scholarly journals Individual- and Facility-Level Factors Associated with Facility Testing among Men in Malawi: Findings from a Representative Community Survey

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 950
Author(s):  
Kelvin Balakasi ◽  
Brooke E. Nichols ◽  
Misheck Mphande ◽  
Christian Stillson ◽  
Shaukat Khan ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Sexual Partner ◽  
Secondary Analysis ◽  
Sub Saharan Africa ◽  
Logistic Regression Models ◽  
Factors Associated ◽  
Testing Uptake ◽  
Outpatient Departments ◽  
Sub Saharan ◽  
Facility Level

(1) Background: Men frequent outpatient departments (OPD) but are underrepresented in HIV testing services throughout sub-Saharan Africa. (2) Methods: We conducted a secondary analysis on data from a community-based survey with men in rural Malawi to assess factors associated with HIV testing, and being offered testing, during men’s OPD visits. We include OPD visits made by men in-need of testing as our unit of observation. Multilevel mixed-effects logistic regression models were conducted. (3) Results: 782 men were eligible for these analyses, with 1575 OPD visits included (median two visits per man; IQR 1–3). 17% of OPD visits resulted in HIV testing. Being offered testing (aOR 42.45; 95% CI 15.13–119.10) and satisfaction with services received (aOR 3.27; 95% CI 1.28–8.33) were significantly associated with HIV testing. 14% of OPD visits resulted in being offered HIV testing. Being married/steady relationship (aOR 2.53; 95% CI 1.08–5.91) and having a sexual partner living with HIV (aOR 8.22; 95% CI 1.67–40.49) were significantly associated with being offered testing. (4) Conclusion: Being offered HIV testing was the strongest factor associated with testing uptake, while HIV status of sexual partner had the strongest association with being offered testing. Implementation of provider-initiated-testing should be prioritized for male OPD visits.

scholarly journals Women’s Empowerment and HIV Testing Uptake: A Meta-analysis of Demographic and Health Surveys from 33 Sub-Saharan African Countries

2020 ◽  
Vol 9 (3) ◽  
pp. 274-286
Author(s):  
Sanni Yaya ◽  
Gebretsadik Shibre ◽  
Dina Idriss-Wheeler ◽  
Olalekan A Uthman
Keyword(s):  
Global Health ◽  
Hiv Testing ◽  
Women's Empowerment ◽  
Sub Saharan Africa ◽  
Wife Beating ◽  
Women’S Empowerment ◽  
Demographic And Health Surveys ◽  
Women Empowerment ◽  
Testing Uptake ◽  
Sub Saharan

Background: There is a growing body of evidence suggesting that women’s empowerment can help achieve better health behaviours and outcomes. However, few have looked at the impact of women’s empowerment on HIV testing in Sub-Saharan Africa (SSA). This study investigated the association between women’s empowerment and HIV testing among women in 33 countries across SSA. Methods: Cross-sectional data from the most recent Demographic and Health Surveys (2005-2018) of 33 countries in SSA were used. Confounder adjusted logistic regression analysis was completed separately for each of the 33 DHS datasets to produce the adjusted Odds Ratio (OR) for the association between women empowerment and HIV testing. The regression analysis strictly accounted for the three design elements (weight, cluster and strata) to produce an estimate representative of the respective countries. Finally, an Individual Participant Data (IPD) meta-analysis approach was used to statistically pool the effect of women empowerment on HIV testing. Results: There was a wide variation in the percentage of women who were empowered among the countries studied, with only a few countries such as South Africa, Angola and Ghana having a high prevalence of negative attitudes toward wife beating. HIV testing was higher in Angola, Lesotho, Uganda and South Africa. While participation in one or two of the three decisions had been marginally associated with lower odds of HIV testing across the SSA regions (0.89; 95%CI: 0.83, 0.97); the corresponding prediction interval crossed the null. Being involved in the three decisions (0.92; 95%CI: 0.84, 1.00) and disagreement to wife-beating (0.99; 95%CI: 0.94, 1.05) had no statistical relationship with HIV testing uptake. Conclusion and Global Health Implications: The two indirect indicators of women empowerment could not predict HIV testing uptake. Further studies are recommended to establish the nature of the relationship between HIV testing and women’s empowerment that is measured through standard tools. Key words: • HIV/AIDS prevention • Women • Empowerment • Gender equality • Global health • Sub-Saharan Africa   Copyright © 2020 Yaya et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.

