A Comparative Study of Effectiveness of Youth Peer HCT Counselors And Adult Counselors (Health Workers) in Promoting Uptake of HIV Counseling and Testing Among the Youth in Lilongwe District, Malawi.

Abstract

Introduction: HIV prevalence among youth (15-24yrs) is higher than the national one (12%). HCT is one of the interventions used to prevent the infection among youth. Use of youth peer counselors in the provision of HCT services is one of the strategies that Malawi has adopted to attract more youth to this service. Objective: To evaluate the effectiveness of youth HCT peer counselors in promoting HCT uptake among the youth through comparison to adult counselors in youth friendly health services sites. Rationale/justification: No study had been published on evaluation of youth HCT peer counselors in Malawi to generate scientific based evidence to improve programming of HCT services for youth. Methods: Comparison was made between two groups of youth in anonymous exit interviews to assess client satisfaction of youth counseled by youth, and youth counseled by adults with a sample size of 214 having 107 youth in each group. HCT sites’ records were reviewed to assess uptake of the services in each HCT site for years 2005 and 2006.Results: No significant difference in client satisfaction of the services between youth who accessed HCT services from youth centres (49.5%) and health facilities was observed (48.2%) (2=1.843, p>0.175). Youth friendliness (2= 38.504, p<0.000), reduced waiting time (2 = 9.341, p<0.0025) and adequate visual and auditory privacy (p<0.013) were the factors that youth viewed would their satisfaction of the services in both settings. Conclusion: Counselors of both types of HCT sites offer features sought by youth, but youth only facilities attracted more youth to the service. Young people wished to be counseled by youthful and friendly providers in private and within a short time.