Removing Barriers to Knowing HIV Status

Morin, Stephen F.; Khumalo-Sakutukwa, Gertrude; Charlebois, Edwin D.; Routh, Janell; Fritz, Katherine; Lane, Tim; Vaki, Taurai; Fiamma, Agnès; Coates, Thomas J.

doi:10.1097/01.qai.0000179455.01068.ab

Cited by 139 publications

(68 citation statements)

References 7 publications

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“…Despite the widespread availability of VCT tests through project-supported static clinics, uptake of HIV testing was low. Barriers to HIV testing are often logistical and can be overcome with community-based strategies [15]. Evidence suggests that community-based VCTs are preferred over static or health facility-based clinics for HIV testing [15] [21] [22] as was observed in our study with a dramatic increase in the uptake of HIV testing during Vivek months.…”

Section: Discussionsupporting

confidence: 60%

“…HIV testing is the gateway for HIV prevention as early initiation of ART and safer sexual behaviour could potentially reduce transmission together with other interventions [6]- [8] [12]. As voiced in earlier literature, addressing individual and contextual barriers and increasing demand facilitates HIV testing uptake [6] [15] [19] [20].…”

Section: Discussionmentioning

confidence: 99%

“…Studies have enumerated several individual level and contextual factors that influence the decision to undergo HIV testing [6] [9] [12]- [16]. Traditional VCT-related barriers, such as low perceived risk for HIV infection [6], lack of access to free testing [15], general negative perception of test services, stigmatizing beliefs coupled with fear of discrimination if diagnosed as HIV-positive [14], shortage of counselors and their competency, concerns about confidentiality and delays in returning HIV test results [6] [17] continue to hamper effective access to and uptake of VCT in many countries. In addition, heterogeneous typologies based on the solicitation sites, workplace, gender, language, culture and controlled by stakeholders such as brothel owners, madams and pimps, restricted service hours of the facilities, distance of the counseling and testing centers and stigma and discrimination faced by SWs from service providers further contribute to the low uptake rate of HIV testing among HRGs [18].…”

Section: Introductionmentioning

confidence: 99%

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Influence of Customized Demand Generation as a Strategy to Increase Uptake of Voluntary Counseling and Testing Services amongst Sex Workers in Mumbai and Thane

Bhardwaj¹,

Ramesh²,

Gaikwad³

2014

WJA

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Background: To demonstrate that customized demand generation leads to increased voluntary HIV counseling and testing (VCT) among Sex Workers (SWs). Methods: FHI 360 Aastha implemented Vivek intervention among SWs in Mumbai and Thane, India using customized demand generation through outreach services for VCT. Program monitoring data and integrated counseling and testing center tracking sheets were used to assess the intervention effect. Results: Higher proportion of registered SWs tested during: 1) Vivek months than other months (17% vs. 5%, p < 0.001); 2) Post-initiation non-Vivek months than pre-Vivek months (4.7%, vs. 1.5% p < 0.001). Conclusions: Customized demand generation approach is successful in increasing HIV testing.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Influence of Customized Demand Generation as a Strategy to Increase Uptake of Voluntary Counseling and Testing Services amongst Sex Workers in Mumbai and Thane

Bhardwaj¹,

Ramesh²,

Gaikwad³

2014

WJA

View full text Add to dashboard Cite

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“…Participants who reported not testing previously were most likely to report fear as the main factor preventing them from accessing testing. Although the survey instrument did not determine the source of such fear, research in sub-Saharan Africa has indicated that despite treatment availability, the potential for a positive HIV test result is a significant barrier to testing (MacPhail et al 2008a, b;Morin et al 2006). Our previous research with South African adolescents has shown an overwhelming fear of the psychological impacts of learning that one is HIV positive, with many believing that this will lead to suicide and a more rapid decline to AIDS and death (MacPhail et al 2008a).…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with HIV Testing Among Public Sector Clinic Attendees in Johannesburg, South Africa

