Factors Associated with HIV-Testing and Acceptance of an Offer of Home-Based Testing by Men in Rural Zambia

Hensen, Bernadette; Lewis, James J.; Schaap, Albertus; Tembo, Margaret; Mutale, Wilbroad; Weiss, Helen A.; Hargreaves, James; Ayles, Helen

doi:10.1007/s10461-014-0866-0

Cited by 41 publications

(77 citation statements)

References 44 publications

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“…This study has shown that provider initiated mobile testing and counselling has the potential to complement access to HIV testing as has been supported by other studies [17, 18]. Additionally, participants who didn’t know their HIV status prior to the survey were linked to the nearest health facility for case management in line with national guidelines.…”

Section: Discussionsupporting

confidence: 66%

The adult prevalence of HIV in Zambia: results from a population based mobile testing survey conducted in 2013–2014

et al. 2016

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ObjectiveTo estimate the adult prevalence of HIV among the adult population in Zambia and determine whether demographic characteristics were associated with being HIV positive.MethodsA cross sectional population based survey to asses HIV status among participants aged 15 years and above in a national tuberculosis prevalence survey. Counselling was offered to participants who tested for HIV. The prevalence was estimated using a logistic regression model. Univariate and multivariate associations of social demographic characteristics with HIV were determined.ResultsOf the 46,099 individuals who were eligible to participate in the survey, 44,761 (97.1 %) underwent pre-test counselling for HIV; out of which 30,605 (68.4 %) consented to be tested and 30, 584 (99.9 %) were tested. HIV prevalence was estimated to be 6.6 % (95 % CI 5.8–7.4); with females having a higher prevalence than males 7.7 % (95 % CI 6.8–8.7) versus 5.2 % (95 % CI 4.4–5.9). HIV prevalence was higher among urban (9.8 %; 95 % CI 8.8–10.7) than rural residents (5.0 %; 95 % CI 4.3–5.8). The risk of HIV was double among urban dwellers than among their rural counterparts. Being divorced or widowed was associated with a threefold higher risk of being HIV positive than being never married. The risk of being HIV positive was four times higher among those with tuberculosis than those without tuberculosis.ConclusionsHIV prevalence was lower than previously estimated in the country. The burden of HIV showed sociodemographic disparities signifying a need to target key populations or epidemic drivers. Mobile testing for HIV on a national scale in the context of TB prevalence surveys could be explored further in other settings.

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Section: Discussionsupporting

confidence: 66%

The adult prevalence of HIV in Zambia: results from a population based mobile testing survey conducted in 2013–2014

et al. 2016

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“…HCT uptake was associated with younger age, sex, and community, being symptomatic for TB and STI and longer time since previous HIV testing, consistent with findings from other studies [18–21]. Contextual heterogeneity has been shown to influence HCT uptake due to factors such as physical features, social organization, networks, and narratives [22].…”

Section: Discussionsupporting

confidence: 85%

What works – reaching universal HIV testing

Shanaube

Schaap

Floyd

et al. 2017

Aids

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Objective:To determine the uptake of home-based HIV counselling and testing (HCT) in four HPTN 071 (PopART) trial communities (implementing a ‘full’ combination HIV prevention package that includes universal HIV testing and treatment) in Zambia. We also explore factors associated with uptake of HCT in these communities.Design:HPTN 071 (PopART) is a three-arm community-randomized trial in 12 communities in Zambia and nine communities in South Africa evaluating the impact of a combination HIV prevention package, including universal HIV testing and treatment, on HIV incidence.Methods:Using a door-to-door approach that includes systematically revisiting households, individuals were offered participation in the intervention, and verbal consent was obtained. Data were analysed for the first 18 months of the intervention, December 2013 to June 2015 for individuals 18 years and older.Results:Among 121 130 enumerated household members, 101 102 (83.5%) accepted the intervention. HCT uptake was 72.2% (66 894/92 612), similar by sex but varied across communities. HCT uptake was associated with younger age, sex, community, being symptomatic for TB and sexually transmitted infections and longer time since previous HIV test. Knowledge of HIV status due to the intervention increased by 36% overall and by 66% among HIV positive participants; the highest impact was among 18–24 years old.Conclusion:Overall acceptance of HIV-testing through offering a door-to-door-based combination HIV prevention package was 72.2%. The intervention increased knowledge of HIV status from ∼50 to ∼90%. However, challenges still remain and a one-off intervention is unlikely to be successful but will require repeated visits and multiple strategies.

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“…This desire for privacy and confidentiality has been observed in numerous other studies in Zambia (Fylkesnes and Siziya, 2004;Fykesnes et al, 2013;Hensen et al, 2015a;Hensen et al, 2015b). For healthcare workers, there may be heightened concerns about having coworkers know their status before the person with HIV has had time to accept the diagnosis and disclose it to partners, family, and friends.…”

Section: %mentioning

confidence: 52%

“…In Zambia, willingness to undergo VCT has generally been found to be higher among those who are able to seek VCT at distant clinics rather than their local clinic (Fylkesnes and Siziya, 2004). VCT uptake is highest in places where home-based testing is available and test-seekers do not have to risk the loss of privacy that would result from being seen at a VCT clinic or invest time and money in traveling to a clinic Hensen et al, 2015a;Hensen et al, 2015b). For Zambians, the benefits of accessing treatment are often perceived to be outweighed by the risks of HIVassociated stigma (Jürgensen et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Knowledge, attitudes, and practices related to voluntary counseling and testing (VCT) for HIV among nursing students in Zambia

Hamukang’andu¹,

Fleming²,

Silwimba³

et al. 2016

Sierra Leone j. biomed. res.

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Access to voluntary counseling and testing (VCT) services has become an important tool in the treatment and prevention of HIV infection. A cross-sectional knowledge, attitudes, and practices (KAP) study was conducted with 50 nursing students in Zambia. All students were aware of where to go for VCT, and 80% had reported using VCT services. However, the participants expressed concerns about privacy and confidentiality related to testing, with most students preferring to seek future VCT at a facility far from their workplace. This ongoing fear of stigma associated with HIV testing was similar to the findings of a recent KAP study conducted among young adults in Bo, Sierra Leone.

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Factors Associated with HIV-Testing and Acceptance of an Offer of Home-Based Testing by Men in Rural Zambia

Cited by 41 publications

References 44 publications

The adult prevalence of HIV in Zambia: results from a population based mobile testing survey conducted in 2013–2014

The adult prevalence of HIV in Zambia: results from a population based mobile testing survey conducted in 2013–2014

What works – reaching universal HIV testing

Knowledge, attitudes, and practices related to voluntary counseling and testing (VCT) for HIV among nursing students in Zambia

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