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Wang D, Zhou Y, Wu D, Tucker JD, Ni Y, Lu Y, Lyu H, Ong J, He X, Huang S, Tang W. Factors Associated with the First-time HIV Testing Among Chinese men who have sex with men Who Received HIV Self-tests from Partners or Friends. AIDS Behav 2024; 28:705-712. [PMID: 38194057 DOI: 10.1007/s10461-023-04259-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2023] [Indexed: 01/10/2024]
Abstract
Secondary distribution of HIV self-testing (HIVST) among individual social networks was an effective approach to expanding HIV testing among men who have sex with men (MSM). However, understanding the factors associated with first-time HIV testing behaviors in the secondary distribution of HIVST programs is limited. Hence, this study aims to identify factors related to first-time testers in the secondary distribution of HIVST. Participants were recruited from five provinces in southern China through Blued, a geo-social gay networking app in China from January 2021 to December 2021. Eligible consented participants (referred to as "seeds") finished a baseline survey and then applied for up to five HIVST kits. They were encouraged to distribute HIVST kits to other MSM (referred to as "alters") and alters were encouraged to scan a QR code to return their photographed testing results. All alters were invited to finish an online survey. In total, 229 seeds reached 292 alters, among whom 126 (43.2%) were first-time testers whereas 166 (56.8%) were non-first-time testers. Importantly, our results demonstrated that the first-time HIV testers were more likely to self-report as heterosexual (aOR = 4.88, 95% CI 1.01-23.61), disclose sexual orientation and/or SSB (aOR = 1.73, 95% CI 1.01-2.96), and receive HIVST knowledge from the seeds (aOR = 3.25, 95% CI 1.02-10.34). However, those who had sex with male partners in the last three months were less likely to be first-time testers (aOR = 0.43, 95% CI 0.23-0.82). Practical implications and limitations were also discussed to improve future HIV prevention programs.
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Affiliation(s)
- Dongya Wang
- School of Communication, University of Miami, Miami, FL, USA
- Dermatology Hospital of Southern Medical University, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
| | - Yi Zhou
- Zhuhai Center for Diseases Control and Prevention, Zhuhai, China
| | - Dan Wu
- University of North Carolina Project-China, Guangzhou, China
- London School of Hygiene and Tropical Medicine, London, UK
| | - Joseph D Tucker
- University of North Carolina Project-China, Guangzhou, China
- London School of Hygiene and Tropical Medicine, London, UK
| | - Yuxin Ni
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, USA
| | - Ying Lu
- Dermatology Hospital of Southern Medical University, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
| | - Hang Lyu
- Zhuhai Center for Diseases Control and Prevention, Zhuhai, China
| | - Jason Ong
- London School of Hygiene and Tropical Medicine, London, UK
| | - Xi He
- Zhuhai Xutong Voluntary Services Center, Zhuhai, China
| | - Shanzi Huang
- Zhuhai Center for Diseases Control and Prevention, Zhuhai, China
| | - Weiming Tang
- Dermatology Hospital of Southern Medical University, Guangzhou, China.
- University of North Carolina Project-China, Guangzhou, China.
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Ndungu K, Gichangi P, Temmerman M. Exploring the willingness toward HIV immediate test and treat among MSM in Nairobi and its environs: a cross-sectional study. Front Public Health 2024; 11:1228709. [PMID: 38235156 PMCID: PMC10792060 DOI: 10.3389/fpubh.2023.1228709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/23/2023] [Indexed: 01/19/2024] Open
Abstract
Background In the test and treat initiative, high-risk populations are screened for human immunodeficiency virus (HIV) infection and start early treatment if diagnosed positive. This study explores factors associated with willingness to initiate testing and immediate treatment among men who have sex with men (MSM) in Nairobi and its environs. The study was informed by a conceptual framework combining the AIDS Risk Reduction Model (ARRM) and the Modified Social Ecological Model. Methods This cross-sectional exploratory study targeted MSM (aged 18-60 years) reporting active engagement in anal or oral sex with men in Nairobi and its surrounding areas. Purposive sampling was used to identify data collection sites, and then snowballing was employed to reach the respondents. Data analysis was performed using SPSS version 23, and binary logistics regression was used for inferential analysis. Results Between July 2018 and June 2019, 391 MSM were recruited to fill out a self-administered questionnaire, out of which 345 complete questionnaires were analyzed. Never been tested for HIV, private/NGO as the facility of the last HIV test, and had unprotected anal sex were listed as the reasons for taking the most recent test, and the results of the most recent HIV test and seeking a post self-test confirmation were associated with a higher likelihood of accepting the immediate HIV test and treat initiative. Additionally, a preference for a health provider as the first source of support, belief in the efficacy of ARVs, and disclosure about being on ART were the other reasons. Additionally, being aged 25+ years, having more than 60 USD monthly income, and having inconsistent condom use during sex were associated with a higher likelihood of accepting the immediate HIV test and treat initiative. Barriers to the immediate test and treat strategy included stigma from healthcare providers and concerns about disruptions in lifestyle through antiretroviral therapy (ART) use. Conclusion Interventions aimed at increasing the HIV test and treat initiative in Kenya may need to take into account the demographic and social characteristics of MSM, including age, lack of habitual HIV testing, and lifestyle changes before and upon enrollment in ART. Projects should also consider working closely with healthcare facilities to strengthen treatment preparation, especially for asymptomatic MSM and those who may not be immediately willing to choose the test and treat strategy.
