A systematic review of barriers and facilitators to voluntary counselling and testing for HIV among young people in Ghana

Abstract Background HIV testing uptake among young people in Ghana remains low despite increased awareness. Existing evidence on factors influencing voluntary counselling and testing (VCT) is scattered. This review synthesises key barriers and facilitators to inform targeted prevention strategies. Methods Aromataris and Pearson’s framework and PRISMA guidelines guided the review. Studies published between 2000 and November 2025 were sourced from major databases and grey literature. Eligible studies examined determinants of VCT among young people in Ghana, and quality was assessed using standard appraisal tools. Results Eight studies met inclusion criteria. Barriers included fear and stigma, low perceived risk, social discouragement, and service-level constraints. Facilitators included accessible and youth-friendly services, personal motivation, supportive social networks, community and faith-based engagement, confidence in care, and protective sexual behaviours. Four studies had low risk of bias and four had moderate risk. Conclusion VCT uptake among Ghanaian youth is shaped by psychosocial, social, and structural factors. Enhancing youth-friendly services, strengthening social support, and improving risk perception can improve HIV testing uptake.