactions. For some
women who chose to disclose their HIV-positive status, they received negative reactions
particularly abandonment were a nagging fear that soon became reality. Further, in contrast,
many of the 28 individuals who had enrolled as couples in the Tanzanian component of the
multicenter VCT trial said in interviews that they valued knowing whether they were infected
with HIV. The knowledge enabled them to learn to live with their condition or that of their
partner (Allen: 306).
In 2006, another study was carried out in Brazil to assess the technological profile of voluntary
HIV counseling and testing centers. A structured self-completion questionnaire with 78
questions was used. Responses that characterized the services' technological profile were
analyzed using K-means clustering technique. Associations between the profiles described and
the municipal contexts were analyzed using the chi-square and residue analysis for proportions,

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and ANOVA and Bonferroni for the means. Findings suggested that, after two decades, the
CTA network shows significant limitations to guarantee diagnosis service quality and
prevention action development. Among the CTA limitations identified, four of them
substantially restrict the capacity these services have to fulfill their role: precarious
infrastructure, counseling and prevention activities, low readiness, and restrictive service
access criteria (Galvão: 1).
Further, the Horizons (2009), carried out a research in Francistown, Botswana to evaluate HIV
counseling testing in ANC settings and adherence for short course Antiretroviral Prophylaxis
for the prevention of mother to child. Data were collected at 10 primary health clinics, one
hospital, and during home visits. In order to evaluate post-test counseling content, providers of
PMTCT services (n = 43) were interviewed and post-test counseling sessions with HIV-
positive pregnant women were observed (n = 22). For evaluation of adherence to AZT for
PMTCT, HIV-positive pregnant women at antenatal clinics (n =22) and HIV-positive women
in the postnatal ward (n = 125) were interviewed. Additionally, home visits were conducted
with a subset of women interviewed (n = 34).Findings showed that, Few women were informed
about available community resources for support, the majority of women reported that
adherence to their AZT regimen was easy, most women recalled that key topics had been
discussed during post-test counseling sessions, but gaps remained and many more. However,
the study had a weakness, the evaluation employed convenience sampling at PMTCT and
delivery sites in one city in Botswana, and therefore the extent to which results can be
generalized to the larger population of all pregnant or recently delivered women in the country
is unknown. Additionally, sample sizes of observations and respondents for some questions
were small.
2.1 HYPOTHESES
a) The less convenient the geographic location of the HTC center, the less likely the
youths’ willingness to access HTC services.
b) The younger the service provider, the less likely the youths will be willing to utilize
HTC services.

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c) The higher the expected benefits from accessing HTC services, the more likely the
youths will be willing to access HTC services.
d) The less the stigma from the relatives, friends and neighbors the more the youths
might access the HTC services.
2.2 IDENTIFICATION AND MEASUREMENTS OF VARIABLES
2.2.1 IDENTIFICATION OF THE VARIABLES:
In the study, the dependent variable identified was utilization. Utilization is the act of using a
service(s). The major concern was to find out the number of youths who use the HIV
counselling and testing (HTC) services in Kalingalinga.
The independent variables were therefore, knowledge, attitude, age of service provider, stigma,
cultural beliefs and quality of service and office hours.
2.2.2 DEFINITION OF VARIABLES:
Below are the definitions of main concepts;
HIV voluntary counselling and testing (HTC) is the process by which an individual undergoes
confidential counselling to enable the individual to make an informed choice about learning
his or her HIV status and to take appropriate action. If the individual decides to take the HIV
test, HTC enables confidential HIV testing. The voluntary nature of VCT is one of its
underlying principles. Counselling for HTC consists of pre-test, post-test and follow-up
counselling.
Knowledge is the general awareness or possession of information, facts, ideas, truths, or
principles.
Inconvenient office hours refer to the number of hours the service provider spends in office
making it possible for clients to utilize his/her services.

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Age refers to the length of time that somebody or something has existed, usually expressed in
years.
Benefits can be defined as the satisfaction that one gets from consuming or using something.
It can further be defined as something that has a good effect or promote well-being.
Stigma can be defined as the negative attitude mostly from people around you towards a
situation you find yourself in.

