Factors Associated with HIV Prevalence and HIV Testing in Sierra Leone: Findings from the 2008 Demographic Health Survey

An application of social marketing for promoting HIV testing in Iran

BACKGROUND

It has been estimated that 60,000 Iranians have been infected with HIV/AIDS and only 36% of them are aware of their status. This study aimed to design, implement and evaluate a social marketing campaign to promote HIV testing in Boyer-Ahmad County, Kohgiluyeh, and Boyer-Ahmad Province, southwest of Iran.

MATERIALS AND METHODS

This study was a quasi-experimental pretest-posttest without a control group, developed based on a social marketing assessment and response tool. To design the intervention formative research was conducted, comprised of four focus group discussion sessions with 42 participants of the target community along with seven in-depth semi-structured personal interviews with health care providers involved in the HIV/AIDS Program. Data analysis was done manually using content analysis and the main content was formulated for the campaign. Afterward, the slogan and messages of the campaign were developed. The campaign's materials including banners, posters, pamphlets, referral forms, and short messages were designed, pretested, and revised. Ultimately, the campaign was conducted for one month in October 2019. To determine the effectiveness of the campaign, the rate of referrals to the Center for Behavioral Health Counseling Services (CBHCS), for three months before and after the campaign, was compared.

RESULTS

Qualitative findings identified that the majority of the interviewees mentioned that the main reasons for the low rate of referrals to get tested for HIV were lack of awareness and information about HIV/AIDS and its diagnosis as well as the free and confidential tests available from the CBHCS. Moreover, the stigma associated with HIV/AIDS was another important reason for low referrals for testing. The rate of referrals for HIV testing in the three months leading up to the campaign was 18, 32, and 23 people, and three months after the campaign was 64, 81, and 44 individuals; respectively. The results of the multivariate analysis demonstrated that the campaign had increased the rates of referrals for HIV testing through its significant influence on females, and individuals with academic degrees.

CONCLUSION

It can be concluded that the social marketing campaign was successful in persuading people to get tested for HIV.

Under-Five Mortality in Sierra Leone and Possible Associated Factors: Evidence from the 2019 Demographic and Health Survey

High under-five mortality rate remains one of the public health challenges, especially in sub-Saharans Africa, accounting for more than half of all global cases. Sierra Leone was and still one of the countries with the highest under-five mortality rate. Using the latest 2019 SLDHS data, we investigated factors associated with under-five mortality in Sierra Leone. A total of 9771 mothers aged 15-49 years in the country were interviewed and included in the analysis. The dependent variable is child status (dead=1; alive=0). A total of 871 (9%) children died before their fifth birthday. Maternal age of 20-24 years (AOR=0.46; CI=0.33-0.64; P<0.001) up to 40-44 years (AOR=0.43; CI=0.27-0.7; P=0.001), currently breastfeeding (AOR=0.20; CI=0.17-0.24; P<0.001), maternal media exposure and usage of reading newspapers/magazines less than once a week (AOR=0.48; CI=0.28-0.85; P=0.011) were more likely to enhance child survivability through their fifth birthday. Also, the child sex being female (AOR=0.68; CI=0.59-0.79) was more likely to survive under-five mortality compared to their male counterpart. On the other hand, mothers who listened to radio at least once a week (AOR=1.31; CI=1.08-1.59; P=0.007) watched television less than once a week (AOR=1.48; CI=1.16-1.90), had two (AOR=3.4, CI=2.78-4.16; P<0.001) or three and above birth (AOR=8.11; CI=6.07-10.83; P<0.001) in five years, had multiple birth children (AOR=1.41; CI=1.08-1.86) and very small-sized child at birth (AOR= 1.95; CI=1.41-2.70) were more likely to lose their children below the age of five years. The factors contributing to under-five mortality in Sierra Leone are critical to ensuring child survival and improving maternal health. Breastfeeding, maternal age, media exposure, child's sex, multiple birth type, very small-sized child and the total number of births in five years were significant drivers of under-five mortality. The result affirms the need for attention to be focused on enhancing the survival rate of under-five children in Sierra Leone.

Epidemiological and viral characteristics of undiagnosed HIV infections in Botswana

Background

HIV-1 is endemic in Botswana. The country’s primary challenge is identifying people living with HIV who are unaware of their status. We evaluated factors associated with undiagnosed HIV infection using HIV-1 phylogenetic, behavioural, and demographic data.

