Background information: In contrast to, many initiatives implemented to prevent HIV/AIDSrninfection; many countries have not so far achieved the planned reduction in HIV/AIDS infection;rnthe main reason mentioned so far being low utilization of VCT for HIV/AIDS. CommunityrnConversation (CC) is a community based strategy meant to enhance the community to utilizernVCT for HIV among many other functions. rnObjective: This study is aimed to determine the disparity in knowledge, attitude and practicerntowards VCT service utilization of population 15-59 years age, between well and poorrncommunity conversation performing rural kebeles of Shebe Dino woreda, SNNPR.rnMethodology: A cross sectional comparative community based study design was employed torncompare the knowledge, attitude and practice towards VCT service among 15-59 years agernpopulation between poor and well community conversation performing rural kebeles in ShebernDino woreda, from August 2010-May 2011. Kebeles were classified as poor or well based onrntheir community conversation performance. A total of 6 kebeles (3 from each CC group) werernselected by lottery method after stratifying each CC groups into three strata by their relativerndistance from the Woreda capital. The number of study participants sampled from each kebele isrnproportional to the size of study population in the kebele. A total sample of size 462, 231 (50%)rnfrom each comparative group were selected and studied. The qualitative data was collected fromrnFocused Group Discussion and analyzed by thematic analysis. A hierarchical logistic regressionrnmodel was used to determine independent predictors of VCT uptake in blocks of two at 95% CI.rnResult: The two CC groups were homogeneous in their major socio demographic factors usingrntwo sample test of proportion (P>0.05), and hence were comparable. VCT Knowledge didnâ€™trnshow statistically significant difference between well and poor CC performing kebeles, with arntwo sample proportion test of difference and 95% CI: 0.05 (-0.04, 0.14). But, attitude andrnutilization of VCT service was statistically higher in well CC performing kebeles than poor CCrnperforming kebeles (73.0% vs.54.1%, P < 0.001) and (97.8 vs. 93.8, P=0.034) respectively. Agerngroup between 15-24 years, single, trader, knowledgeable about HIV transmissions, and positivernattitude to VCT services were independent predictors of VCT service utilization.rn rnConclusion: Proportion of study participantsâ€™ with positive attitude towards VCT and practice ofrnVCT service utilization was higher in a well CC group compared to a poor CC kebeles. Howeverrnthe study population in the two CC groups is not different by their knowledge towards VCTrnservice (i.e. CC does have effect on VCT attitude and practice but not on knowledge).VCTrnservice utilization depends on oneâ€™s age, occupation, marital status and knowledge of HIVrntransmission. Therefore, there should be consistent monitoring and evaluation of the CCrnprogram, not only by the criteria in use but also in terms of its effect on KAP of the targetrnpopulation towards VCT and or HIV to strengthen CC in all CC kebeles.