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Affiliation(s)
- Kingori Ndungu
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Peter Gichangi
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Department of Environment and Health Sciences, Technical University of Mombasa, Mombasa, Kenya
- International Centre for Reproductive Health, Mombasa, Kenya
| | - Marleen Temmerman
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- International Centre for Reproductive Health, Mombasa, Kenya
- Aga Khan University Hospital, Nairobi, Kenya
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Muinde R, Owuor K, Mutiso J, Mwangi J, Wekesa P. Optimizing HIV case identification: investigating client characteristics predictive of HIV positivity from provider-initiated testing (PITC) in central Kenya. BMC Health Serv Res 2023; 23:1005. [PMID: 37726795 PMCID: PMC10508048 DOI: 10.1186/s12913-023-09876-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 08/04/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Routine program data indicates positivity rates under 2% from HIV testing services (HTS) at sites supported by Centre for Health Solutions-Kenya in Central Kenya. Achieving the UNAIDS 95:95:95 goals requires continuous identification of people living with HIV in an environment of diminishing resources. We assessed non-clinical and clinical characteristics of persons who tested HIV-positive aimed at improving the process of HTS through Provider-Initiated HIV Testing & Counseling (PITC). METHODS We conducted a retrospective analysis of routine PITC program data collected between October 2018 and September 2019 from six health facilities located in three counties in central Kenya. Stratification was based on county and facility volume. A multivariable logistic regression model, clustered adjusted for facility using robust standard errors, was used to determine predictors of a positive HIV result. RESULTS The total sample was 80,693 with an overall positivity rate of 1.2%. Most, (65.5%), were female and 6.1% were < 15 years. Most clients, 55,464 (68.7%), had previously tested for HIV. Client characteristics associated with a higher odds of positivity on multivariable analysis included: being female (adjusted odds ratio [aOR] 1.27, 95% confidence interval [CI] (1.03-1.57); adults 15 years and above compared to children < 15 years, divorced and married polygamous compared to married monogamous [aOR 3.98, 95% CI (2.12-7.29) and aOR 2.41 95% CI (1.48-3.94) respectively]; clients testing for the first time compared to repeat testers in less than 12 months [aOR 1.39, 95% CI (1.27-1.51)]. Similarly, repeat testers in more than 12 months compared to repeat testers in less than 12 months [aOR 1.90, 95% CI (1.55-2.32)]; presumptive TB clients compared to those without signs of TB [aOR 16.25, 95% CI (10.63-24.84)]. Clients tested at inpatient departments (IPD) were more likely to get a positive HIV result compared to those tested at outpatient departments (OPD), and other departments. CONCLUSIONS The study findings highlight client characteristics such as age, marital status, HIV test entry point, first-time test, repeat test after 12 months, and TB status as factors that could influence PITC results and could be used to develop a screening tool to target eligible clients for HTS in low HIV prevalence settings.
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Affiliation(s)
| | | | | | - Jonathan Mwangi
- Division of Global HIV & TB, Center for Global Health, US Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Paul Wekesa
- Centre for Health Solutions, Nairobi, Kenya.
