Socio-economic and demographic factors associated with never having tested for HIV among sexually active men across the four administrative regions of Uganda

Otim, Jude; Nelson, Otim; Katagwa, Igeme

doi:10.1186/s12889-021-12384-2

Cited by 4 publications

(6 citation statements)

References 62 publications

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“…This study found higher odds of HIV testing uptake among multiple sexual partners with the age over 24 years old as compared to their youngers who are those between the ages of 15–24 years old. The effect of age on HIV testing behavior observed was consistent with other studies done in Germany [ 17 ], East African countries [ 66 ], Uganda [ 67 ], Nairobi [ 68 ], Burkina Faso [ 63 ]and Ethiopia [ 61 ]. The possible reason can be that older people have had a variety of life experiences that increase their chance of contracting HIV/AIDS.…”

Section: Discussionsupporting

confidence: 89%

“…Several studies have found significantly higher odds of HIV testing uptake among individuals with higher educational attainment when it is compared with those who have lower educational level. This can be supported by study which was done among Germany [ 17 ], East African countries [ 66 ], Uganda [ 67 ], Burkina Faso [ 63 ], Nigeria [ 74 ] and Ethiopia [ 21 ]. The results presented here further confirm that the odds of having been tested for HIV were significantly higher among multiple sexual partners with secondary or higher educational attainment.…”

Section: Discussionmentioning

confidence: 83%

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Pooled prevalence, spatial variation and associated factors of HIV testing uptake among multiple sexual partners in Sub Saharan Africa: Spatial and multilevel analysis

Lealem,

Zeleke,

Andargie

et al. 2024

PLoS ONE

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Background Uptake of HIV testing is vital for the early diagnosis of HIV infection and initiation of treatment, which are used to eliminate the disease’s progression and reduce HIV-related mortality. Even if determining HIV testing is imperative to prevent HIV/AIDS among multiple sexual partners who are at higher risk of sexually transmitted infections, most of the countries in Sub Saharan Africa did not fulfil the global targets of UNAIDS. Moreover there is a paucity of literature on spatial variation and factors associated with HIV testing among high-risk groups in SSA. This study aimed to assess the pooled prevalence, spatial variation and determinants of HIV testing uptake among multiple sexual partners in Sub Saharan Africa. Methods The Demographic and Health Surveys data conducted between 2011 and 2021 in 30 Sub-Saharan Africa countries was used to analyze total weighted sample of 56,210 multiple sexual partners. Exploratory spatial data analysis, with countries as the unit of analysis was conducted using ArcGIS V10.7.1 and Sat Scan V 10.1 soft wares. A multilevel binary logistic regression model was used to identify the factors associated with the HIV testing uptake. The Adjusted odds Ratio with a 95% confidence interval was reported to declare the strength of association and their statistical significance. Results The spatial patterns of HIV testing uptake were found to be non-random. Primary clusters were identified around western and central sub- regions. Multiple sexual partners who were ever married, those attended primary level and above education, those from rich wealth status, aged above 24 years, having good HIV related knowledge, and exposed to media were positive association with HIV testing uptake. However, being male, having working status and living in rural area were negatively associated with HIV testing uptake. At the community-level, multiple sexual partners from communities in Eastern and southern sub regions, countries with upper middle income and countries with the survey year after 2014 were more likely to utilize HIV testing services compared with their counterparts. Conclusion In this study, the pooled prevalence of the HIV testing uptake among multiple sexual partners was found to be lower than the universal target and showed differences in HIV testing uptake across Sub-Saharan Africa region. Both individual and community-level factors affected HIV testing uptake among multiple sexual partners. Stakeholders should implement interventions to help increase the uptake of HIV testing among those risky groups in this region.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 83%

Pooled prevalence, spatial variation and associated factors of HIV testing uptake among multiple sexual partners in Sub Saharan Africa: Spatial and multilevel analysis

Lealem,

Zeleke,

Andargie

et al. 2024

PLoS ONE

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“…Being ever married increased the likelihood of both HIV testing and ART uptake, consistent with other studies [ 74 – 81 ] and possibly due to perceived risk within relationships and premarital HIV counselling and testing. Consistent with other studies [ 75 , 78 , 82 , 83 ], higher educational levels were positively associated with HIV testing, likely because education influences health awareness and access to testing services [ 84 , 85 ]. Wealthier individuals also had higher odds of HIV testing and ART uptake, in line with other studies [ 77 , 86 – 88 ].…”

Section: Discussionsupporting

confidence: 86%

The Association Between HIV-Related Stigma and the Uptake of HIV Testing and ART Among Older Adults in Rural South Africa: Findings from the HAALSI Cohort Study