Methods

As part of the Botswana Combination Prevention Project, 20% of households in 30 villages were tested for HIV and followed from 2013 to 2018. A total of 12,610 participants were enrolled, 3596 tested HIV-positive at enrolment, and 147 participants acquired HIV during the trial. Extensive socio-demographic and behavioural data were collected from participants and next-generation sequences were generated for HIV-positive cases. We compared three groups of participants: (1) those previously known to be HIV-positive at enrolment (n = 2995); (2) those newly diagnosed at enrolment (n = 601) and (3) those who tested HIV-negative at enrolment but tested HIV-positive during follow-up (n = 147). We searched for differences in demographic and behavioural factors between known and newly diagnosed group using logistic regression. We also compared the topology of each group in HIV-1 phylogenies and used a genetic diversity-based algorithm to classify infections as recent (< 1 year) or chronic (≥ 1 year).

Results

Being male (aOR = 2.23) and younger than 35 years old (aOR = 8.08) was associated with undiagnosed HIV infection (p < 0.001), as was inconsistent condom use (aOR = 1.76). Women were more likely to have undiagnosed infections if they were married, educated, and tested frequently. For men, being divorced increased their risk. The genetic diversity-based algorithm classified most incident infections as recent (75.0%), but almost none of known infections (2.0%). The estimated proportion of recent infections among new diagnoses was 37.0% (p < 0.001).

Conclusion

Our results indicate that those with undiagnosed infections are likely to be young men and women who do not use condoms consistently. Among women, several factors were predictive: being married, educated, and testing frequently increased risk. Men at risk were more difficult to delineate. A sizeable proportion of undiagnosed infections were recent based on a genetic diversity-based classifier. In the era of “test and treat all”, pre-exposure prophylaxis may be prioritized towards individuals who self-identify or who can be identified using these predictors in order to halt onward transmission in time.

Predictors of HIV testing among youth aged 15–24 years in The Gambia

Background

Worldwide, an estimated 38.0 million people lived with the human immunodeficiency virus in 2019, and 3.4 million young people aged 15~24 years were living with HIV. Sub-Saharan Africa carries a significant HIV burden with West and Central Africa most affected with HIV. Among the young people living with HIV in West and Central Africa, an estimated 810,000 were aged 15~24 years. This study aimed to assess predictors that influence the uptake of HIV testing among youth aged 15~24 years in The Gambia.

Methods

The 2013 Gambia Demographic and Health Survey data for youth aged 15~24 years was used. The Andersen behavioral model of health service use guided this study. A cross-sectional study design was used on 6194 subjects, among which 4730 were female. The analysis employed Chi-squared tests and hierarchical logistic regression.

Results

Less than one-quarter of the youth 1404 (22.6%) had ever been tested for HIV. Young people aged 20~24 years (adjusted odds ratio (aOR): 1.98), who were females (aOR: 1.13), married youth (aOR: 3.89), with a primary (aOR: 1.23), secondary or higher education (aOR: 1.46), and who were from the Jola/Karoninka ethnic group (aOR: 1.81), had higher odds of having been tested for HIV. Those with adequate HIV knowledge and those who were sexually active and had aged at first sex ≥15 years (aOR: 3.99) and those <15 years (aOR: 3.96) were more likely to have been tested for HIV compared to those who never had sex.

Conclusion

This study underscores the low level of model testing on HIV testing among youth (15~24 years) in The Gambia. Using Anderson’s Model of Health Service Utilization, the predisposing factors (socio-demographic and HIV knowledge) and the need-for-care factors (sexual risk behaviors) predict healthcare utilization services (HIV testing) in our study; however, only socio-demographic model explained most of the variance in HIV testing. The low effect of model testing could be related to the limited number of major variables selected for HIV knowledge and sexual risk behavior models. Thus, consideration for more variables is required for future studies.

Prevalence of risk factors for human immunodeficiency virus among women of reproductive age in Sierra Leone: a 2019 nationwide survey

Background and aim

For over 40 years of the HIV/AIDS global epidemic, no effective cure nor vaccine is yet available, making the current control strategies focused on curbing new infections through risk reduction. The study aimed to determine the prevalence of HIV risk factors and their associated socio-demographics among women of reproductive age in Sierra Leone.

Methods

We used weighted data from the Sierra Leone Demographic and Health Survey (SLDHS) of 2019 for 12,005 women aged 15–49 years. Multistage sampling was used to select study participants. Exposure to HIV risk factors was considered if a woman reported at least one of the following; having multiple sexual partners, transactional sex, non-condom use for the unmarried, and having other sexually transmitted infections (STIs). We, then, conducted multivariable logistic regression to explore the associated socio-demographics. All the analyses were done using SPSS (version 25).

Results

Of the 12,005 women, 38.1% (4577/12005) (95% confidence interval (CI) 37.3–39.0) had at least one of the four risk factors. Women of 15 to 19 years (adjusted odds ratio (AOR) = 1.34, 95% CI 1.00–1.80) and 20 to 34 years (AOR = 1.25, 95% CI 1.05–1.49) had more odds of having HIV risk factors compared to those of 35 to 49 years. Urban residents (AOR = 1.49, 95% CI 1.17–1.89) and those from the Northwestern region (AOR = 1.81, 95% CI 1.26–2.60) were also more likely to encounter HIV risk factors compared to their respective counterparts. Moreover, unmarried women (AOR = 111.17, 95% CI 87.55–141.18) and those working (AOR = 1.38, 95% CI 1.14–1.67) also had higher odds of having HIV risk factors, compared to their respective counterparts. Sex of household head and parity were also significant associates.