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Msukwa MT, MacLachlan EW, Gugsa ST, Theu J, Namakhoma I, Bangara F, Blair CL, Payne D, Curran KG, Arons M, Namachapa K, Wadonda N, Kabaghe AN, Dobbs T, Shanmugam V, Kim E, Auld A, Babaye Y, O'Malley G, Nyirenda R, Bello G. Characterising persons diagnosed with HIV as either recent or long-term using a cross-sectional analysis of recent infection surveillance data collected in Malawi from September 2019 to March 2020. BMJ Open 2022; 12:e064707. [PMID: 36153024 PMCID: PMC9511604 DOI: 10.1136/bmjopen-2022-064707] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/09/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES In Malawi, a recent infection testing algorithm (RITA) is used to characterise infections of persons newly diagnosed with HIV as recent or long term. This paper shares results from recent HIV infection surveillance and describes distribution and predictors. SETTING Data from 155 health facilities in 11 districts in Malawi were pooled from September 2019 to March 2020. PARTICIPANTS Eligible participants were ≥13 years, and newly diagnosed with HIV. Clients had RITA recent infections if the rapid test for recent infection (RTRI) test result was recent and viral load (VL) ≥1000 copies/mL; if VL was <1000 copies/mL the RTRI result was reclassified as long-term. Results were stratified by age, sex, pregnancy/breastfeeding status and district. RESULTS 13 838 persons consented to RTRI testing and 12 703 had valid RTRI test results and VL results after excluding clients not newly HIV-positive, RTRI negative or missing data (n=1135). A total of 12 365 of the 12 703 were included in the analysis after excluding those whose RTRI results were reclassified as long term (n=338/784 or 43.1%). The remainder, 446/12 703 or 3.5%, met the definition of RITA recent infection. The highest percentage of recent infections was among breastfeeding women (crude OR (COR) 3.2; 95% CI 2.0 to 5.0), young people aged 15-24 years (COR 1.6; 95% CI 1.3 to 1.9) and persons who reported a negative HIV test within the past 12 months (COR 3.3; 95% CI 2.6 to 4.2). Factors associated with recent infection in multivariable analysis included being a non-pregnant female (adjusted OR (AOR) 1.4; 95% CI 1.2 to 1.8), a breastfeeding female (AOR 2.2; 95% CI 1.4 to 3.5), aged 15-24 years (AOR 1.6; 95% CI 1.3 to 1.9) and residents of Machinga (AOR 2.0; 95% CI 1.2 to 3.5) and Mzimba (AOR 2.4; 95% CI 1.3 to 4.5) districts. CONCLUSIONS Malawi's recent HIV infection surveillance system demonstrated high uptake and identified sub-populations of new HIV diagnoses with a higher percentage of recent infections.
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Affiliation(s)
- Malango T Msukwa
- Department of Global Health, I-TECH, University of Washington, Lilongwe, Malawi
| | - Ellen W MacLachlan
- Department of Global Health, I-TECH, University of Washington, Seattle, Washington, USA
| | - Salem T Gugsa
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Joe Theu
- Department of Global Health, I-TECH, University of Washington, Lilongwe, Malawi
| | - Ireen Namakhoma
- Department of Global Health, I-TECH, University of Washington, Lilongwe, Malawi
| | - Fred Bangara
- Department of Global Health, I-TECH, University of Washington, Lilongwe, Malawi
| | - Christopher L Blair
- Department of Global Health, I-TECH, University of Washington, Lilongwe, Malawi
| | - Danielle Payne
- Centers for Disease Control and Prevention, Lilongwe, Malawi
| | - Kathryn G Curran
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Melissa Arons
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Khumbo Namachapa
- Department of HIV and AIDS, Ministry of Health, Lilongwe, Central Region, Malawi
| | - Nellie Wadonda
- Centers for Disease Control and Prevention, Lilongwe, Malawi
| | | | - Trudy Dobbs
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Evelyn Kim
- Centers for Disease Control and Prevention, Lilongwe, Malawi
| | - Andrew Auld
- Centers for Disease Control and Prevention, Lilongwe, Malawi
| | - Yusuf Babaye
- Department of Global Health, I-TECH, University of Washington, Lilongwe, Malawi
| | - Gabrielle O'Malley
- Department of Global Health, I-TECH, University of Washington, Seattle, Washington, USA
| | - Rose Nyirenda
- Department of HIV and AIDS, Ministry of Health, Lilongwe, Central Region, Malawi
| | - George Bello
- Department of Global Health, I-TECH, University of Washington, Lilongwe, Malawi
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Nardell MF, Hedt-Gauthier B, Earnshaw VA, Bogart LM, Dietrich JJ, Courtney I, Tshabalala G, Bor J, Orrell C, Gray G, Bangsberg DR, Katz IT. Understanding Repeat Positive HIV Testing in South Africa Under Changing Treatment Guidelines. AIDS Behav 2022; 26:1366-1376. [PMID: 34705150 PMCID: PMC9007825 DOI: 10.1007/s10461-021-03493-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2021] [Indexed: 01/06/2023]
Abstract
Some people with HIV (PWH) test positive multiple times without initiating antiretroviral therapy (ART). We surveyed 496 ART-eligible PWH following routine HIV testing at three clinics in Soweto and Gugulethu, South Africa in 2014-2015. Among repeat positive testers (RPTs) in this cohort, we compared rates of treatment initiation by prior treatment eligibility and assessed psychosocial predictors of treatment initiation in logistic regression models. RPTs represented 33.8% of PWH in this cohort. Less than half of those who reported eligibility for ART on prior testing started treatment upon retesting, in contrast to two thirds of RPTs who were previously ineligible for treatment who started treatment once they learned of their eligibility. Those who reported coping through substance use were more likely to decline treatment versus those not using substances. PWH who test repeatedly represent a vulnerable population at risk for ART non-initiation who may benefit from interventions addressing individualized coping strategies.
