Factors affecting the utilization of HIV counseling and testing services: A case-control study in Indonesia

Objective: To analyze factors affecting the utilization of human immunodeficiency virus counseling and testing (HCT) service among human immunodeficiency virus risk groups at Hessa Air Genting Health Center, Asahan Regency, North Sumatera, Indonesia. Methods: This quantitative unmatched case-control study was conducted from April 2024 to April 2025 at Hessa Air Genting Health Center, Asahan Regency, North Sumatra Province, Indonesia. Female sex workers and men who have sex with men were selected using purposive sampling based on predefined inclusion and exclusion criteria. Data were collected via questionnaires and analyzed using SPSS version 18.0, with univariate analysis, bivariate analysis ( Chi -square test), and multivariate analysis (logistic regression analysis). Results: Comprehensive analysis of 75 cases and 75 controls was conducted to identify factors affecting the utilization of HCT services. Specifically, this study identified significant effects of knowledge ( OR 3.2, 95% CI 1.5-7.0, P =0.003), perception ( OR 5.6, 95% CI 2.5-12.5, P <0.001), information media ( OR 3.1, 95% CI 1.4-6.8, P =0.005), and health workers encouragement ( OR 4.0, 95% CI 1.5-10.4, P =0.005). In contrast, access to health services did not have a significant effect. Conclusions: Knowledge, perception, information media, and health worker encouragement had significant effects on HCT service utilization, with perception identified as the dominant factor. To improve utilization, strengthening positive perceptions, targeted training for healthcare workers, strengthened partnerships with local non-governmental organizations, and the use of social media for health promotion are recommended.