scholarly journals Women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa: a multi-country analysis of demographic and health surveys

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Abdul-Aziz Seidu ◽  
Joseph Kojo Oduro ◽  
Bright Opoku Ahinkorah ◽  
Eugene Budu ◽  
Francis Appiah ◽  
...  
Keyword(s):  
Decision Making ◽  
Hiv Testing ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Healthcare Decision ◽  
African Countries ◽  
Healthcare Decision Making ◽  
Decision Making Capacity ◽  
Testing Uptake ◽  
Sub Saharan

Abstract Background Global commitment to stop Human Immunodeficiency Virus (HIV) and ensure access to HIV treatment calls for women empowerment, as these efforts play major roles in mother-to-child transmission. We examined the association between women’s healthcare decision-making capacity and uptake of HIV testing in sub-Saharan Africa. Methods We used data from the current Demographic and Health Surveys (DHS) of 28 countries in sub-Saharan Africa, conducted between January 1, 2010 and December 31, 2018. At the descriptive level, we calculated the prevalence of HIV testing in each of the countries. This was followed by the distribution of HIV testing across the socio-demographic characteristics of women. Finally, we used binary logistic regression assess the likelihood of HIV testing uptake by women’s health care decision-making capacity and socio-demographic characteristics. The results were presented as Crude Odds Ratios (COR) and Adjusted Odds Ratios (AOR) with their corresponding 95% confidence intervals signifying precision. Statistical significance was set at p-value < 0.05. Results We found that prevalence of HIV testing uptake in the 28 sub-Saharan African countries was 64.4%, with Congo DR having the least (20.2%) and the highest occurred in Rwanda (97.4%). Women who took healthcare decisions alone [COR = 3.183, CI = 2.880–3.519] or with their partners [COR = 2.577, CI = 2.335–2.844] were more likely to test for HIV, compared to those whose healthcare decisions were taken by others, and this persisted after controlling for significant covariates: [AOR = 1.507, CI = 1.321–1.720] and [AOR = 1.518, CI = 1.334–1.728] respectively. Conclusion Sub-Saharan African countries intending to improve HIV testing need to incorporate women’s healthcare decision-making capacity strategies. These strategies can include education and counselling. This is essential because our study indicates that the capacity of women to make healthcare decisions has an association with decision to test for their HIV status.

scholarly journals Epidemiological rather than macro-economic factors correlate with socioeconomic inequalities in HIV testing in 16 sub-Saharan African countries

2021 ◽  
Author(s):  
Pearl Anne Ante-Testard ◽  
Laura Temime ◽  
Kevin Jean
Keyword(s):  
Hiv Testing ◽  
Contextual Factors ◽  
Socioeconomic Inequalities ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Economic Factors ◽  
African Countries ◽  
Hiv Epidemic ◽  
Testing Uptake ◽  
Sub Saharan

In order to reach the first 95 (i.e., 95% of people living with HIV having knowledge of their status) of the 2030 UNAIDS 95-95-95 targets, it is crucial to better understand the contextual or structural factors driving socioeconomic inequalities in HIV testing uptake. It is still unclear whether they are mostly influenced by epidemiological or by macro-economic factors. Here, to shed light on this issue, we measured and decomposed socioeconomic inequalities in HIV testing in sub-Saharan Africa in relation to contextual factors using a novel method, the Recentered Influence Function decomposition method. Indeed, we found that HIV testing uptake was more concentrated among the rich in 12 of 16 sub-Saharan African countries based on population-based surveys. The level of the HIV epidemic seems to drive the level of response of HIV testing programs, rather than the per capita Gross Domestic Product of a country (i.e., national indicator of economic development). Our results suggest that when responding to the HIV epidemic, there is a need to monitor and assess inequalities in addition to monitoring HIV incidence and prevalence. Keywords: HIV, HIV testing, socioeconomic inequalities, contextual factors, sub-Saharan Africa, decomposing inequalities

scholarly journals HIV Self-Testing Uptake and Intervention Strategies Among Men in Sub-Saharan Africa: A Systematic Review

2021 ◽  
Vol 9 ◽  
Author(s):  
Akeen Hamilton ◽  
Noah Thompson ◽  
Augustine T. Choko ◽  
Mbuzeleni Hlongwa ◽  
Pauline Jolly ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hiv Testing ◽  
Sex Workers ◽  
Linkage To Care ◽  
Intervention Strategies ◽  
Sub Saharan Africa ◽  
Manual Search ◽  
Self Testing ◽  
Testing Uptake ◽  
Sub Saharan