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CHAPTER THREE
3.1 METHODOLOGY
3.1.1 AREA OF STUDY:
The research was conducted in Kalingalinga. Kalingalinga compound is located to the East of
Lusaka district and is about 3 to 5 kilometers from the City Centre. The area is highly densely
populated with approximately 35000 to 45000 people and despite that, it’s an urban and
planned settlement.
3.1.2 RESEARCH DESIGN:
In the study, the design used was an analytical design. This study or design was used because
the research sought to find out factors that might hinder the utilization of HIV Counseling and
Testing services among the youths of Kalingalinga compound in Lusaka.
3.1.3 DESCRIPTION OF THE POPULATION:
The population from which the sample came from included all youths in Kalingalinga
compound who are fifteen to thirty-four years in different household. 15 to 34 years was used
because that is the age group defined as youth by the United Nations. (United Nations 1993).
3.1.4 SAMPLE SIZE:
The sample comprised of one hundred and eighty (180) youths in different households of
Kalingalinga Compound. This is because the sample size was manageable in terms of data
collection, cost effective and economic in terms of time. The sample was large enough and
representative of the population hence generalization of the research findings was made
possible. Questions were asked till respondents gave same responses.
3.1.5 SAMPLING DESIGN AND PROCEDURE:
The sampling process that was used in this study was purposive sampling, meaning that the
researcher samples with a purpose in mind based on either the skill or need or judgment or
speculation that can give us what we want. It was advantageous because in situations where

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one needs to reach out to the sample quickly you would have no problems. The proportion does
not necessarily matter in this respect. However, the characteristics of the respondent was very
important to this research as it guided on the people who are eligible to be interviewed. Using
purposive sampling enabled the researcher to get the opinions of the participants on the subject
of your study.
3.1.6 RESEARCH INSTRUMENTS OR TOOLS:
The information pertaining to the factors that may hinder the youths from utilization of HIV
voluntary Counseling and testing services in Kalingalinga was collected using scheduled
structured interviews. Closed ended questions was used because they are easy to answer.
Therefore, even those respondents with humble education background will not inconvenience
the procedure. On the other hand, open ended questions was used so as to gather very divergent
views on the topic. In cases where respondents were unable to understand English, they were
interviewed using an appropriate convenient local language such as Nyanja and Bemba.
3.1.7 DATA COLLECTION:
Data collection consisted of household interviews using a questionnaire. An interviewer
method was applied to solicit information from informants who were youths of Kalingalinga.
This method was appropriate because the majority of the population was assumed to be semi-
literate. For those that are illiterate, they were guided by the interviewer by interviewing them
in an appropriate and convenient local language such as Bemba or Nyanja. It is also important
to note that the questionnaires were piloted/pre-tested before the actual data collection exercise
in order to check for consistence, accuracy and ambiguity. A total of 10 questionnaires were
used in the pre-test in Kalingalinga on random people.
3.1.8 DATA ANALYSIS:
Quantitative data was analyzed using the Statistical Package for Social Sciences (SPSS). The
data that was collected using scheduled and structured interview questionnaire and were
checked for uniformity, consistency, accuracy and ambiguity. Data was entered using Census
and Survey Processing System (CSPro). The data was then transferred to SPSS which was then
helped us to effectively analyze data and interpreting the various relationships between
variables. Qualitative data obtained from this community was transcribed and then manually
analyzed.

24. 24
3.2 ETHICAL CONSIDERATION:
The topic investigated was quite sensitive as it borders on culture, religious beliefs and personal
confidentiality. Thus, the study ensured that all information that was collected remained in
privacy. Anonymity was taken into account by not disclosing names and a decision not to
participate was strictly respected. The research did not use embarrassing questions or
threatening questions/statements when collecting data. The study also acquired informed
consent of the interviewee.
3.3 LIMITATIONS:
 Lack of adequate funds for transport to and fro the location, printing of questionnaires,
food while in the field, and many more required for the research to be conducted
 Due to the sensitivity of the topic and the cultural beliefs on HIV counselling and testing,
there is likelihood that some respondents concealed certain information relevant to this
research.
 Language was somehow a barrier in that not all the respondents know how to speak fluent
Nyanja, Bemba and English, in which the researcher had commanded.
 Sampling was a challenge because the topic dealt with youths who in this regard don’t
own houses, so locating the appropriate respondents was very tricky.