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Affiliation(s)
- Maria F Nardell
- Division of Global Health Equity, Brigham and Women's Hospital, Thorn Building 14th Floor, Boston, MA, 02120, USA.
- Harvard Medical School, Boston, USA.
- Department of Medicine, Brigham and Women's Hospital, Boston, USA.
| | - Bethany Hedt-Gauthier
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA
- Massachusetts General Hospital Center for Global Health, Boston, USA
| | - Valerie A Earnshaw
- Department of Human Development and Family Sciences, University of Delaware, Newark, USA
| | | | - Janan J Dietrich
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Health Systems Research Unit, South African Medical Research Council, Western Cape, South Africa
| | - Ingrid Courtney
- Desmond Tutu Health Foundation, University of Cape Town Medical School, Cape Town, South Africa
| | - Gugulethu Tshabalala
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Jacob Bor
- Department of Global Health, Boston University School of Public Health, Boston, USA
| | - Catherine Orrell
- Desmond Tutu Health Foundation, University of Cape Town Medical School, Cape Town, South Africa
| | - Glenda Gray
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- Office of the President, South African Medical Research Council, Western Cape, South Africa
| | - David R Bangsberg
- Oregon Health & Science University-Portland State University School of Public Health, Portland, USA
| | - Ingrid T Katz
- Harvard Medical School, Boston, USA
- Department of Medicine, Brigham and Women's Hospital, Boston, USA
- Massachusetts General Hospital Center for Global Health, Boston, USA
- Harvard Global Health Institute, Cambridge, USA
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Nardell MF, Adeoti O, Peters C, Kakuhikire B, Govathson-Mandimika C, Long L, Pascoe S, Tsai AC, Katz IT. Men missing from the HIV care continuum in sub-Saharan Africa: a meta-analysis and meta-synthesis. J Int AIDS Soc 2022; 25:e25889. [PMID: 35324089 PMCID: PMC8944222 DOI: 10.1002/jia2.25889] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 02/01/2022] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Men are missing along the HIV care continuum. However, the estimated proportions of men in sub-Saharan Africa meeting the UNAIDS 95-95-95 goals vary substantially between studies. We sought to estimate proportions of men meeting each of the 95-95-95 goals across studies in sub-Saharan Africa, describe heterogeneity, and summarize qualitative evidence on factors influencing care engagement. METHODS We systematically searched PubMed and Embase for peer-reviewed articles published between 1 January 2014 and 16 October 2020. We included studies involving men ≥15 years old, with data from 2009 onward, reporting on at least one 95-95-95 goal in sub-Saharan Africa. We estimated pooled proportions of men meeting these goals using DerSimonion-Laird random effects models, stratifying by study population (e.g. studies focusing exclusively on men who have sex with men vs. studies that did not), facility setting (healthcare vs. community site), region (eastern/southern Africa vs. western/central Africa), outcome measurement (e.g. threshold for viral load suppression), median year of data collection (before vs. during or after 2017) and quality criteria. Data from qualitative studies exploring barriers to men's HIV care engagement were summarized using meta-synthesis. RESULTS AND DISCUSSION We screened 14,896 studies and included 129 studies in the meta-analysis, compiling data over the data collection period. Forty-seven studies reported data on knowledge of serostatus, 43 studies reported on antiretroviral therapy use and 74 studies reported on viral suppression. Approximately half of men with HIV reported not knowing their status (0.49 [95% CI, 0.41-0.58; range, 0.09-0.97]) or not being on treatment (0.58 [95% CI, 0.51-0.65; range, 0.07-0.97]), while over three-quarters of men achieved viral suppression on treatment (0.79 [95% CI, 0.77-0.81; range, 0.39-0.97]. Heterogeneity was high, with variation in estimates across study populations, settings and outcomes. The meta-synthesis of 40 studies identified three primary domains in which men described risks associated with engagement in HIV care: perceived social norms, health system challenges and poverty. CONCLUSIONS Psychosocial and systems-level interventions that change men's perceptions of social norms, improve trust in and accessibility of the health system, and address costs of accessing care are needed to better engage men, especially in HIV testing and treatment.
