Horizons Projects | Decisions to Seek HIV Voluntary Counseling and Testing Among Zambian Adolescents: Influences of Individual, Familial, and Environmental Factors

HORIZONS PROJECT
Decisions to Seek HIV Voluntary Counseling and Testing Among Zambian Adolescents: Influences of Individual, Familial, and Environmental Factors

Researchers from the Johns Hopkins University School of Public Health, Development Aid from People to People (DAPP), and Horizons explored the relationship between adolescent demand for HIV voluntary counseling and testing (VCT) and the attitudes and responses of families, peers, and partners before and after the counseling and testing process.

This two-phased study, including both in-depth interviews and a household survey with adolescents, was conducted from June 2003 to February 2004 in Ndola, Zambia.

Key findings included:

Most adolescents who have tested for HIV report having had sex, often linked to alcohol use.
Parents feel a growing responsibility to educate their children about HIV, and adolescents welcome such guidance.
Adolescents frequently talk with family and friends before and after seeking VCT.
Learning and disclosing one’s HIV status is not linked to accessing care and support services.
Respondents who perceive they are at risk of HIV, have had sex, and have discussed VCT are more likely than their peers to plan to take an HIV test.
Respondents who are sexually experienced, have discussed VCT with their families, and believe that their families will not be upset if they take an HIV test are more likely than their peers to have tested for HIV.
Youth identified two main barriers to seeking VCT: perceived negative reactions of family and friends, and fear of HIV-related stigma.

Program implications include:

When promoting VCT, include messages that foster communication about VCT within families and among friends.
Continue providing confidential VCT services that are accessible to adolescents.
Further investigate how to involve young people's sex partners in VCT.

Location

Ndola, Zambia

Duration

June 2003–September 2005

Horizons and Population Council researchers

Ellen Weiss, Ann McCauley

Non-Council collaborators

Michael Sweat, Julie Denison (Johns Hopkins School of Public Health)

Cecilia Kaonga (Development AID from People to People

HOPE Humana

Donor

US Agency for International Development

Publications/Resources
Horizons and Population Council researchers' names appear in boldface type.

2006
Denison, J.A., Nalakwanji Lungu, Wendy A. Dunnett-Dagg, Ann McCauley, and Michael D. Sweat. “Social relationships and adolescents’ HIV counseling and testing decisions in Zambia,” Horizons Research Summary. Washington, DC: Population Council. (PDF)

Lee, Alison. "Family matters: Zambia study highlights role of families in youths’ testing decisions," Horizons Report, December. Washington, DC: Population Council. (full text)