Socio-economic determinants of HIV testing and counselling: a comparative study in four African countries
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Date
2013
Journal Title
Journal ISSN
Volume Title
Publisher
Tropical Medicine and International Health
Abstract
Research indicates that individuals tested for HIV have higher socio-economic status
than those not tested, but less is known about how socio-economic status is associated with modes of
testing. We compared individuals tested through provider-initiated testing and counselling (PITC),
those tested through voluntary counselling and testing (VCT) and those never tested.
methods Cross-sectional surveys were conducted at health facilities in Burkina Faso, Kenya,
Malawi and Uganda, as part of the Multi-country African Testing and Counselling for HIV
(MATCH) study. A total of 3659 clients were asked about testing status, type of facility of most
recent test and socio-economic status. Two outcome measures were analysed: ever tested for HIV and
mode of testing. We compared VCT at stand-alone facilities and PITC, which includes integrated
facilities where testing is provided with medical care, and prevention of mother-to-child transmission
(PMTCT) facilities. The determinants of ever testing and of using a particular mode of testing were
analysed using modified Poisson regression and multinomial logistic analyses.
results Higher socio-economic status was associated with the likelihood of testing at VCT rather
than other facilities or not testing. There were no significant differences in socio-economic
characteristics between those tested through PITC (integrated and PMTCT facilities) and those not
tested.
conclusions Provider-initiated modes of testing make testing accessible to individuals from lower
socio-economic groups to a greater extent than traditional VCT. Expanding testing through PMTCT
reduces socio-economic obstacles, especially for women. Continued efforts are needed to encourage
testing and counselling among men and the less affluent.
Description
Keywords
HIV, testing, sub-Saharan Africa, socio-economic, voluntary counselling and testing, , provider-initiated testing and counselling
Citation
Obermeyer, C. M., Neuman, M., Hardon, A., Desclaux, A., Wanyenze, R., Ky‐Zerbo, O., ... & Namakhoma, I. (2013). Socio‐economic determinants of HIV testing and counselling: a comparative study in four A frican countries. Tropical medicine & international health, 18(9), 1110-1118.doi:10.1111/tmi.12155