Epidemiologic correlates of willingness to be tested for HIV and prior testing among married men in India

Levels and determinants of HIV testing uptake among Ghanaian men

The uptake of HIV testing has always been found to be lower among men compared with women in many developing countries. The aim of this study was to ascertain the level and determinants of HIV testing uptake among men aged 15 to 59 in Ghana. This article was based on data from the 2003, 2008 and 2014 Ghana Demographic and Health Surveys. A bivariate statistical method was used to calculate the levels of uptake while three logit models were fitted to estimate the determinants of HIV uptake among the respondents. The total levels of the uptake of HIV testing among the respondents were 9.1%, 14.7% and 22.7% for 2003, 2008 and 2014, respectively; 15% overall. These were significantly determined by age, educational attainment, religious affiliation, wealth and work status, region of residence and media exposure. HIV testing uptake is very low among men in Ghana, albeit it has seen consistent improvements over the past years. Specially tailored HIV education and prevention programmes should be targeted at men in areas of low uptake, based on their different characteristics, in order to increase uptake.

Knowledge and Concern about STIs/HIV and Sociodemographic Variables Associated with Getting Tested for HIV Among the General Population in Spain

HIV testing is important in terms of prevention and treatment. However, HIV testing rates in the Spanish general population remains low. Therefore, HIV testing promotion constitutes a key issue. A high level of knowledge about HIV/AIDS is associated with having been tested for HIV. The general aim of this study was to determine the prevalence of people who had ever been tested for HIV in Spain. The sample consisted of 1,106 participants from the general population - 60.0% females and 40.0% males - aged between 17 and 55 years old. The assessment instruments were a questionnaire on sociodemographic data and HIV testing, a scale of knowledge about STIs and HIV/AIDS, and a scale of concern about STIs/HIV. Results showed that greater knowledge about STIs and HIV was associated with a greater likelihood of being tested for HIV (OR = .77; 95.0% CI = .73-.82; p < .05). In addition, higher concern about HIV/AIDS decreased the likelihood of not having been tested for HIV (OR = .87; 95.0% CI = .83-.92; p < .05). In fact, the higher participants concern about STIs was, the lower their likelihood of not having been tested for HIV was (OR = .87; 95.0% CI = .83-.91; p < .05). It is necessary to promote HIV testing in the general population as well as to consider their socio-demographic and psychological characteristics.

Couples HIV counselling and couple relationships in India, Georgia and the Dominican Republic

BACKGROUND

Couples HIV counseling and testing is essential for combination HIV prevention, but its uptake remains very low. We aimed to evaluate factors associated with couples HIV counseling uptake in India, Georgia and the Dominican Republic, as part of the ANRS 12127 Prenahtest intervention trial.

METHODS

Pregnant women ≥15 years, attending their first antenatal care (ANC) session between March and September 2009, self-reporting a stable partner, and having received couple-oriented post-test HIV counseling (trial intervention) were included. Individuals and couple characteristics associated with the acceptability of couples HIV counseling were assessed using multivariable logistic regression for each study site.

RESULTS

Among 711 women included (232, 240 and 239 in the Dominican Republic, Georgia and India, respectively), the uptake of couples HIV counseling was 9.1% in the Dominican Republic, 13.8% in Georgia and 36.8% in India. The uptake of couples HIV counseling was associated with women having been accompanied by their partner to ANC, and never having used a condom with their partner in the Dominican Republic; with women having been accompanied by their partner to ANC in India; with women having a higher educational level than their partner and having ever discussed HIV with their partner in Georgia.

CONCLUSION

Couple HIV counseling uptake was overall low. Strategies adapted to local socio-cultural contexts, aiming at improving women's education level, or tackling gender norms to facilitate the presence of men in reproductive health services, should be considered.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT01494961 . Registered December 15, 2011. (Retrospectively registered).

Sexual Behavior, HIV Prevalence and Awareness Among Wives of Migrant Workers: Results from Cross-sectional Survey in Rural North India

Background:

Migration has been linked to the spread of HIV epidemic from the urban areas of western India to the rural areas of north India.

Objectives:

This is the first population-based study among the wives of migrant workers of Muzaffarpur district in Bihar with objectives to describe their sexual behavior within marriage, estimate the prevalence of HIV, and to know their awareness regarding HIV/AIDS.

Methods:

A two-stage cluster survey was conducted by randomly selecting 25 eligible wives from each of the 34 selected villages. A total of 850 wives were interviewed and the blood samples were collected for HIV testing. To determine the factors associated with HIV/AIDS-awareness, we calculated adjusted odds ratios and 95% confidence intervals (CI) using multiple logistic regression analysis.