Mahlalela,

Manne-Goehler,

Ohene-Kwofie

et al. 2024

AIDS Behav

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HIV testing and antiretroviral therapy (ART) remain critical for curbing the spread of HIV/AIDS, but stigma can impede access to these services. Using data from the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI), we used a multivariable logistic regression to examine the correlation between HIV-related stigma, HIV testing and ART uptake in older adults. We used four questions to measure stigma, with three assessing social stigma (reflecting social distancing preferences) and one assessing anticipated stigma (disclosure concern). We combined the three social stigma questions to generate a social stigma score ranging from 0 to 3, with higher scores indicating higher stigma. Anticipated stigma was prevalent 85% (95% CI 0.84–0.86), and social stigma was also frequent 25% (95% CI 0.24–0.27). Higher social stigma scores correlated with decreased HIV testing for all participants with social stigma. Compared to those with a score of 0, odds of testing decreased with higher stigma scores (OR = 0.66, 95% CI 0.53–0.81, p = 0.000) for a score of 1 and (OR = 0.56, 95% CI 0.38–0.83, p = 0.004) for a score of 3. ART uptake also decreased with higher social stigma scores among people living with HIV (PLWH), although it was significant for those with a score of 2 (OR = 0.41, 95% CI 0.19–0.87, p = 0.020). These findings emphasize that HIV-related stigma hampers testing and ART uptake among older adults in rural South Africa. Addressing stigma is crucial for improving testing rates, early diagnosis, and treatment initiation among the older population and achieving UNAIDS 95–95–95 targets.

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“…Several plausible explanations about the increased likelihood of testing amongst men in relatively wealthier households have been mooted. These men usually have little to no financial and geographical barriers to accessing health care services, and have better exposure to relevant HIV information and education materials [ 49 , 57 – 59 ]. Moreover, wealth and education are often interrelated and exhibit a synergistic relationship, each amplifying the benefits of the other [ 60 ].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, wealth and education are often interrelated and exhibit a synergistic relationship, each amplifying the benefits of the other [ 60 ]. Conversely, men in relatively poorer households may have little to no spare time for HIV testing uptake with a daily round-the-clock focus on making ends meet [ 49 , 57 – 59 ]. Additionally, Sub-Saharan Africa has been noted to have higher HIV infection rates among wealthier individuals compared to poorer individuals, unlike the global norm, which may also explain the increased likelihood of testing [ 61 ].…”

Section: Discussionmentioning

confidence: 99%

A multilevel analysis of the determinants of HIV testing among men in Sub-Saharan Africa: Evidence from Demographic and Health Surveys across 10 African countries

Ijaiya,

Anibi,

Abubakar

et al. 2024

PLOS Glob Public Health

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Sub-Saharan Africa, the epicenter of the HIV epidemic, has seen significant reductions in new infections over the last decade. Although most new infections have been reported among women, particularly adolescent girls, men are still disadvantaged in accessing HIV testing, care, and treatment services. Globally, men have relatively poorer HIV testing, care, and treatment indices when compared with women. Gender norms and the associated concept of masculinity, strength, and stereotypes have been highlighted as hindering men’s acceptance of HIV counseling and testing. Therefore, men’s suboptimal uptake of HIV testing services will continue limiting efforts to achieve HIV epidemic control. Thus, this study aimed to identify individual, neighborhood, and country-level determinants of sub-optimal HIV testing among men in Sub-Saharan African countries. We analyzed demographic and health datasets from surveys conducted between 2016 and 2020 in Sub-Saharan African Countries. We conducted multivariable multilevel regression analysis on 52,641 men aged 15–49 years resident in 4,587 clusters across 10 countries. The primary outcome variable was ever tested for HIV. HIV testing services uptake among men in these ten Sub-Saharan African countries was 35.1%, with a high of 65.5% in Rwanda to a low of 10.2% in Guinea. HIV testing services uptake was more likely in men with increasing age, some form of formal education, in employment, ever married, and residents in relatively wealthier households. We also found that men who possessed health insurance, had some form of weekly media exposure, and had accessed the internet were more likely to have ever received an HIV test. Unlike those noted to be less likely to have ever received an HIV test if they had discriminatory attitudes towards HIV, comprehensive HIV knowledge, recent sexual activity, and risky sexual behavior were positive predictors of HIV testing services uptake among men. Furthermore, men in communities with high rurality and illiteracy were less likely to receive an HIV test. Individual and community-level factors influence the uptake of HIV testing among Sub-Saharan African men. There was evidence of geographical clustering in HIV testing uptake among men at the community level, with about two-thirds of the variability attributable to community-level factors. Therefore, HIV testing programs will need to design interventions that ensure equal access to HIV testing services informed by neighborhood socioeconomic conditions, peculiarities, and contexts.

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Socio-economic and demographic factors associated with never having tested for HIV among sexually active men across the four administrative regions of Uganda

Cited by 4 publications

References 62 publications

Pooled prevalence, spatial variation and associated factors of HIV testing uptake among multiple sexual partners in Sub Saharan Africa: Spatial and multilevel analysis

Pooled prevalence, spatial variation and associated factors of HIV testing uptake among multiple sexual partners in Sub Saharan Africa: Spatial and multilevel analysis

The Association Between HIV-Related Stigma and the Uptake of HIV Testing and ART Among Older Adults in Rural South Africa: Findings from the HAALSI Cohort Study

A multilevel analysis of the determinants of HIV testing among men in Sub-Saharan Africa: Evidence from Demographic and Health Surveys across 10 African countries

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