Conclusions

More than a third of women in Sierra Leone had encountered at least one HIV risk factor, and this was associated with age, place of residence, region, marital status, working status, household head and parity. There is a need for strengthening HIV/AIDS education programs, laws and policies targeting the young, working, unmarried and urban-resident women.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12879-022-07037-7.

Factors associated with HIV testing and counselling services among women and men in Nepal: a cross-sectional study using data from a nationally representative survey

OBJECTIVES

This study is set up to explore the factors associated with Human Immunodeficiency Virus (HIV) testing among women and men in Nepal.

STUDY DESIGN

Nepal Demographic and Health Survey, 2016 adopts a cross-sectional design.

SETTING

Nepal.

PARTICIPANTS

Women and men of age 15-49 years.

PRIMARY OUTCOME MEASURES

Our primary outcome was ever tested for HIV. We used multivariable analysis at a 95% level of significance to measure the effect in outcome variables.

RESULTS

About one in 10 women (10.8%) and one in five men (20.5%) ever tested for HIV. Women who had media exposure at least once a week ((adjusted odds ratio (aOR)=2.8; 95% CI: 1.4 to 5.3) were more likely to get tested for HIV compared with those who had no media exposure at all. Similarly, those who had their recent delivery in the health facility (aOR=3.9; 95% CI: 2.4 to 6.3) were more likely to get tests for HIV compared with those delivered elsewhere. Likewise, among men, compared with adolescents (15-19 years), those from older age groups were more likely to get tested for HIV. Compared with no education, secondary (aOR=2.3; 95% CI: 1.4 to 3.6) and higher education (aOR=1.7; 95% CI: 1.0 to 2.8) had higher odds of getting tested for HIV. Similarly, wealth quintiles in richer and richest groups were more likely to get tested for HIV compared with the poorest quintile. Other characteristics like media exposure, paid sex and 2+ sexual partners were positively associated with being tested for HIV.

CONCLUSIONS

HIV testing is not widespread and more men than women are accessing HIV services. More than two-thirds of women who delivered at health facilities never tested for HIV. It is imperative to reach out to people engaging in risky sexual behaviour, people with lower educational attainment, and those in the lower wealth quintile for achieving 95-95-95 targets by 2030.

Barriers and Facilitators for HIV Testing Practice Among Ethiopian Women Aged 15-24 years: Analysis of the 2016 Ethiopian Demographic and Health Survey

BACKGROUND

In developing countries, youth women are most at risk of HIV infection. Center for Disease Control recommends that people who participate in high-risk behaviors get tested for HIV at least annually. In 2016, the Ethiopian Ministry of Health set goals to identify 90% of the people living with HIV by 2030. But undiagnosed HIV infections are still high in the country. To alleviate the problem, it is vital to identify the factors that hinder HIV testing practice. Therefore, this study aimed to identify the facilitators and barriers of HIV testing practice among Ethiopian youth women.

METHODS

The analysis was done on 6401 women aged 15-24 years using data from the 2016 Ethiopia Demographic Health Survey (EDHS). The main outcome variable was self-reported HIV testing practice. Multivariable logistic regression was used to identify the facilitators and barriers of HIV testing practice.

RESULTS

In this study, 37.7% [95% CI: (33.6, 39.1)] of youth women were tested for HIV in their life. Being married (AOR=4.7; 95% CI: (3.67, 6.01)), divorced [AOR=6.2; 95% CI: (3.98-9.54)], having primary level of education [AOR=2.4;95% CI: (1.79-3.13)], and secondary level of education [AOR=4.0; 95% CI: (2.87-5.63)], being rich [AOR=2.3;95% CI: (1.39-3.91)] and being in the highest wealth index catagory [AOR=2.6;95% CI: (1.30-5.16)] increase the odds of HIV testing. However, lack of media acccess [AOR = 0.7; 95 CI %: (0.54-0.87)], lack of comprehensive HIV knowledge [AOR = 0.68; 65% CI: (0.53-0.86)] and having discriminatory attitude towards PLHIV[AOR=0.79;95% CI: (0.64-0.97)] decrease the odds of HIV testing.

CONCLUSION

The practice of HIV testing among youth populations was low as compared to national recommendations. Lack of media access, lack of comprehensive knowledge about HIV, and having discriminatory attitudes were the barriers to HIV testing practice. Marriage, secondary or higher education attainment, and high wealth index category were the facilitators for HIV testing. Improving HIV-related knowledge, improving media access, and minimizing discriminatory attitudes are strongly recommended to promote HIV testing practice.

