A Multilevel Analysis of the Determinants of HIV Testing in Zimbabwe: Evidence from the Demographic and Health Surveys

Abstract

Introduction: Zimbabwe is still burdened with HIV epidemic and the government has an ambitious aim in the post-2015 era to end the AIDS epidemic by 2030. To achieve this, the government has set up the 90-90-90 strategic milestones to be achieved by 2020. It is a daunting task to increase HIV testing uptake from the current estimate of 56% to 90% to meet these targets. The current government's initiative requires an understanding of determinants of HIV testing. Objectives: The specific objectives of this study are to: (i) identify the individual and communitylevel determinants of HIV testing, focussing on predisposing, enabling and perceived need factors (PREP); and (ii) establish gender differences. Most PREP factors associated with HIV testing are largely consistent with patterns in Southern Africa (e.g., higher uptake by women and those who are wealthier), but unique patterns have also emerged. In particular, results reveal important gender differences: rural residence is associated with lower uptake of HIV testing for women (OR=0.74) but higher for men (OR=1.16); community wealth is a more important factor in enabling HIV testing than household wealth for women, but the converse is true for men; and individual-level, rather than community-level stigma is important for women, while for men, it is community-level stigma that is important. Conclusion: Observed gender disparities in determinants of HIV testing calls for gender specific response. Couple-oriented HIV counselling and testing services where men accompany their spouse to HIV screening during pregnancy may help increase HIV testing uptake for males and reduce gender disparities.

<p>HIV Voluntary Counseling and Testing Uptake and Associated Factors Among Sexually Active Men in Ethiopia: Analysis of the 2016 Ethiopian Demographic and Health Survey Data</p>

“…The magnitude from our study is greater than many findings from studies done in Burkina Faso, Ethiopia, Cambodia, and South Africa. 9,15,[20][21][22][23] But the current figure is less than the result drawn from the study done in Malawi. 10 Most of the studies reviewed clarified that the majority of the figures were less than those of the results obtained by the current study and this may have linkage with the duration when the studies were conducted, meaning that they were mostly done before the year of this study since in the most recent times the VCT for HIV uptake is expected to increase.…”

“…Regarding wealth status, the odds of getting tested for HIV/AIDS for the rich males was 58.6% higher than for the poor. Different studies [14][15][16]20,28 also showed that rich people are more likely to accept HIV VCT as compared to the poor. This could be explained by different reasons.…”

HIV Voluntary Counseling and Testing Uptake and Associated Factors among Sexually Active Men in Ethiopia: Evidence from the 2016 EDHS Using Multilevel Modeling

“…HIV VCT uptake among sexually active men in Ethiopia was estimated to be 45.69% (95% CI: [43.08%, 48.33%]). The magnitude of our study is greater than many ndings done in Burkina Faso, Ethiopia, Cambodia, and South Africa (9,15,(20)(21)(22)(23). But the current gure is less than the result drawn from the study done in Malawi (10).…”

“…Regarding wealth status, the odds of getting tested for HIV/AIDS for the rich males were 58.6% higher than the poor. Different studies (14)(15)(16)20,28) also showed that rich people are more likely to accept HIV VCT as compared to poor people. This could be explained by different reasons.…”

Context matters: a multicountry analysis of individual‐ and neighbourhood‐level factors associated with women's sanitation use in sub‐Saharan Africa

“…Women's individual responses were nested in communities. Communities were represented by DHS primary sampling units of about 20–200 people because they are the most consistent measure of community between DHS data sets and have been used to represent community in a number of multilevel studies using DHS data .…”