Abstract
BACKGROUND: Voluntary counseling and testing (VCT) for HIV/AIDS is characterized by several key components, including pretest and posttest counseling, as well as the formulation of individualized risk reduction plans. Adolescents, including secondary school students, represent a population particularly vulnerable to HIV infection due to various biological, psychological, and social factors. OBJECTIVE: The present study aimed to assess the knowledge, perception, attitude, and barriers toward VCT for HIV/AIDS among secondary school students in Iringa Rural District, Tanzania. METHODS: A descriptive cross-sectional study was conducted in Iringa Rural District, targeting secondary school students. A random sampling technique was employed to select the participating schools. Data were collected through self-administered questionnaires, which were completed solely by students who voluntarily consented to participate in the study. Data management and analysis were carried out using Epi Info™ 7.2 software. RESULTS: The study involved 127 secondary school students aged 15-25 years from three schools in Iringa Rural District, with 69 (54.3%) female and 58 (45.7%) male participants. All students were aware of the VCT services. The primary source of VCT information was school-based education (92, 33.3%), followed by radio/TV (65, 23.6%), friends/family (46, 16.7%), and magazines (35, 12.7%). Some students also cited health centers, hospitals, and religious seminars (38, 13.8%) as sources. Knowledge of VCT increased with education level, with Form IV students showing the highest awareness (67, 55.4%). Most students understood VCT's main purpose: 88 (50.6%) of them linked it to knowing one's HIV status, 58 (33.3%) to HIV prevention, and 28 (16.1%) to preparing for test results. No misconceptions about VCT's purpose were reported. Attitudes toward HIV testing showed that stigma concerns increased with age, particularly among those aged 17-18 years, where 26 (60.5%) were unwilling to be identified as HIV-positive. Nonetheless, 65 (51.2%) students supported knowing their HIV status and 86 (54.4%) said they would inform others and change their behavior after testing. Key barriers to VCT uptake included fear of stigma (71, 50.6%), lack of confidentiality, insufficient trained personnel, and poor infrastructure. CONCLUSIONS: The study found that secondary school students in Iringa Rural District had generally high awareness and positive attitudes toward VCT, mainly informed through schools and media. Awareness increased with education level, but willingness to disclose test results remained low due to stigma and confidentiality concerns. While many students were ready to take responsible actions after testing, barriers such as fear, misinformation, and limited access to services persisted. The study emphasizes the need for improved school-based VCT programs, better-trained staff, community education, and strategies to address stigma and infrastructural gaps.