Intention to Seek Regular HIV and Syphilis Testing and Associated Factors Among Female Sex Workers in Uganda

Abstract

Background: Few studies have evaluated intentions to undergo periodic sexually transmitted infection (STI) and HIV testing among female sex workers (FSW) in Sub-Saharan Africa. We aimed to assess intention to seek periodic syphilis and HIV testing among FSW in Uganda. Methods: Between July and October 2018, we conducted a cross-sectional study among 441 FSW. Participants were recruited through peer referrals. Self-reported data on intention to take a syphilis test in the next 3 months and an HIV test in next 6 months were obtained using an interviewer-administered questionnaire. We used constructs of the Integrated Change Model to assess intentions, attitudes, norms, social influences and self-efficacy towards 3-monthly syphilis and 6-monthly HIV testing. Predictors of intention to seek testing were estimated using linear regression.Results: A total of 441 FSW were included in the analysis, and the median age was 26 years (interquartile range [IQR] 23–30). Most (66.9%) reported high intention to take an HIV test in the next 6 months, and 51.9% showed high intention to take a serological syphilis test in the next 3 months. In multivariable analysis, never testing for HIV was associated with low intention of testing (β=-0.15, p=0.001). Factors significantly associated with high intentions to test for HIV in the next 6 months were perceived influence of significant others (β=0.08, p=0.03), high self-efficacy (β=0.26, p=0.001) and high attitude scores (β=0.45, p=0.001). Similarly, high attitude (β=0.30, P=0.001) and descriptive norms (β=0.32, P=0.001) were associated with high intentions to test for syphilis in the next three months. Conclusion: These results suggest public health programs promoting routine HIV and syphilis testing should consider factors such as attitudes, descriptive norms, social influences, self-efficacy and past behaviours which inform intention to undergo STI testing.