Frequency of HIV-testing and factors associated with multiple lifetime HIV-testing among a rural population of Zambian men

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  • Hensen, B.
    • Other Affiliation: Department of Social and Environmental Health Research, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
  • Lewis, JJ
    • Other Affiliation: MRC Tropical Epidemiology Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
  • Schaap, A.
    • Other Affiliation: MRC Tropical Epidemiology Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK; ZAMBART Project, Ridgeway Campus, University of Zambia, Nationalist Road, Lusaka, Zambia
  • Tembo, M.
    • Other Affiliation: ZAMBART Project, Ridgeway Campus, University of Zambia, Nationalist Road, Lusaka, Zambia
  • Vera-Hernández, M.
    • Other Affiliation: University College London and Institute for Fiscal Studies, London, UK
  • Mutale, W.
    • Other Affiliation: Department of Public Health, University of Zambia School of Medicine, Lusaka, Zambia
  • Weiss, HA
    • Other Affiliation: MRC Tropical Epidemiology Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
  • Hargreaves, J.
    • Other Affiliation: Department of Social and Environmental Health Research, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
  • Stringer, Jeffrey
    • Affiliation: School of Medicine, Department of Obstetrics and Gynecology
    • Other Affiliation: Global Women’s Health Division; Institute for Global Health and Infectious Diseases
  • Ayles, H.
    • Other Affiliation: ZAMBART Project, Ridgeway Campus, University of Zambia, Nationalist Road, Lusaka, Zambia; Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
Abstract
  • Abstract Background Across sub-Saharan Africa, men's levels of HIV-testing remain inadequate relative to women’s. Men are less likely to access anti-retroviral therapy and experience higher levels of morbidity and mortality once initiated on treatment. More frequent HIV-testing by men at continued risk of HIV-infection is required to facilitate earlier diagnosis. This study explored the frequency of HIV-testing among a rural population of men and the factors associated with more frequent HIV-testing. Methods We conducted a secondary analysis of a population-based survey in three rural district in Zambia, from February-November, 2013. Households (N = 300) in randomly selected squares from 42 study sites, defined as a health facility and its catchment area, were invited to participate. Individuals in eligible households were invited to complete questionnaires regarding demographics and HIV-testing behaviours. Men were defined as multiple HIV-testers if they reported more than one lifetime test. Upon questionnaire completion, individuals were offered rapid home-based HIV-testing. Results Of the 2376 men, more than half (61 %) reported having ever-tested for HIV. The median number of lifetime tests was 2 (interquartile range = 1-3). Just over half (n = 834; 57 %) of ever-testers were defined as multiple-testers. Relative to never-testers, multiple-testers had higher levels of education and were more likely to report an occupation. Among the 719 men linked to a spouse, multiple-testing was higher among men whose spouse reported ever-testing (adjusted prevalence ratio = 3.02 95 % CI: 1.37-4.66). Multiple-testing was higher in study sites where anti-retroviral therapy was available at the health facility on the day of a health facility audit. Among ever-testers, education and occupation were positively associated with multiple-testing relative to reporting one lifetime HIV-test. Almost half (49 %) of ever-testers accepted the offer of home-based HIV-testing. Discussion Reported HIV-testing increased among this population of men since a 2011/12 survey. Yet, only 35 % of all men reported multiple lifetime HIV-tests. The factors associated with multiple HIV-testing were similar to factors associated with ever-testing for HIV. Men living with HIV were less likely to report multiple HIV-tests and employment and education were associated with multiple-testing. The offer of home-based HIV-testing increased the frequency of HIV-testing among men. Conclusion Although men's levels of ever-testing for HIV have increased, strategies need to increase the lifetime frequency of HIV-testing among men at continued risk of HIV-infection.
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  • Article
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  • In Copyright
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  • Hensen et al.
Language
  • English
Bibliographic citation
  • BMC Public Health. 2015 Sep 24;15(1):960
Publisher
  • BioMed Central
Date uploaded
  • October 5, 2015

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