25. 25
CHAPTER FOUR
4.1 FINDINGS
RESULTS
4.1.0 Overview
This chapter presents the findings of the research based on the methods described in chapter
three. It shows that the factors affecting the use of voluntary counselling and testing among
youths of Kalingalinga in Zambia are situated within the socio-economic conditions, socio-
cultural, demographic factors and knowledge youths have on HTC services.
The previous chapter dealt with the research design and methodology. This chapter presents
the findings of the study.
The data were collected and all participants selected met the inclusion criteria which were:
- All youths of Kalingalinga Compound.
- Literate and illiterate.
The participants (180) were randomly sampled. The results are presented in four major
sections: Background profile of participants; Socio-economic information of participants;
Knowledge about HIV Counselling and Testing (HTC) services, and finally, Attitude and
utilization of HIV Counseling and Testing (HTC).
4.1.1 BACKGROUND PROFILE OF THE PARTICIPANTS
Age
Background characteristics like age are thought to have an influence on the knowledge,
attitudes and perceptions of people towards use of voluntary counselling and testing services.
The table below shows the age distribution of youths in Kalingalinga who were part of the 180
sample.
Table 1 : Percent Distribution of Respondents

26. 26
Frequency Percent Cumulative
Percent
15-19 19
10.6
51.7
23.3
12.2
2.2
100.0
10.6
20-24 93 62.2
25-29 42 85.6
30-34 22 97.8
35-39 4 100.0
Total 180
Source: Field Data (A Total 180 Respondents Were Sampled)
Table 1 shows that the mode is age group 20-24 years representing 51.7 percent of the sample.
This means that most youths of Kalingalinga are aged between 20 and 24 years. The table also
shows that there are few youths who are aged 35-39 in Kalingalinga compound which is
represented by 2.2 percent of the total sample. The rest are 10.6, 23.3 and 12.2 percent for age
groups 15-19, 25-29 and 30-34 respectively.
Sex
Table 2: Sex
Frequency Percent Valid Percent Cumulative Percent
Valid
male 86 47.8 47.8 47.8
female 94 52.2 52.2 100.0
Total 180 100.0 100.0
According to Table 2 on Sex of the sampled population, 86 (48 percent) were male while 94
(52 percent) were female. This means that majority of the sampled population were ladies.
Marital Status
It is believed that marriage has an effect on the utilization of counselling and testing couples
are expected to do an HIV test before marriage and it should therefore be expected that
respondents with such a background have a positive attitude towards reporting using HTC
services.
The survey covered 180 respondents using structured questionnaires and the following are the
results given by the respondents regarding their marital status.

27. 27
Table 3: Marital status
Frequency Percent Cumulative Percent
single 120 66.7
28.9
3.3
1.1
100.0
66.7
married 52 95.6
divorced 6 98.9
widowed 2 100.0
Total 180
As shown in Table 3 and Figure 1.1 above most of the respondents are single giving a total of
66.7 percent followed by those who are married with 28.9 percent, widowed 1.1 percent, and
those who are divorced with 3.3 percent. These values of their frequencies are presented in the
bar graph below;
Figure 1. Marital Status

28. 28
Educational Attainment
From previous studies, it is expected that youths with higher educational attainment are more
likely to go for testing or at least know about VCT. In this study, the number of youths who
had been to school were 170 and 10 did no go to school of the total 180 sampled. The
distribution of those who reported having been to school’s levels of education is represented in
Figure 4 below.
The table above shows that respondents who are been up to primary school represent 10.6
percent of the 180 sampled and 11.2 of the total number of youths who have been to school.
Those with secondary education with 41.2 percent while 47.6 percent have tertiary education.
This means that majority of the youths in Kalingalinga have attained tertiary school hence we
expect to have more knowledge on VCT because we are dealing with learned youths. This
information is further presented in the pie chart below were 48 percent have gone up to tertiary
school, 41 percent secondary school and 11 percent primary of the 170 out total sample of 180
who have attended school.
Figure 2: Educational Attainment
Table 4: School Attendance
Frequency Percent Cumulative Percent
no 10
5.6
94.4
100.0
5.6
yes 170 100.0
Total 180
Table 5: Education level Attained
Frequency Percent Valid Percent Cumulative Percent
Primary 19 10.6 11.2 11.2
Secondary 70 38.9 41.2 52.4
Tertiary 81 45.0 47.6 100.0
Total 170 94.4 100.0
Missing System 10 5.6
Total 180 100.0

29. 29
Employment Status
Majority of the sampled population represented by 68.3 percent are in a salaried employment
while only 31.7 percent responded no to being in a salaried employment.
Table 6: Employment Status
Frequency Percent Cumulative Percent
no 57 31.7
68.3
100.0
31.7
yes 123 100.0
Total 180
4.1.2 KNOWLEDGE AND AVAILABILITY OF HTC SERVICES
Knowledge about HIV Counselling and Testing (HTC)
This section analyzes women’s contraception knowledge and independent variables through
cross tabulation.
The Table 7 below shows the awareness of the VCT services offered at in Kalingalinga at the
Community Health centre. As shown through the table all the 180 respondents are aware of the
HTC services offered at the Kalingalinga Clinic.
Table 7: Ever heard about HTC
Frequency Percent Valid Percent Cumulative Percent
Valid yes 180 100.0 100.0 100.0
11%
41%
48%
Education Attainment
primary secondary tertiary

