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

Chapter Two

LITTERATURE REVIEW

2.0. DEFINITION OF CONCEPTS

- Adolescent: a young person who is developing from a child into an adult ^1,33

Early adolescence: between 10-13 years Mid adolescence: 14-15 years.

Late adolescence: between 16-19 years

- Youth: the time of life when a person is young, especially before a child becomes an adult¹

- Adult: a fully grown person who is legally responsible for their actions¹

Note that in this study we are dealing with unmarried young adults aged between 15 (mid adolescents) and 30 years.

- Knowledge: the state of knowing about a particular fact or situation¹. The study deals with the state of knowing about HIV PCT.

- Perception: the way you notice things, the ability to understand the true nature of something¹ . The study deals with the way respondents notice HIV PCT and understand its true nature.

2.1. PREMARITAL EXAMINATION IN GHANA AND IN KINTAMPO

«Laws on Premarital examination» is classified by WHO among core specific legislations for the prevention of Sexually Transmitted Infections (STIs) and other diseases in new couples in a country ¹¹. Yet so far in Ghana there is no specific law about premarital counseling and testing that describes its objectives, practical procedures and formal legal processes. However current existing policies (National Population Policy 1994, Adolescent reproductive Health Policy 2000 and National Reproductive Health Service Policy and Standards 2003, National HIV/AIDS and STI Policy) clearly mention the importance of «Information and counseling'' for young people, including premarital counseling and testing ^9,33,34,61. For instance the section 4.3.7 of the objectives of the above revised National Population Policy strongly shows the government's responsibilities towards young people, and I quote «To educate the youth on population matters which directly affect them such as sexual relationships, fertility regulation, adolescent health, marriage and childbearing, in order to guide them towards responsible parenthood and small family sizes»³⁴. The right for young people to have access to all information and counseling regarding reproductive health is also reemphasized in the adolescent reproductive health policy in section 3.2 which states: « ... Available evidence suggest that adolescents behave responsibly when they are well informed, especially on issues such as career development, relationships and reproductive health. Therefore at this stage individuals need adequate and reliable information to enable them make the right decisions and choices...»³³. In addition in the national strategic framework for HIV-AIDS, access to HIV VCT (including HIV premarital exam) is considered nation wide as a crucial service in the national response to combat HIV/AIDS ^35,36. All these literatures, just to mention a few, demonstrate that Ghanaian young people have the right to access HIV premarital counseling and testing services in order to make informed and right decisions and choices towards marriage.

In Ghana, like in most countries in sub-Saharan Africa, pre-marital HIV VCT is being widely promoted, particularly by churches and religious groups. Meanwhile in practice due to the expressed need of such service by young adults, HIV premarital examination is being carried out, not commonly, in certain towns, including Kintampo town. In fact report from the laboratory of Kintampo District Hospital (KDH) indicates that since January 2004 till July 2005, 14 would-be couples aged between 24 - 34 years old were received for HIV PCT, of whom 12 (86%) were sent by their churches while 2 (14%) came voluntarily. None of them tested HIV positive. These data showing a timid starting of the service in an embryonic stage constitute an undeniable and strong opportunity which will enable the smooth official implementation of HIV PCT in the District.

In general premarital examination is done on voluntary demand and consent of some would-be couples or in most cases by some churches that impose it instead. Furthermore, the examination has a selective meaning since in most cases it targets only HIV-AIDS testing and forgets about all other required premarital tests, thus resulting in an incomplete premarital check-up.