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Factors Influencing Couples Seeking HIV Volunteer Counseling and Testing Theoretical Orientation & Conceptual Framework; Research Hypotheses

Theoretical Framework
The Health Belief Model (HBM) offers a useful framework for understanding the relationship between perception of personal threat posed by a health problem and the factors that influence and predict readiness for action in addressing a perceived health threat (U.S. Department of Health and Human Services, 2005). The HBM provides six constructs that affect a person’s health beliefs and participation with couple volunteer counseling and testing: perceived susceptibility, perceived severity, perceived barriers, perceived benefits, cues to actions and self-efficacy (U.S. Department of Health and Human Services, 2005).
All six constructs were confirmed by Dr. Suzanne Bronheim (2008). The ‘perceived susceptibility’ construct of the HBM involves the community’s level of knowledge and literacy level, among others (Bronheim, 2008). For perceived severity, the construct involves the community’s perception of how serious the condition is, previous experiences with trauma, and the acceptance based on religious beliefs. Additionally, perceived benefit involves the question of whether the proposed action will work, while perceived barriers include the trust in the medical system and government sources. Further, cues to actions can be affected by the credibility of sources, and the preferred delivery system. Finally, self-efficacy involves the individual or the community’s confidence in their ability to achieve a desired change (Bronheim, 2008). Within this study, this framework was used to identify predictors of couple VCT participation (the decision to act) and to recommend appropriate strategies to increase uptake of couple VCT.
The relationship between socio-demographic factors have been demonstrated to be predictive of individual HIV counseling and testing in Ethiopia (Shitaye, A., Nuru, A., Getu, D., 2004), and couple counseling and testing in other sub-saharan African countries (Helleringer, S., Kohler, H.-P., & Frimpong, J. A. 2011; Chomba, Allen, Kanweka, 2008). . These predictors have been useful in modification of health promotion campaigns and development of interventions. It is hypothesized that education level, sexual practices, and urban residence will be the strongest predictors of participation in couple VCT.
Research Questions
RQ 1       What is the relationship of occupation type and reasons for testing?
Null:      There is a relationship between professional occupation types and pre-marital reasons for testing.
Alt:         There is no significant relationship between professional occupation type and pre-marital reasons for testing.
RQ2        What is the relationship of urban versus rural residence and reasons for testing?
Null:       There is a relationship between urban residence and couples that seek VCT.
Alt:         There is no relationship between urban residence and couples that seek VCT.
RQ3: What is the relationship between sex practices and couples that seek VCT?
Null: There is no significant relationship between persons that have a history of a sexually transmitted infection and seeking of couple VCT.
Alt: There is a relationship between persons that have a history of a sexually transmitted infection and seeking of couple VCT.
RQ4        How does mechanism knowledge of Couples VCT influence couples to seek VCT?
Null:       There is a significant relationship between outreach and couples seeking couple VCT.
Alt:         There is no relationship Knowledge between outreach and couples seeking couple VCT.
Conceptual Framework

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