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East Afr Med J. 1994 Aug;71(8):483-9.

Demographic and AIDS-related characteristics of consenters to a population-based HIV-survey: results from a pilot study in Arusha, Tanzania.

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  • 1Tanzanian-Norwegian AIDS Project (MUTAN), Arusha.

Abstract

The aim was to compare demographic and AIDS-related characteristics of people who consented to HIV-testing as part of a population survey with those who did not consent to HIV-testing. Subjects, aged 15-54 years, living in ten randomly selected clusters of households in one ward of Arusha town were asked to participate in a structured interview and to provide a blood sample for HIV-testing. Measurements included demographic variables and AIDS-related factors, such as knowledge of AIDS and sexual behaviour, and HIV-testing with Western Blot confirmation. Sixty-two percent of the eligible population (N = 600) participated in the interview, while 38% consented to HIV-testing. Odds ratio analysis techniques were used to compare consenters and non-consenters. More women than men participated in the interview (OR = 4.23), and participating men were younger than non-participating men (29.1 vs 31.9 years). Subjects who had attended secondary school were underrepresented among the HIV- test consenters (OR = 0.40). No other demographic or AIDS-related differences were observed between HIV-test consenters and non-consenters. At least in this pilot, non- consenters did not appear to be at any higher risk for HIV-infection than the consenters. Future population-based HIV-surveys might have to compromise on maximizing participation rate in order to secure informed, non-coerced consent from participants.

PIP:

Tanzania is one of the countries in East Africa most severely affected by the HIV/AIDS epidemic. Population-based HIV surveys have been given high priority by the research community in Tanzania because of their ability to provide information on the progression of the epidemic. One major methodological problem with such surveys, however, is the potential for low participation rates which may, in turn, challenge the validity of the data. The authors compared the demographic and AIDS-related characteristics of people who consented to HIV testing as part of a population survey with those who did not consent to such testing. One ward of Arusha was approached in 1991 through the local government and party leaders in which 360 men and 378 women aged 15-54 years were initially registered as eligible to participate in the study. 138 of the individuals had moved, were traveling outside of town for the duration of the study, or had died, and were therefore ineligible to participate in the study. 372 of the remaining 600 individuals consented to participate in a structured interview; 77.8% of the women and 43.9% of men. Only eight people actually refused to be interviewed. 148 others who were not interviewed had work obligations which had them away from home, while information is lacking on reasons for the nonparticipation of 72 subjects. Men who consented to be interviewed were of mean age 29.1 years compared to non-consenters who were of mean age 31.9 years. 227 of the subjects interviewed gave their consent to be tested for HIV-1. Odds ratio analysis techniques were used to compare consenters and non-consenters. In addition to the sex and age differences between the two groups, subjects with secondary or higher education were more likely to refuse HIV testing than subjects with less formal education. No other demographic or AIDS-related differences were observed between HIV test consenters and non-consenters. Non-consenters did not appear to be at any higher risk for HIV infection than consenters. These study results indicate the existence of a potential conflict between achieving a high participation rate and obtaining informed noncoerced consent for participation in population-based HIV surveys. This problem may be increasing as populations become more aware of the HIV/AIDS epidemic and its consequences.

PMID:
7867536
[PubMed - indexed for MEDLINE]
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