Background: HIV testing is an essential gateway to HIV prevention and treatment services. However, HIV testing uptake remains low among men due to stigma, discrimination, and confidentiality concerns. HIV self-testing (HIVST) is an alternative HIV testing method that can address many of these barriers for men. We conducted a systematic review to examine HIVST uptake and intervention strategies among Men in Sub-Saharan Africa.Methods: We used a systematic approach to survey literature published from January 2010 to June 2020 using five electronic databases (PubMed-Medline, CINAHL Complete, PsychINFO, Google Scholar, and Web of Science) and a manual search. Studies were included if they were peer-reviewed, published in English, and examined HIVST willingness, uptake, and/or linkage to care and included men in Sub-Saharan Africa.Results: Sixty-three articles related to HIVST were reviewed. Of the included articles, 37 discussed HIVST uptake/acceptability and 24 discussed intervention strategies. Both oral swab and finger-prick methods had high acceptability with ease of access and availability of the test cited as important by men. Free HIVST kits were preferred by men. Secondary distribution of kits via peers, sexual partners, and female sex workers were successful.Conclusion: HIV self-testing is highly acceptable to men. More efforts are needed to develop policies to implement HIVST programs targeting men in Sub-Saharan Africa, including a focus on linkage to care in sub-Saharan Africa. Future interventions should directly target men independently in tandem with using peers and their romantic partners to promote self-testing among men in sub-Saharan Africa. HIVST kit distribution strategies should be combined with services that can offer confirmatory tests and counseling for men as well as linkage to care.

scholarly journals Barriers to HIV testing uptake among men in sub-Saharan Africa: a scoping review

2020 ◽  
Vol 19 (1) ◽  
pp. 13-23 ◽  
Author(s):  
Mbuzeleni Hlongwa ◽  
Tivani Mashamba-Thompson ◽  
Sizwe Makhunga ◽  
Khumbulani Hlongwana
Keyword(s):  
Hiv Testing ◽  
Scoping Review ◽  
Sub Saharan Africa ◽  
Testing Uptake ◽  
Sub Saharan

scholarly journals People Who Inject Drugs, HIV Risk, and HIV Testing Uptake in Sub-Saharan Africa

2013 ◽  
Vol 24 (6) ◽  
pp. e35-e44 ◽  
Author(s):  
Alice K. Asher ◽  
Judith A. Hahn ◽  
Marie-Claude Couture ◽  
Kelsey Maher ◽  
Kimberly Page
Keyword(s):  
Hiv Testing ◽  
Hiv Risk ◽  
People Who Inject Drugs ◽  
Sub Saharan Africa ◽  
Testing Uptake ◽  
Sub Saharan

scholarly journals Time trends in socio-economic inequalities in HIV testing: insights from population-based surveys in 16 sub-Saharan African countries

2019 ◽  
Author(s):  
Pearl Anne Ante-Testard ◽  
Tarik Benmarhnia ◽  
Anne Bekelynck ◽  
Rachel Baggaley ◽  
Eric Ouattara ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Time Trends ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Absolute Difference ◽  
Demographic And Health Surveys ◽  
African Countries ◽  
Testing Uptake ◽  
Sub Saharan ◽  
Economic Inequalities

SummaryBackgroundOverall increase in the uptake of HIV testing in the past decades may hide discrepancies across socio-economic groups. We used population-based surveys conducted in sub-Saharan Africa to quantify socio-economic inequalities in recent HIV testing uptake, together with their trends over the two past decades.MethodsWe analyzed the data from Demographic and Health Surveys in sub-Saharan African countries where at least one survey was conducted before and after 2008. Country- and gender-specific proportions of recent (<12 month) HIV testing were assessed across wealth and education groups, and inequalities were quantified using the relative and slope indices of inequalities. Time trends in inequalities were assessed and results were pooled across countries using random-effect meta-analyses.FindingsWe analyzed data from 32 surveys conducted between 2003 and 2016 in 16 countries among 537,784 participants. In pre-2008 surveys, women reported higher HIV testing uptake than men in 8 out of 16 countries, and in 15 out of 16 countries in post-2008 surveys. After 2008, the wealthiest women were on average 2.77 (95% CI 1.42-5.40) times more likely to report recent testing than the poorest; and 3.55 (1.85-6.81) times in men. The averaged absolute difference in recent testing between the richest and poorest was 11.1 (4.6-17.5) percentage points in women and 15.1 (9.6-20.6) in men. Over time, relative inequalities in recent HIV testing decreased in both genders, while absolute inequalities plateaued in women and increased in men.InterpretationsThe overall increase in HIV testing uptake that was stimulated by the impetus to scale up HIV treatment in sub-Saharan Africa led to a decrease in relative inequalities, while absolute inequalities persisted. Within most countries, large inequalities still remained, both in absolute and relative scales, especially in West and Central Africa. A greater focus should be put on equity in monitoring HIV testing programs.A French version of this article is available in the Appendices [Une version française de cet article est disponible en appendice].FundingINSERM-ANRS (France Recherche Nord & Sud Sida-HIV Hépatites), grant number ANRS-12377.

