Determinants of Voluntary Counseling and Testing Service Uptake Among Adult Sub-Saharan Africans: A Systematic Review and Meta-Analysis.

Objective: To examine the major determinants of VCT service uptake among adults in SSA. Methods: Electronic databases were searched to identify eligible English language publications. Reporting of the study selection procedure was done according to PRISMA and the selected articles were also critically appraised. Results: We found 8 significant determinants of VCT uptake among adults in SSA, such as less physical access [OR (Odds ratio): 0.77 (95% CI (Confidence interval): 0.62-0.96), p < 0.01], older age [OR: 1.36 (95% CI: 1.08-1.73), p < 0.01], higher education level [OR: 1.60 (95% CI: 1.24-2.05), p < 0.01], high knowledge of HIV and VCT awareness [OR: 1.40 (95% CI: 1.03-1.90), p < 0.01], unprotected sexual practices [OR: 1.75 (95% CI: 1.18-2.58), p < 0.01], discussion on HIV among partners and others [OR: 1.76 (95% CI: 1.10-2.81), p < 0.01], other STIs [OR: 1.40 (95% CI: 1.00-1.98), p < 0.01], and divorced/separated [OR: 1.39 (95% CI: 1.12-1.72), p < 0.01]. Conclusion: This study showed that 8 determinants were significantly associated with VCT service uptake in SSA. Thus, HIV interventions and policy initiatives should be tailored to these determinants to ensure scale-up of VCT service uptake in SSA.