Knowledge and perception on HIV premarital counseling and testing among unmarried young people of Kintampo town in the republic of Ghana,

5.7.4. WAYS TO PROMOTE HIV PCT IN K'PO DISTRICT

For easy classification we wanted to see which measures should be put in place in decreasing order of priority, depending on what beneficiaries of the service suggested in Table 15. Thus we created the following classification scale:

1. First line measure: when 100% of respondents suggest it.

2. Second line measure: when 90-99 % of respondents suggest it.

3. Third line measure: when 80-89 % of respondents suggest it.

4. Fourth line measure: when 70-79 % of respondents suggest it.

5. Fifth line measure: when 50-69 % of respondents suggest it.

6. Sixth line measure: when 30-49 % of respondents suggest it.

7. Last line measure (negligible): when less than 30 % of respondents suggest it.

Using the above scale based on the «Yes» frequency distribution for each measure suggested by respondents, we could deduce from Table 15 that 15 interventions in 5 gradual steps (Figure 14) are actually needed in Kintampo district in order to promote HIV PCT.

Depending on the resources available, the district health authorities should address the suggested measures one by one and step by step to make sure HIV PCT is established smoothly.

Because 100% of respondents insisted that other tests should be added to HIV/AIDS in order to reduce stigma associated to HIV/AIDS, this is a crucial action which should be done in priority as the very first line intervention. In fact literature supports that premarital examinations should be global and not selective so that it integrates all required tests such as Hepatitis B, Sickle cell test, Rhesus factor, just to mention a few.^5,14,15,18 Integration of other tests in premarital screening has shown success in many parts of the World.¹⁰

Others measures such as mass sensitization campaigns, open discussions on youth sexual education, provision of care and support, reducing stigma and discrimination associated to HIV have also proved success in VCT practice wordwide.¹⁰

Figure 14 below describes the 15 interventions to be put in place in 5 steps in order to promote HIV PCT in Kintampo District.

	Figure 14. Steps and actions needed in order to promote										% CI of Yes Answers
		HIV PCT in the K'po District, based on suggestions									Lower Limit	Upper Limit
		of beneficiary respondents.						Last line action	Step 7	-	0	29%
						15	6^th line actions	Step 6	Others (PCT done before pride price is paid, quoting that couple did PCT during marriage ceremony, PCT films /posters...)		30	49%
						5^th line action	Step 5	-			50	69%
				14	4^th line actions	Step 4	Strictly prohibit all marriage (be it civil, religious or traditional) before PCT is done, through a decree law				70	79%
			13	3^rd line actions	Step 3	-					80	89%
	12	2^nd line actions	Step2	Setting a specific law (decree-law) on premarital examinations in Ghana							90	99%
	11			Reducing stigma and discrimination against people living with HIV/AIDS
	10			Creating youth HIV associations/clubs like Virgin club etc
	9			Recommending a prenuptial medical certificate from the doctor for each fiancé before celebration of marriage
	8			Providing care and support services for people living with HIV/AIDS
	7			Mention PCT in the health reproductive policies
	6			Teach PCT in the health education & reproduction matters in school
	5			Encouragement by providing free treatment for any other diseases detected among those would-be couples who come for HIV PCT
	4			Churches and mosques teach PCT to young couple before marriage
	3			Open discussions on Youth sexual education about HIV-AIDS and PCT in youth durbars such as sports...
	2			Mass sensitization campaigns about PCT through durbars, Radio/TV, news papers, churches/mosques, NGO, associations, clubs, schools & university, Hotels, hospitals etc
1	1^stline action	Step1	Add other premarital required tests to reduce stigma associated to HIV								100%
Source: Field Survey, Kintampo, June 2005.