30. 30
The Table 8 below shows the different forms of ways respondents came to know about VCT
services from. The highest being 164 informed through the clinic while the least was 109 by
magazines. The others are 161 through VCT Centre, 144 through Radio, 138 through television
and so on. The data is further represented in Figure 3 below
Table 8: Where you heard about VCT from.
Frequency Percentage
Where did you hear
about VCT services
Television 138 76.1
Posters 137 76.1
Radio 144 80.1
Newspaper 130 72.1
Magazine 109 60.6
Mobile TV 127 70.6
Clinic 164 91.1
School 126 70.1
VCT Centre 161 89.4
Figure 3: Where you heard about VCT

31. 31
Respondents’ Awareness
When asked about how often they have awareness campaigns in the community, the
respondents gave the information presented in Table 9. As shown below majority of the
respondents representing 78 percent said sometimes while 13 percent responded that they never
and only 8 percent agreed to having seen some awareness program in Kalingalinga.
Table 9: Awareness Programmes
Frequency Percent Cumulative Percent
Always 15 8.3 8.3
Sometimes 141 78.3 86.7
Never 24 13.3 100.0
Total 180 100.0
Do you know a place where they offer VCT
Table 10: Where they offer VCT
Frequency Percent Cumulative Percent
138 137
144
130
109
127
164
126
161
0
20
40
60
80
100
120
140
160
180
SAMPLEPOPULATION Heard about VCT

32. 32
yes 178 98.9
1.1
98.9
no 2 100.0
Total 180 100.0
Of the 180 respondents 178 (98.9 percent) know of a place they offer VCT services in
Kalingalinga and only 2 (1.1 percent) don’t know which means that almost everyone in
Kalingalinga knows a place where VCT services are offered. Figure 10 on the hand provides
answers on the distance to VCT services available. The respondents who know a place where
VCT is offered are 178 and among those, 111 (62 percent) said the distance is below 1km.
Some other respondents said it’s between 1km – 5km and is represented by 63 (35 percent) and
lastly 4 (2 percent) that said it’s more than 5km from there residents.
Distance to VCT Centres
Table 11: How Far from respondents’ residents
Frequency Valid Percent Cumulative Percent
less than 1km 111 62.4 62.4
1km - 5km 63 35.4 97.8
more than 5km 4 2.2 100.0
Total 178 100.0
4.1.3 CURRENTLY USING OR EVER USED AND THE EXPERIENCE
Have you ever gone for VCT?

33. 33
Figure 4: Ever gone for VCT
Respondents were asked to mention if they have ever been tested for HIV. Out of 178
respondents 137 (77 percent) mentioned they have been tested for HIV and 41 (23 percent)
have not been tested.
Do you pay for VCT?
Table 12: Do you pay for VCT services
Frequency Valid Percent Cumulative Percent
Valid
Yes 4 2.2 2.2
No 174 97.8 100.0
Total 178 100.0
23%
77%
Ever Gone For VCT
Valid no
Valid yes

34. 34
It is clear from the responses above that majority of the sampled population are offered to
them free of charge. 98 percent of the respondents said they do not pay while 2 percent
said they pay for the voluntary and counselling services.
How long do you wait for results
Table 13 : length of results presentation
Frequency Percent Valid Percent Cumulative
Percent
Valid
hours 130 72.2 95.6 95.6
days 6 3.3 4.4 100.0
Total 136 75.6 100.0
Missing System 44 24.4
Total 180 100.0
Respondents also asked to mention how much time they spent waiting for their test results. It
is evident from the figure above that the majority (96%) mentioned that they were satisfied
with the time they spent waiting for their test results by indicating the least time, and only 4%
mentioned were not. Furthermore, Figure 5 also shows that respondents are not affected by
time of results presentation. 126 were not affected by the wait while 9 confirmed being affected
by the wait for results.
Did the time of waiting affect your visiting VCT Centres?
Figure 5: Effects of the waiting of Results

35. 35
If you have never gone for VCT, what could be the reason
Table 14: Never gone for VCT
Frequency Percent Valid Percent Cumulative
Percent
Valid
stigma among friends 22 12.2 45.8 45.8
no need to know 11 6.1 22.9 68.8
fear of results 12 6.7 25.0 93.8
lack of knowledge 3 1.7 6.3 100.0
Total 48 26.7 100.0
Missing System 132 73.3
Total 180 100.0
Respondents who had never gone for testing (48) were asked what prevented them from going
for an HIV test at Kalingalinga Clinic. The majority (46 percent) mentioned stigma among
friends, followed by 25 percent who mentioned the fear of results and then 23 percent who said
no need to know results and the rest (6%) mentioned the lack of knowledge of location of the
VCT Centre.
Reasons for failure to Access VCT
Table 15: Failure to Access VCT
9
126
0
20
40
60
80
100
120
140
yes no
Valid
Chart Title