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Affiliation(s)
- Maria F Nardell
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Oluwatomi Adeoti
- Department of Medicine, Boston Medical Center, Boston, Massachusetts, USA
| | - Carson Peters
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA
| | - Bernard Kakuhikire
- Faculty of Business and Management Sciences, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Caroline Govathson-Mandimika
- Health Economics and Epidemiology Research Office, University of the Witwatersrand, Johannesburg, South Africa
- Department of Internal Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Lawrence Long
- Health Economics and Epidemiology Research Office, University of the Witwatersrand, Johannesburg, South Africa
- Department of Internal Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Sophie Pascoe
- Health Economics and Epidemiology Research Office, University of the Witwatersrand, Johannesburg, South Africa
- Department of Internal Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Alexander C Tsai
- Harvard Medical School, Boston, Massachusetts, USA
- Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts, USA
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Ingrid T Katz
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Global Health Institute, Cambridge, Massachusetts, USA
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Nabukalu D, Ponticiello M, Bennett T, Clark S, King R, Mwanga-Amumpaire J, Sundararajan R. Factors associated with HIV testing among traditional healers and their clients in rural Uganda: Results from a cross-sectional study. Int J STD AIDS 2021; 32:1043-1051. [PMID: 33978547 PMCID: PMC8542622 DOI: 10.1177/09564624211015028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Uptake of HIV testing is suboptimal in Uganda, particularly in rural communities. Reaching UNAIDS 95-95-95 goals requires strategies to increase HIV testing among hard-to-reach populations. This cross-sectional study sought to characterize engagement with HIV testing among traditional healers and their clients in rural Uganda. We enrolled 175 traditional healers and 392 adult clients of healers in Mbarara District. The primary outcome for this study was having received an HIV test in the prior 12 months. Most clients (n = 236, 65.9%) had received an HIV test within 12 months, compared to less than half of healers (n = 75, 46.3%) who had not. In multivariate regression models, male clients of healers were half as likely to have tested in the past year, compared with female (adjusted odds ratios (AORs) = 0.43, 95% CI = 0.26-0.70). Increasing age negatively predicted testing within the past year (AOR = 0.95, 95% CI = 0.93-0.97) for clients. Among healers, more sexual partners predicted knowing ones serostatus (AOR = 1.6, 95% CI 1.03-2.48). Healers (AOR = 1.16, 95% CI 1.07-1.26) and clients (AOR = 1.28, 95% CI 1.13-1.34 for clients) with greater numbers of lifetime HIV tests were more likely to have tested in the past year. Traditional healers and their clients lag behind UNAIDS benchmarks and would benefit from programs to increase HIV testing uptake.
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Affiliation(s)
- Doreen Nabukalu
- Department of Community Health, 108123Mbarara University of Science and Technology, Mbarara, Uganda
| | - Matthew Ponticiello
- Department of Emergency Medicine, 12295Weill Cornell Medicine, New York, NY, USA
| | - Thomas Bennett
- Department of Emergency Medicine, 12295Weill Cornell Medicine, New York, NY, USA
| | - Sunday Clark
- Department of Emergency Medicine, 12295Weill Cornell Medicine, New York, NY, USA
| | - Rachel King
- Global Health Sciences, 8785University of California San Francisco, San Francisco, CA, USA
| | - Juliet Mwanga-Amumpaire
- Department of Pediatrics and Child Health, 108123Mbarara University of Science and Technology, Mbarara, Uganda
| | - Radhika Sundararajan
- Department of Emergency Medicine, 12295Weill Cornell Medicine, New York, NY, USA
- Weill Cornell Center for Global Health, New York, NY, USA
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