Results:

34 (3%) of 850 wives reported condom use with their husband. HIV prevalence was 0.59% (95% CI: 0.19-1.37%) among the wives of migrant workers. Out of 850 wives, 132 (15.5%) had heard about HIV. Condoms use (OR = 3.21, 95% CI: 1.22-7.90) and premarital sex (OR=7.44, 95% CI: 1.6-33.67) were found significantly positively associated with HIV knowledge of wives. HIV awareness of the wives was significantly associated with age-group 15-24 years, literacy status, and possession of television and husbands’ literacy status. The knowledge about HIV among wives had significant positive impact on condoms use and premarital sex. HIV prevalence among the wives of migrant workers was higher than the prevalence among women in the general population. Education was found to be positively associated with awareness about HIV.

Conclusions:

Effective interventions are needed for increasing awareness of HIV among wives of migrant workers in Bihar.

Is it time to bring the "Parent" into the prevention of parent to child transmission programs in India? A study of trends over a 10-year period in a prevention of parent to child transmission clinic in India

OBJECTIVES

The present study evaluated the changes in serology and human immunodeficiency virus (HIV) testing behaviors over a 10-year period in a center in India.

METHODS

We used clinical data collected at the antenatal clinic from 2002 to 2011. The key outcomes were: (1) Proportion of women who opted for HIV test and those who tested positive; (2) proportion of male partners who came in for HIV test and those who tested positive; and (3) proportion of women who opted for continuation of pregnancy or for medical termination of pregnancy.

RESULTS

We tested 11,452 women for HIV over the 10-year period from 2002 to 2011. The proportion of women who opted for HIV testing was 72.0% (95% confidence interval [CI]: 70.7-73.4%). The acceptance of test increased from 35.9% (95% CI: 31.7-40.4%) in 2002 to the peak of 82.6% (95% CI: 78.6-86.8%) in 2009 (P < 0.001). The overall HIV prevalence over the decade was 0.70% (95% CI: 0.55-0.87%). The prevalence high at 1.11% (95% CI: 0.23-3.24%) in 2002 and reduced to 0.37% (95% CI: 0.12-0.87%) in 2011 (P < 0.001). Only 0.57% of male partners tested for HIV over this time period.

CONCLUSION

Strategies to improve acceptance of testing in pregnant women should be included in the Indian guidelines. The male partners do not get tested. Thus, this component needs to be strengthened - by targeted interventions for male spouses - to make the program more effective.

Which Psychological Factors are Related to HIV Testing? A Quantitative Systematic Review of Global Studies

Deciding to test for HIV is necessary for receiving HIV treatment and care among those who are HIV-positive. This article presents a systematic review of quantitative studies on relationships between psychological (cognitive and affective) variables and HIV testing. Sixty two studies were included (fifty six cross sectional). Most measured lifetime testing. HIV knowledge, risk perception and stigma were the most commonly measured psychological variables. Meta-analysis was carried out on the relationships between HIV knowledge and testing, and HIV risk perception and testing. Both relationships were positive and significant, representing small effects (HIV knowledge, d = 0.22, 95 % CI 0.14-0.31, p < 0.001; HIV risk perception, OR 1.47, 95 % CI 1.26-1.67, p < 0.001). Other variables with a majority of studies showing a relationship with HIV testing included: perceived testing benefits, testing fear, perceived behavioural control/self-efficacy, knowledge of testing sites, prejudiced attitudes towards people living with HIV, and knowing someone with HIV. Research and practice implications are outlined.

Is it time to bring the "Parent" into the prevention of parent to child transmission programs in India? A study of trends over a 10-year period in a prevention of parent to child transmission clinic in India

OBJECTIVES

The present study evaluated the changes in serology and human immunodeficiency virus (HIV) testing behaviors over a 10-year period in a center in India.

METHODS

We used clinical data collected at the antenatal clinic from 2002 to 2011. The key outcomes were: (1) Proportion of women who opted for HIV test and those who tested positive; (2) proportion of male partners who came in for HIV test and those who tested positive; and (3) proportion of women who opted for continuation of pregnancy or for medical termination of pregnancy.

RESULTS

We tested 11,452 women for HIV over the 10-year period from 2002 to 2011. The proportion of women who opted for HIV testing was 72.0% (95% confidence interval [CI]: 70.7-73.4%). The acceptance of test increased from 35.9% (95% CI: 31.7-40.4%) in 2002 to the peak of 82.6% (95% CI: 78.6-86.8%) in 2009 (P < 0.001). The overall HIV prevalence over the decade was 0.70% (95% CI: 0.55-0.87%). The prevalence high at 1.11% (95% CI: 0.23-3.24%) in 2002 and reduced to 0.37% (95% CI: 0.12-0.87%) in 2011 (P < 0.001). Only 0.57% of male partners tested for HIV over this time period.

CONCLUSION

Strategies to improve acceptance of testing in pregnant women should be included in the Indian guidelines. The male partners do not get tested. Thus, this component needs to be strengthened - by targeted interventions for male spouses - to make the program more effective.