et al. 2008

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Uptake of VCT remains low in many sub-Saharan African countries. Men and women aged 15 and older were recruited from a family planning, STI, and VCT clinic in inner-city Johannesburg between 2004 and 2005 to take part in a cross-sectional survey on HIV testing (n = 198). Fourty-eight percent of participants reported previously testing for HIV and, of these, 86.9% reported disclosing their status to their sex partner. In multivariable analyses, individuals whose partners had been tested for HIV were more likely to have tested (AOR 2.92; 95% CI: 1.38-6.20). In addition, those who reported greater blame/ shame attitudes towards people living with HIV/AIDS were less likely to have tested (AOR 0.35; 95% CI: 0.16-0.77) while those reporting more equitable attitudes towards people living with HIV/AIDS were more likely to have tested (AOR 2.87; 95% CI: 1.20-6.86). Promotion of and increased access to couples HIV testing should be made available within the South African context. Abstract Uptake of VCT remains low in many subSaharan African countries. Men and women aged 15 and older were recruited from a family planning, STI, and VCT clinic in inner-city Johannesburg between 2004 and 2005 to take part in a cross-sectional survey on HIV testing (n = 198). Fourty-eight percent of participants reported previously testing for HIV and, of these, 86.9% reported disclosing their status to their sex partner. In multivariable analyses, individuals whose partners had been tested for HIV were more likely to have tested (AOR 2.92; 95% CI: 1.38-6.20). In addition, those who reported greater blame/ shame attitudes towards people living with HIV/AIDS were less likely to have tested (AOR 0.35; 95% CI: 0.16-0.77) while those reporting more equitable attitudes towards people living with HIV/AIDS were more likely to have tested (AOR 2.87; 95% CI: 1.20-6.86). Promotion of and increased access to couples HIV testing should be made available within the South African context.

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“…In Malawi, Smith, and Watkins (2005) found that women were more worried about getting HIV from unfaithful husbands, while men were more worried about getting HIV from their extramarital partners. Other studies from the region suggest that women who suspect that their main partner has other sexual partners may be more inclined to test for HIV (Luseno & Wechsberg, 2009; Morin et al, 2006). Few studies, however, have obtained data from couples, which could provide clarifying information regarding the effect of perceived risk on both partners’ testing behaviors.…”

Section: Introductionmentioning

confidence: 99%

The Influence of Relationship Power Dynamics on HIV Testing in Rural Malawi

Conroy

2014

The Journal of Sex Research

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Using the theory of gender and power (TGP) and data from the Tsogolo la Thanzi (TLT) study, we examined how relationship power shapes young people’s decisions to test for HIV in rural Malawi (N=932), a high-HIV prevalence setting undergoing rapid expansions in testing services. We used generalized estimating equations (GEE) to examine associations among five constructs of relationship power (socioeconomic inequalities, relationship dominance, relationship violence, relationship unity, and mistrust), perceived risk, and receiving an HIV test over a 16-month period. The results indicate that young Malawians are testing for HIV at relatively high rates, repeatedly, and not just during pregnancy. Over the study period, 47.3% of respondents received at least one HIV test outside of TLT (range: 0–4). The GEE analysis revealed that men and women with higher levels of relationship unity were less likely to test for HIV. For men, being a victim of sexual coercion was an additional barrier to testing. Women’s testing decisions were more strongly influenced by perceptions of a partner’s risk for HIV than their own, whereas men relied more on self-assessments. The results highlight that testing decisions are deeply embedded within the relationship context, which should be considered in future HIV testing interventions.

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Removing Barriers to Knowing HIV Status

Abstract: Same-day HIV testing in community settings seems to be acceptable in sub-Saharan Africa. Barriers to HIV testing are often logistic and can be overcome with community-based strategies. These strategies need to be refined to address the needs of those not using mobile testing services.

Cited by 139 publications

References 7 publications

Influence of Customized Demand Generation as a Strategy to Increase Uptake of Voluntary Counseling and Testing Services amongst Sex Workers in Mumbai and Thane

Influence of Customized Demand Generation as a Strategy to Increase Uptake of Voluntary Counseling and Testing Services amongst Sex Workers in Mumbai and Thane

Factors Associated with HIV Testing Among Public Sector Clinic Attendees in Johannesburg, South Africa

The Influence of Relationship Power Dynamics on HIV Testing in Rural Malawi

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