Socio‐economic determinants of <scp>HIV</scp> testing and counselling: a comparative study in four <scp>A</scp>frican countries

Obermeyer, Carla Makhlouf; Neuman, Melissa; Hardon, Anita; Desclaux, Alice; Wanyenze, Rhoda K.; Ky-Zerbo, Odette; Cherutich, Peter; Namakhoma, Ireen

doi:10.1111/tmi.12155

Cited by 51 publications

(58 citation statements)

References 25 publications

(40 reference statements)

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“…As previously documented, we observed among both men and women that testing uptake increased with educational level and wealth [13, 25, 35, 36]. Similarly, high HIV-related knowledge and access to broader information channels, through media exposure, was associated with HIV testing [35–39]. These results highlight the importance of providing health education to both women and men while deploying targeted efforts to reach populations with low uptake of HIV testing.…”

Section: Discussionsupporting

confidence: 80%

Uptake of HIV testing in Burkina Faso: an assessment of individual and community-level determinants

Kirakoya‐Samadoulougou

Jean

Maheu‐Giroux

2017

BMC Public Health

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BackgroundPrevious studies have highlighted a range of individual determinants associated with HIV testing but few have assessed the role of contextual factors. The objective of this paper is to examine the influence of both individual and community-level determinants of HIV testing uptake in Burkina Faso.MethodsUsing nationally representative cross-sectional data from the 2010 Demographic and Health Survey, the determinants of lifetime HIV testing were examined for sexually active women (n = 14,656) and men (n = 5680) using modified Poisson regression models.ResultsOne third of women (36%; 95% Confidence Interval (CI): 33–37%) reported having ever been tested for HIV compared to a quarter of men (26%; 95% CI: 24–27%). For both genders, age, education, religious affiliation, household wealth, employment, media exposure, sexual behaviors, and HIV knowledge were associated with HIV testing. After adjustment, women living in communities where the following characteristics were higher than the median were more likely to report uptake of HIV testing: knowledge of where to access testing (Prevalence Ratio [PR] = 1.41; 95% CI: 1.34–1.48), willing to buy food from an infected vendor (PR = 2.06; 95% CI: 1.31–3.24), highest wealth quintiles (PR = 1.18; 95% CI: 1.10–1.27), not working year-round (PR = 0.90; 95% CI: 0.84–0.96), and high media exposure (PR = 1.11; 95% CI: 1.03–1.19). Men living in communities where the proportion of respondents were more educated (PR = 1.23; 95% CI: 1.07–1.41) than the median were more likely to be tested.ConclusionsThis study shed light on potential mechanisms through which HIV testing could be increased in Burkina Faso. Both individual and contextual factors should be considered to design effective strategies for scaling-up HIV testing.

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Section: Discussionsupporting

confidence: 80%

Uptake of HIV testing in Burkina Faso: an assessment of individual and community-level determinants

Kirakoya‐Samadoulougou

Jean

Maheu‐Giroux

2017

BMC Public Health

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“…20,48,50 In regards to HIV knowledge and awareness, the highest estimates for HIV testing coverage are observed among individuals with medium to higher HIV/AIDS awareness, echoing the results found in the previous studies. 7,13 At community level, community poverty, HIV-related stigma and media exposure were found to be associated with HIV testing. Community level risky sexual behaviour and HIV awareness were not associated with HIV testing, consistent with findings from previous studies.…”

Section: Key Findingsmentioning

confidence: 99%

“…Individuals who are divorced, widowed and married tend to have higher odds of HIV testing than never married individuals. [12][13][14] For example, married individuals were found to be 2.54 times more likely to be tested for HIV than never married individuals in South Africa. 15 Similarly, a study in Ivory Coast 16 found that never married individuals were 66% less likely to be tested than married people.…”

Section: Introductionmentioning

confidence: 99%

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

Gazimbi

Magadi²

2017

HIV/AIDS Res Treat Open J

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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.

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“…While a history of childhood sexual violence is not associated with HIV Testing and Counseling (HTC) knowledge or uptake, family wealth was strongly associated. Previous research indicates that HTC knowledge and testing rates are associated with wealth and socioeconomic status in a variety of contexts (Helleringer, Kohler, Frimpong, & Mkandawire, 2009) and has been confirmed in several national surveys in Africa (Central Statistical Office, Ministry of Health, Tropical Diseases Research Center and University of Zambia, & Macro International Inc., 2009; National Statistical Office & ICF Macro, 2011; Obermeyer et al, 2013; Uganda Ministry of Health, 2011). For example, the 2011/2012 Tanzania AIDS Indicator Survey (Tanzania Commission for AIDS Commission, National Bureau of Statistics, Office of the Chief Government Statistician, & ICF International, 2013) found that 83.8% of females in the lowest wealth quintile knew where to go for HIV testing compared to 93.0% in the highest wealth quintile, and 53.4% of females in the lowest quintile had ever been tested for HIV compared to 69.6% in the highest quintile.…”

Section: Discussionmentioning

confidence: 85%

HIV and Childhood Sexual Violence: Implications for Sexual Risk Behaviors and HIV Testing in Tanzania

Chiang¹,

Chen²,

Gladden³

et al. 2015

AIDS Education and Prevention

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Prior research has established an association between sexual violence and HIV. Exposure to sexual violence during childhood can profoundly impact brain architecture and stress regulatory response. As a result, individuals who have experienced such trauma may engage in sexual risk-taking behavior and could benefit from targeted interventions. In 2009, nationally representative data were collected on violence against children in Tanzania from 13–24 year old respondents (n = 3,739). Analyses show that females aged 19–24 (n = 579) who experienced childhood sexual violence, were more likely to report no/infrequent condom use in the past 12 months (AOR = 3.0, CI [1.5, 6.1], p = 0.0017) and multiple sex partners in the past 12 months (AOR = 2.3, CI [1.0, 5.1], p = 0.0491), but no more likely to know where to get HIV testing or to have ever been tested. Victims of childhood sexual violence could benefit from targeted interventions to mitigate impacts of violence and prevent HIV.

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Socio‐economic determinants of HIV testing and counselling: a comparative study in four African countries

Cited by 51 publications

References 25 publications

Uptake of HIV testing in Burkina Faso: an assessment of individual and community-level determinants

Uptake of HIV testing in Burkina Faso: an assessment of individual and community-level determinants

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

HIV and Childhood Sexual Violence: Implications for Sexual Risk Behaviors and HIV Testing in Tanzania

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