Premium
Socio‐economic determinants of HIV testing and counselling: a comparative study in four A frican countries
Author(s) -
Obermeyer Carla Makhlouf,
Neuman Melissa,
Hardon Anita,
Desclaux Alice,
Wanyenze Rhoda,
KyZerbo Odette,
Cherutich Peter,
Namakhoma Ireen
Publication year - 2013
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12155
Subject(s) - voluntary counseling and testing , logistic regression , medicine , developing country , poisson regression , environmental health , multinomial logistic regression , socioeconomic status , human immunodeficiency virus (hiv) , family medicine , health facility , demography , population , health services , economic growth , sociology , economics , machine learning , computer science
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 B urkina F aso, K enya, M alawi and U ganda, as part of the M ulti‐country A frican T esting and C ounselling 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 P oisson 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.