scholarly journals A systematic review and network meta-analyses to assess the effectiveness of HIV self-testing distribution strategies

2021 ◽  
Author(s):  
Ingrid Eshun-Wilson ◽  
Muhammad S Jamil ◽  
Witzel T. Charles ◽  
Dave V Glidden ◽  
Johnson Cheryl ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hiv Testing ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Web Based ◽  
Standard Testing ◽  
Self Testing ◽  
Testing Uptake ◽  
Sub Saharan ◽  
Meta Analyses

Abstract Background We conducted a systematic review and network meta-analysis to identify which HIV self-testing (HIVST) distribution strategies are most effective. Methods We abstracted data from randomized controlled trials and observational studies published between June 4, 2006 and June 4, 2019. Results We included 33 studies, yielding six HIVST distribution strategies. All distribution strategies increased testing uptake compared to standard testing: in sub-Saharan Africa, partner HIVST distribution ranked highest (78% probability); in North America, Asia and the Pacific regions, web-based distribution ranked highest (93% probability), and facility based distribution ranked second in all settings. Across HIVST distribution strategies HIV positivity and linkage was similar to standard testing. Conclusion A range of HIVST distribution strategies are effective in increasing HIV testing. HIVST distribution by sexual partners, web-based distribution, as well as health facility distribution strategies should be considered for implementation to expand the reach of HIV testing services.

scholarly journals Decomposing the rural–urban gap in factors associated with childhood immunisation in sub-Saharan Africa: evidence from surveys in 23 countries

2021 ◽  
Vol 6 (1) ◽  
pp. e003773
Author(s):  
Edward Kwabena Ameyaw ◽  
Yusuf Olushola Kareem ◽  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Sanni Yaya
Keyword(s):  
Decomposition Analysis ◽  
Household Wealth ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Childhood Immunisation ◽  
Urban Settings ◽  
Factors Associated ◽  
Rural And Urban ◽  
Full Immunisation ◽  
Sub Saharan

BackgroundAbout 31 million children in sub-Saharan Africa (SSA) suffer from immunisation preventable diseases yearly and more than half a million children die because of lack of access to immunisation. Immunisation coverage has stagnated at 72% in SSA over the past 6 years. Due to evidence that full immunisation of children may be determined by place of residence, this study aimed at investigating the rural–urban differential in full childhood immunisation in SSA.MethodsThe data used for this study consisted of 26 241 children pooled from 23 Demographic and Health Surveys conducted between 2010 and 2018 in SSA. We performed a Poisson regression analysis with robust Standard Errors (SEs) to determine the factors associated with full immunisation status for rural and urban children. Likewise, a multivariate decomposition analysis for non-linear response model was used to examine the contribution of the covariates to the observed rural and urban differential in full childhood immunisation. All analyses were performed using Stata software V.15.0 and associations with a p<0.05 were considered statistically significant.ResultsMore than half of children in urban settings were fully immunised (52.8%) while 59.3% of rural residents were not fully immunised. In all, 76.5% of rural–urban variation in full immunisation was attributable to differences in child and maternal characteristics. Household wealth was an important component contributing to the rural–urban gap. Specifically, richest wealth status substantially accounted for immunisation disparity (35.7%). First and sixth birth orders contributed 7.3% and 14.9%, respectively, towards the disparity while 7.9% of the disparity was attributable to distance to health facility.ConclusionThis study has emphasised the rural–urban disparity in childhood immunisation, with children in the urban settings more likely to complete immunisation. Subregional, national and community-level interventions to obviate this disparity should target children in rural settings, those from poor households and women who have difficulties in accessing healthcare facilities due to distance.

Sign in / Sign up

Export Citation Format

Share Document