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Objectives  To examine factors affecting readiness for and acceptability of voluntary HIV counselling and testing (VCT).

Methods  Participants in a population‐based HIV survey conducted in an urban population in Zambia in 1996 were offered VCT. Although 29% of them expressed interest in being tested (readiness), only 4% of this group used the services (i.e. acceptability). When the survey was repeated 3 years later, VCT was designed differently to assess acceptability. At the cluster level the participants were randomly allocated to VCT either at the local clinic (similar to 1996, n = 1102) or at an optional location (n = 1343).

Results  Readiness varied significantly by age group (47% in age group 20–24 years vs. 18% in age group 40–49 years). There were contrasts between young (15–24 years) and older age groups (25–49 years) regarding the main factors associated with readiness. Whereas self …