Equity in HIV testing: evidence from a cross-sectional study in ten Southern African countries

BMC International Health and Human Rights

Research Article

Anne Cockcroft¹  Steven Mitchell²  Neil Andersson³  Gilles Lamothe⁴ 

[1] CIET Trust Botswana, PO Box 1240, Gaborone, Botswana;CIETcanada, 1 Stewart Street, Ottawa, Ontario, Canada;Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Mexico;Department of Mathematics and Statistics, University of Ottawa, Canada;

关键词: Intimate Partner Violence;    Partner Violence;    Risky Sexual Behaviour;    Testing Uptake;    Southern African Country;   

DOI  :  10.1186/1472-698X-10-23

 received in 2010-04-09, accepted in 2010-09-13,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundHIV testing with counseling is an integral component of most national HIV and AIDS prevention strategies in southern Africa. Equity in testing implies that people at higher risk for HIV such as women; those who do not use condoms consistently; those with multiple partners; those who have suffered gender based violence; and those who are unable to implement prevention choices (the choice-disabled) are tested and can have access to treatment.MethodsWe conducted a household survey of 24,069 people in nationally stratified random samples of communities in Botswana, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland, Tanzania, Zambia, and Zimbabwe. We asked about testing for HIV in the last 12 months, intention to test, and about HIV risk behaviour, socioeconomic indicators, access to information, and attitudes related to stigma.ResultsAcross the ten countries, seven out of every ten people said they planned to have an HIV test but the actual proportion tested in the last 12 months varied from 24% in Mozambique to 64% in Botswana. Generally, people at higher risk of HIV were not more likely to have been tested in the last year than those at lower risk, although women were more likely than men to have been tested in six of the ten countries. In Swaziland, those who experienced partner violence were more likely to test, but in Botswana those who were choice-disabled for condom use were less likely to be tested. The two most consistent factors associated with HIV testing across the countries were having heard about HIV/AIDS from a clinic or health centre, and having talked to someone about HIV and AIDS.ConclusionsHIV testing programmes need to encourage people at higher risk of HIV to get tested, particularly those who do not interact regularly with the health system. Service providers need to recognise that some people are not able to implement HIV preventive actions and may not feel empowered to get themselves tested.

【 授权许可】

CC BY   
© Mitchell et al; licensee BioMed Central Ltd. 2010