36. 36
frequency percent
Reason for
failure to access.
poor service delivery 2 66.7
location of VCT centre 2 66.7
fear of results 3 100.0
stigma from friends 2 67.7
inconvenient hours 1 33.3
Respondents were asked on reasons they fail to access HTC services, and the three who
responded to this question gave the reason of fear of results as the biggest reason.
School attendance * have you ever gone for VCT Cross tabulation
Table 16 : Cross Tabulation
have you ever gone for VCT Total
no yes
school attendance
no 3 7 10
yes 38 130 168
Total 41 137 178
X2= 2.30, DF = 1, P-value > 0.05
It can be seen from the graph above that 3 out of 10 of the respondents that have not attended
school mentioned that they have not gone for VCT as compared to 7 that mentioned that they
have gone for VCT. Further, 130 of the respondents that have attended school mentioned that
they have gone for VCT compared to 38 who mentioned that they have not gone for VCT.
In addition, with the P-value of .590 which is greater than .05 it can be concluded that there is
no significant relationship between school attendance and ever having gone for VCT.
Do you know a place where they offer VCT * have you ever gone for VCT
Cross tabulation.
Table 17: Cross Tabulations 2

37. 37
have you ever gone for VCT Total
no Yes
do you know a place where they
offer VCT
yes 40 137 177
no 1 0 1
Total 41 137 178
X2= 3.360, DF = 1, P-value > 0.05
As shown in the table above 40 of the respondents who know of a place where they offer VCT
services have not gone for VCT compared to the 137 who have gone. On the other there is no
respondent who does not know of a place they offer VCT service who has not gone for VCT
compared to only one respondent who has never gone VCT.
In addition, the P-value of .067 is greater than 0.05 and therefore it can be concluded that there
is no significant relationship between knowing a place where they offer VCT services and
having gone for VCT.
If you have never gone for VCT, what could be the reason* how far is the
place Cross tabulation
Table 18
how far is the place Total
less than 1km 1km - 5km more than 5km
if you have never gone for
VCT, whatcould be the
reason
stigma among friends 16 4 2 22
no need to know 6 5 0 11
fear of results 8 3 0 11
lack of knowledge 1 1 0 2
Total 31 13 2 46
X2= 4.960, DF = 6, P-value> .05
According to the table above, among the respondents who have never gone for VCT because
of stigma; 16 are in a radius of less than One Kilometer while 4 between one and Five Kilometer
and only 2 stay Five Kilometers from the Centre. There is no correlation between how far the
place is and the reason for not going for VCT.

38. 38
Employment status * if you have never gone for VCT, what could be the
reasonCross tabulation
Table 19:
if you have never gone for VCT, what could be the reason Total
stigma among
friends
no need to
know
fear of results lack of
knowledge
employment
status
no 7 9 4 2 22
yes 15 2 8 1 26
Total 22 11 12 3 48
X2= 8.758, DF= 3, P-value < .05
Among the people who are not in any salaried employment 7 said they never gone for VCT
because of stigma among friends while 9 because there is no need to know, 4 are afraid of
results lastly 2 who said they lacked knowledge of the VCT services. Furthermore, 1 of the
employed has never gone for VCT because of lack of knowledge, 8 for fear of results, 2 said
there is no need to know while 15 said it’s because of stigma from friends. In addition, the P-
value (0.033) is less than .05 which means there is availability of a correlation between the
employment status and going for VCT.

