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BMC Public Health. 2015 Feb 12;15:132. doi: 10.1186/s12889-015-1388-z.

HIV testing service awareness and service uptake among female heads of household in rural Mozambique: results from a province-wide survey.

Author information

1
Department of Medicine, Division of Infectious Diseases, Vanderbilt University School of Medicine, 1611 21st Avenue South, A-2200, Medical Center North, Nashville, TN, USA. hnpaulin@gmail.com.
2
Department of Biostatistics, Nashville, TN, USA. meridith.blevins@Vanderbilt.Edu.
3
Vanderbilt University, Vanderbilt Institute for Global Health (VIGH), Nashville, TN, USA. meridith.blevins@Vanderbilt.Edu.
4
Department of Medicine, Division of Infectious Diseases, Vanderbilt University School of Medicine, 1611 21st Avenue South, A-2200, Medical Center North, Nashville, TN, USA. john.r.koethe@Vanderbilt.Edu.
5
Department of Biostatistics, Nashville, TN, USA. nicole.l.hinton@Vanderbilt.Edu.
6
Department of Preventive Medicine, Nashville, TN, USA. lmevaz@gmail.com.
7
Friends in Global Health (FGH), Maputo, Mozambique. lmevaz@gmail.com.
8
Save the Children, Washington, D.C., USA. lmevaz@gmail.com.
9
Department of Preventive Medicine, Nashville, TN, USA. avedoce@gmail.com.
10
Vanderbilt University, Vanderbilt Institute for Global Health (VIGH), Nashville, TN, USA. avedoce@gmail.com.
11
Department of Preventive Medicine, Nashville, TN, USA. abraham.mukolo@Vanderbilt.Edu.
12
Vanderbilt University, Vanderbilt Institute for Global Health (VIGH), Nashville, TN, USA. abraham.mukolo@Vanderbilt.Edu.
13
Friends in Global Health (FGH), Maputo, Mozambique. Elisee.Ndatimana@fgh.org.mz.
14
Department of Pediatrics, Nashville, TN, USA. troy.moon@Vanderbilt.Edu.
15
Vanderbilt University, Vanderbilt Institute for Global Health (VIGH), Nashville, TN, USA. troy.moon@Vanderbilt.Edu.
16
Friends in Global Health (FGH), Maputo, Mozambique. troy.moon@Vanderbilt.Edu.
17
Department of Pediatrics, Nashville, TN, USA. sten.vermund@Vanderbilt.Edu.
18
Vanderbilt University, Vanderbilt Institute for Global Health (VIGH), Nashville, TN, USA. sten.vermund@Vanderbilt.Edu.
19
Department of Medicine, Division of Infectious Diseases, Vanderbilt University School of Medicine, 1611 21st Avenue South, A-2200, Medical Center North, Nashville, TN, USA. william.wester@Vanderbilt.Edu.
20
Vanderbilt University, Vanderbilt Institute for Global Health (VIGH), Nashville, TN, USA. william.wester@Vanderbilt.Edu.

Abstract

BACKGROUND:

HIV voluntary counseling and testing (VCT) utilization remains low in many sub-Saharan African countries, particularly in remote rural settings. We sought to identify factors associated with service awareness and service uptake of VCT among female heads of household in rural Zambézia Province of north-central Mozambique which is characterized by high HIV prevalence (12.6%), poverty, and suboptimal health service access and utilization.

METHODS:

Our population-based survey of female heads of household was administered to a representative two-stage cluster sample using a sampling frame created for use on all national surveys and based on census results. The data served as a baseline measure for the Ogumaniha project initiated in 2009. Survey domains included poverty, health, education, income, HIV stigma, health service access, and empowerment. Descriptive statistics and logistic regression were used to describe service awareness and service uptake of VCT.

RESULTS:

Of 3708 women surveyed, 2546 (69%) were unaware of available VCT services. Among 1162 women who were aware of VCT, 673 (58%) reported no prior testing. In the VCT aware group, VCT awareness was associated with higher education (aOR = 2.88; 95% CI = 1.61, 5.16), higher income (aOR = 1.41, 95% CI = 1.06, 1.86), higher numeracy (aOR = 1.05, CI 1.03, 1.08), more children < age 5 in the home (aOR = 1.53; 95% CI = 1.07, 2.18), closer proximity to a health facility (aOR = 1.05; 95% CI = 1.03, 1.07), and mobile phone ownership (aOR = 1.37; 95% CI = 1.03, 1.84) (all p-values < 0.04). Having a higher HIV-associated stigma score was the factor most strongly associated with being less likely to test. (aOR = 0.41; 95% CI = 0.23, 0.71; p<0.001).

CONCLUSIONS:

Most women were unaware of available VCT services. Even women who were aware of services were unlikely to have been tested. Expanded VCT and social marketing of VCT are needed in rural Mozambique with special attention to issues of community-level stigma reduction.

PMID:
25881182
PMCID:
PMC4339241
DOI:
10.1186/s12889-015-1388-z
[Indexed for MEDLINE]
Free PMC Article

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