HIV testing and Counselling Among Tuberculosis Suspected Patients in Kassala State, Sudan: A Determinant Study

Abstract Background: Acceptance and use of HIV Testing and Counselling (HTC) services of Tuberculosis(TB) suspected patients is low, which limit the opportunities of detecting those in need of HIV treatment and care. This study aimed to assess the psychosocial beliefs related to intention to use HTC services among TB suspected patients and the relevance of these beliefs for behaviour change intervention in Sudan. Methods: TB suspected patients (N= 383) completed a cross-sectional questionnaire from five separate TB facilities. The questionnaire was based on the Reasoned Action Approach (RAA) model. Eligibility criteria included attending Tuberculosis Management Units (TBMUs) in Kassala State as suspected TB patients and aged 18-64 years. A Confidence Interval Based Estimation of Relevance (CIBER) analysis approach was employed to investigate the effects of beliefs on the intention to use HTC services and to establish their relevance regarding interventions.Result: The CIBER results showed the beliefs included in the study accounted for 59% to 70% of the variance in intention to use HTC services. The participants' beliefs "My friends think I have to use HTC services" is highly relevant for behaviour change interventions because it had a relatively low average score and is strongly associated with intention to use HTC services. The belief " If I would fear to be stigmatized if I get HIV positive result " on average had a relatively high score. It was negatively associated with intention to use HTC services, so it is highly relevant for intervention development. The " Health care providers will keep my HIV test result confidential " belief was positively associated with intention to use HTC services with an average score on the middle at the scale and needs reinforcement in interventions. The mean score of the belief " I could have the cost to reach HTC services " was in the middle of the scale but it was not associated with intention and therefore is not a variable to be targeted for interventions. Conclusion: The study revealed that the relevance of salient beliefs of intention to use HTC services varies among TB suspected patients. It is essential to develop interventions to enhance the intention to use HTC services based on beliefs (sub-determinants) that are most relevant.