39. 39
CHAPTER FIVE
5.0 DISCUSSION OF FINDINGS
5.1 OVERVIEW
This thesis aimed to identify the factors that may hinder the utilization of counselling and
testing among youths in Kalingalinga. The thesis has identified a few factors affecting the use
of VCT services among youths.
This section therefore, discusses the findings. Firstly, a brief overview of the main findings is
highlighted. Factors of HTC and use are comparatively discussed around key variables/factors
in an attempt to draw differences in factors of use of HTC services.
5.2 OVERVIEW OF MAIN FINDINGS
According to the presented data above, the use of VCT services in not actually worse though
still stands to be a concern for Zambia. The study reveals that 77 percent of the 180 youths who
know about VCT have actually gone for testing before and only 23 percent haven’t. This would
be due to the fact that majority of the respondents are learned as awareness in out of the picture
because it’s evident enough from the responses that there scarce prevalence of awareness
programs in Kalingalinga compound.
The factors of utilization of counselling and testing services are varied. The study reveals that
school attendance, age, marital status, employment status and so on have no much impact on
the use of VCT for the youths of Kalingalinga. These factors will be explained further in the
discussions below.
5.2.1 Knowledge and Availability of HTC services
The study reveals that 100 percent of the population have knowledge on the HTC services
offered in Kalingalinga. However, there is no clear explanation to weather there stands a
relationship between HTC knowledge and use among Kalingalinga youths. The whole
population agreed to have heard about VCT with majority having heard about it on radio (164)
followed by Television and so on. It was discovered that in as much as the youths know about
the VCT services, there are no awareness programs in the area. 78 percent responded to this
question with ‘sometimes’ while 13 percent said they have never heard any awareness and only
8 percent agreed to having had some awareness. Not only have the youths heard about HTC
services but also know where to get tested and this is proved by 178 out of the 180 respondents
saying yes when asked if they knew a place where they offered VCT services which majority
said clinic. It’s so astonishing to see how knowledgeable the youths of Kalingalinga are in as

40. 40
much as the VCT is concerned considering that there are less awareness programs in
Kalingalinga.
The study also showed that distance is not a hindrance to youths of Kalingalinga using HTC
services because 62 percent said the distance is less than one kilometer and the services are
also free of charge. This means that majority of the youths of Kalingalinga live nearer to the
VCT services provision centers.
In another vein, a small number of the total sample didn’t have access to the HTC services with
the majority mentioning fear of results as the main problem.
5.2.2 Currently using or everused and the experience
Despite all the youths having heard about the VCT services only 78 percent have visited the
facility for testing and 23 percent have never. In as much as majority have gone foe VCT it’s
something worry about for the 23 percent who have never gone. The time period from testing
procedure to presentation is also not really a matter in as much as we try to find out the problems
that hinder the youths of Kalingalinga with 126 respondents not having any problem with the
time of results presentation. Age of the attendant maybe another problem youths face in as
much as VCT is concerned. From the data presented above 78 out of 134 respondents
responded negatively to the question.
The study also showed that there is great benefiting from the procedures before testing due to
the fact that most of the responses where positive and showed that counselling is a necessity
before testing is done as “it helps me to get ready of the results coming and accept whatever
they are going to be.”
This study also shows that youths who never went for VCT is due to stigma and fear of the
results which due to lacking a full understanding of the whole process. This could be because
of lack of a proper understanding of the whole problem of HIV/AIDS. Stigma prevails because
of lack of knowledge therefore, the only way is to teach the community on the importance of
eradicating AIDS and that VCT is the first step.
5.2.3 School attendance and VCT Use
The study also reveals that most of the people who go for VCT are learned and have been to
school. The reason for this could be the fact that there has been an increase in the availability
and accessibility of education services (Kebede 2006) in Zambia because according to the
findings there is no relationship between going to school and going for VCT. Its already clear

41. 41
that Kalingalinga lack awareness programs to help people know more about VCT and the
importance as to avoid fear of results and enhance 100 percent going for VCT in the years to
come.
5.2.4 Employment status and never gone for VCT,
The study shows that the majority of the unemployed don’t go because they feel do not need
to know their statuses while the employed don’t go because of the stigma among friends. This
shows that knowledge works some part in understanding the importance of going for VCT
because if only the unemployed were learned would they understand the importance of
knowing your status. We assume it unemployment due to no qualification. The study also
shows that the services are free, which means that employment status does not play a role in
someone going for VCT and does not affect someone from not going either.
The study also shows that a greater number of youths have attained an education and are in a
form of employment and are also the biggest users of VCT services. This can be attributed to
the fact that these youths might have attained some form of education mostly primary
education. Educated youths are more likely to know about VCT services and to be more
confident in approaching service providers than youths with no education. Education helps to
have better access to VCT services (Mwaba 2000). Most youths in Kalingalinga have at least
attained some form of education and surprisingly majority with tertiary education.

