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Trop Med Int Health. 2013 Sep;18(9):1110-1118. doi: 10.1111/tmi.12155.

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

Author information

1
Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
2
Institute for Global Health, University College London, London, UK.
3
University of Amsterdam, Amsterdam, The Netherlands.
4
Institut de Recherches pour le Développement, Dakar, Senegal.
5
Makerere University School of Public Health, Kampala, Uganda.
6
Programme d'Appui au Monde Associatif et Communautaire, Ouagadougou, Burkina Faso.
7
National AIDS Control Program, Nairobi, Kenya.
8
Reach Trust, Lilongwe, Malawi.

Abstract

OBJECTIVES:

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.

KEYWORDS:

HIV; access; provider-initiated testing and counselling; socio-economic; sub-Saharan Africa; testing; voluntary counselling and testing

PMID:
23937702
PMCID:
PMC3808878
DOI:
10.1111/tmi.12155
[Indexed for MEDLINE]
Free PMC Article

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