42. 42
5.3 CONCLUSION
Despite the commitment by the Zambian government as stated in their health policy towards
attainment of youth’s health and family planning being a key priority, it is clear that much has
been done to combat factors affecting youth’s knowledge and use of VCT services. It is clear
from the study that youth’s wealth index, education attainment, age and occupation all does
not pose a great challenge on their use of VCT services.
From the findings it is clear that improving the livelihood of the population is important.
Knowing your status is the first step you take in trying to fight against the HIV pandemic which
torments the country Zambia and world at large. VCT awareness programs should be
intensified to meet the needs of youths. Programs intended to improve VCT use among youths
should put into consideration age factors since most Zambians get initiated into sexual activities
at an earlier age and consequently enter marriage or other activities related to sexuality. Finally,
building of more VCT centers and improving the provision of awareness programs to let the
youths have full understanding of the whole process would go a long way toward reducing
levels of unmet needs of reducing cases of HIV among the youths in Zambia.
5.4 RECOMMENDATIONS
Based on the study findings, the survey wishes to recommend that:
 Parents should play as the first awareness program even before the young man or
woman leaves the house.
 There need to build more VCT centers around Kalingalinga to avoid queues for that’s
so discouraging for the fact that the process is voluntary.
 Use well trained and experienced counsellors that have an understanding of the delicacy
of the service.
 Advertise more though media by use of social media sites because a lot of youths use
them for fun and communication.
 Having door-to-door campaigns to invite youths for testing would be a bad idea and
also to include them in activities to do with VCT so that they feel involved.

43. 43
BIBLIOGRAPHY
Allan Guttmacher Institute, (1998). Categorically Unequal: The American Stratification
System, New York: Russell sage foundation.
Allen H (1994), Satisfaction, Physical Activity, Obesity and Well-being. J Epidemiology
Community Health, 2nd Edition, Rev Panam Salud Publishers, Brazil.
Bordley G. (1992)."Cleaning Up Their Act”: The Effects of Marriage and Cohabitation on
Contraceptive Use. Newbury Park, California: SAGE Publications Limited.
Boswell L, (2002). Contraceptives use and effects: Journal of Epidemiology & Community
Health. Scotland.
Bucharest P, (2008). Higher Education in Developing Countries. A Task Force on Higher
Education and Society. Washing DC USA.
Central Statistical Office, (1970); 1969 Census of Population and Housing Summary Report,
CSO, Lusaka, Zambia.
Central Statistical Office, (2007). Zambia Demographic Health Survey. Lusaka .Zambia
Coates, P.M. (1998). Effects of Marital Transitions on Changes in Dietary and Other Health
Behaviours in U.S. Male Health Professionals. Journal of Epidemiology and Community
Health. USA.
Diangamo D.S and Dzekedzeke K, (2001); 2000 Census in Zambia, Statistics division United
Nations Secretariat, New York.
Friedman M. (2005). Marital Status, Marital Satisfaction, and Body Image Dissatisfaction.
Hewitt D. (2006). Women's Alcohol and other drug use: increasing our understanding. Ottawa:
Health, Canada.
Horizons, (2001). Effects of Marital Transitions on Changes in Contraceptives use and Other
Health Behaviours in U.S. Women. Belmort, CA: Wadsworth/ Learning. USA.
Ladner B. (1996). Accessing the Influence of Religion on Health Behaviour. Louisiana, USA.
Ministry of Health. (2008). National Reproductive Health Policy. MOH. Lusaka.

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Siegel J.S and Swanson D, (2004). The Methods and Materials of Demography, Elsevier Press,
San Diego, California, USA.
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Williamson D. (2005). Health Behaviours: Evidence that the relationship is not conditional on
income. Canada Press. Canada.

45. 45
APPENDIX
Questionnaire no…….
THE UNIVERSITY OF ZAMBIA
SCHOOL OF HUMANITIES AND SOCIAL SCIENCES
DEPARTMENT OF POPULATION STUDIES
QUESTIONNAIRE: DEM 4214 (2015)
TOPIC: Utilization of HIV voluntary counselling and testing services among the youths of
Kalingalinga compound.
Dear Respondent,
I am a fourth year student at the University of Zambia, Great EastRoad Campus, carrying out a research
project on the above topic for purely academic purposes.
You have been randomly selected to help in the research responding to my questions either in the
questionnaire or through interview. Be guaranteed that the information being solicited will be treated
with maximum confidentiality.
Your cooperation will greatly be appreciated.
INSTRUCTIONS
1. Please answer all the questions and if you are in doubt seek clarifications from the interviewer.
2. Tick the answer that expresses your view as shown. √
3. Write your answers as precise as possible for questions which require your answers to be in
written form.
4. Only one response is required for each question.
Do not indicate your name on the questionnaire.

46. 46
SECTION A: DEMOGRAPHIC & SOCIO-ECONOMIC
DETAILS
For official
use only
Q01 What is your sex 1. Male
2. Female
Q02 How old were you
on your last
birthday?
……………………….
Q03 What is your
marital status?
1 Single
2 Married
3 Divorced
4 Widowed
Q04
Q05
If not single, how
many children do
you have?
Have you ever
attended any
school?
......................................
1 No
2 Yes
Q06 If yes to Q05,
What is your
highest education
attainment?
1. Primary
2. Secondary
3. Tertiary
Q07 What is your
religion?
1. Christian
2. Muslim
3. Hindu
4. Buddhist
5. Other,
specify.…………….

47. 47
Q08 Are you in any
salaried
employment?
1. No
2. Yes
Q09 If no, what’s your
source of income
for survivor?
………………………………
SECTION B: KNOWLEDGE AND AVAILABILITYOF HTC SERVICES
Q10 Have you ever
heard about HIV
testing and
counselling
(VCT)?
1. Yes
2. No
Q11 Where did you
hear about the
VCT services?
(Tick all that
apply)
A. Television
B. Posters
C. Radio
D. Newspaper
E. Magazine
F. Mobile TV
G. Clinic
H. School
I. VCT centre
J. Posters
Yes No

48. 48
Q12 How often do you
have VCT
awareness
programs in your
area?
1. Always
2. Sometimes
3. Never
Q13 Do you know of a
place where they
offer VCT
services?
1. Yes
2. No
Q14 Where is this place
where can you get
these VCT
services?(Tick all
that apply)
A. Clinic/Hospital
B. Chemist
C. School
D. VCT centre
E. Community Hall
F. Church
G. Counsellors’ House
Yes No
Q15 How far is the
place mentioned
above from your
residence?
1. Less than 1km
2. 1km – 5km
3. More than 5km
Q16 Do you pay for
these VCT
services?
1. Yes
2. No
Q17 If yes to Q16, How
affordable are
VCT services?
1. Affordable
2. Not affordable

49. 49
Q18 Do you have
access to these
VCT services?
1 Yes
2 No
Q19 If no to Q18, What
is the reason for
failure of access to
the VCT services?
(Tick all that
apply)
A. Poor service delivery
B. Location of the VCT
centre
C. Fear of results
D. Stigma from friends
E. Inconvenient hours
Yes No
Q20 Do you feel the
location of the
VCT service is
problem to
residents who
would like to go
for testing?
1. Yes
2. No
SECTION C: CURRENTLYUSING OR EVER USED AND THE EXPERIENCE
Q21 Have you ever
gone for VCT?
1. No
2. Yes
Q22 If yes to Q21,how
long does it take
for the results to be
presented?
1 Hours
2 Days
3 Weeks

50. 50
Q23 Did the time of
results presentation
affect your use of
the VCT services?
1 Yes
2 No
Q24 If yes to Q23,how
did that affect you?
…………………………………
…………………………………
……………………………..
Q25 How can you
categorise your
experience in terms
of the VCT service
provision?
1 Very good
2 Good
3 Average
4 Poor
5 Very poor
Q26 How old was the
person who
attended to you at
the VCT centre?
1 Young (18 and Below)
2 Medium age (18 – 40)
3 Very old (40 and
Above)
Q27 Do you feel the age
of the attendant at
VCT centres has an
impact on the
clients who use the
service?
1 Yes
2 No
Q28 If you have never
gone for HIV
voluntary
counselling and
1. Stigma among friends
2. No need to know HIV
status

51. 51
SECTION D: BELIEFS ANDPREVAILNG VIEWS
(Tick in the appropriate box per
question)
Strongly
agree.
1
Agree. 2 Neutral.
3
Disagree.
4
Strongly
disagree.
5
Q32 VCT should only be
done by couples.
testing before, what
could be the
reason?
3. Fear of Results
4. Too busy with work
5. Lack of Knowledge
Q29 Do people around
you play a role in
your decision to go
for HIV testing?
1 Yes
2 No
Q30 Have you ever
quarrelled with
your partner over
HIV testing?
1 Yes
2 No
Q31 What is your say
on the procedure of
counselling before
testing?
…………………………………
…………………………………
…………

52. 52
Q33 Youths should not be
taught on VCT.
Q34 Youths who talk about
HIV testing are
promiscuous
Q35 Only females should
concern themselves
with testing.
Q36 Knowing your status
reduces the chances of
sexual activities.
Q37 Testing brings about
stigma and rejection in
society.
Q38 It is a taboo to talk
about HIV with your
parent(s) or guardians
Q39 What do you think
should be done to
improve the availability
of knowledge on HTC
services in your
community?
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END OF QUESTIONAIRE, THANK YOU FOR YOUR COOPERATION.