Using Anderson's Model of Health Service Utilization to Assess the Use of HIV Testing Services by Sexually Active Men in Ghana

Introduction: Globally, HIV testing and counseling is considered a key cost-effective component of HIV prevention and treatment. This study sought to use Anderson's model of health service utilization to assess the uptake of HIV testing services by sexually active men in Ghana. Materials and Methods: Data were from the 2014 Ghana Demographic and Health Survey. Both bivariate and multivariate analysis were conducted. The multivariate analysis results are presented as Adjusted Odds ratios (AORs) with 95% confidence intervals (CI). Statistical significance was declared at p < 0.05. Results: A total of 3,052 sexually active men aged 15-59 were included in the analysis. Of these, 25.4% tested for their HIV status. Men aged 30-39 (AOR = 2.715, CI = 1.458, 5.054), those with higher level of education (AOR = 3.566,CI = 2.309, 5.509), married (AOR = 1.50, CI = 1.167, 1.931), and men in Upper East (AOR = 2.625, CI = 1.608, 4.285) had higher odds of HIV testing uptake than their counter parts aged 15-19, those with no formal education unmarried and those in Western Region, respectively. However, men with no religion (AOR = 0.606, CI = 0.376, 0.975) and those who belong to the Mole-Dagbani ethnic group (AOR = 0.633, CI = 0.429, 0.934) had lower odds of HIV testing uptake compared to those who are Christians, and Akans, respectively. Men who have subscribed to health insurance (AOR = 1.896, 95% CI = 1.361, 2.643), those in the rich wealth quintile (AOR = 1.896, CI = 1.361, 2.643), those who read newspaper (AOR = 1.552, CI = 1.198, 2.012), listened to radio (AOR = 1.530, CI = 1.087, 2.153) at least once a week, and men who experienced discharge from their penis (AOR = 1.056, CI = 1.200, 1.515) had higher odds of HIV testing uptake. Conclusion: Uptake of HIV testing among Ghanaian men is relatively low. There is the need for a concerted effort by various stakeholders to strengthen current efforts to target younger and unmarried men, men with low level of education, those who do not profess any religious affiliation and men belonging to Mole-Dagbani ethnic group.

Uptake and correlates of HIV testing among men in Malawi: evidence from a national population-based household survey

BACKGROUND

HIV testing is one of the key strategies in the HIV/AIDS prevention and control programmes. However, studies examining utilization of this service by men in Malawi are limited. The aim of this study was to assess the uptake and determinants of HIV testing among men in Malawi.

METHODS

Secondary data analysis was conducted on cross-sectional household data for 7478 men aged 15 to 54 years drawn from the 2015-16 Malawi Demographic and Health Survey. Descriptive statistics, bivariate and multivariable logistic regression analyses were performed to identify the socio-demographic, behavioral and health service related factors that are associated with HIV testing service utilisation by men in Malawi. All analyses were performed using the complex sample analysis procedure of the Statistical Package for the Social Sciences version 22.0 to account for the multistage sampling used in Demographic Health Survey.

RESULTS

Overall, 69.9% of the participants had ever been tested for HIV. The results indicate that age, region of residence, marital status, covered by health insurance, education and age at first sexual debut are significant predictors of HIV testing among men in Malawi. In particular, men who were in the age group 30-39 years (AOR = 3.00; 95% CI = 2.35-3.82), married (AOR = 3.03; 95% CI = 2.51-3.65), those with secondary or above education (AOR = 3.02; 95% CI = 2.33-3.91), and those who had health insurance (AOR = 1.66; 95% CI = 1.05-2.63) were likely to utilise HIV testing service than their counterparts.

CONCLUSION

The findings suggest that HIV testing services and programmes need to target younger unmarried men aged 15-19, men with low level or no education and expand HIV testing services to the central and southern regions of Malawi. Targeting the undiagnosed men living with HIV in a timely manner is a crucial and necessary step not only for achieving the UNAIDS' 90-90-90 targets but for individuals to benefit from antiretroviral treatment and to sustainably reduce population-level HIV transmission.

HIV prevalence in suspected Ebola cases during the 2014-2016 Ebola epidemic in Sierra Leone

BACKGROUND

The 2014-2016 Ebola virus epidemic in West Africa was the largest outbreak of Ebola virus disease (EVD) in history. Clarifying the influence of other prevalent diseases such as human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS) will help improve treatment and supportive care of patients with EVD.

CASE PRESENTATION

We examined HIV and hepatitis C virus (HCV) antibody prevalence among suspected EVD cases from the Sierra Leone-China Friendship Biological Safety Laboratory during the epidemic in Sierra Leone. HIV and HCV antibodies were tested in 678 EVD-negative samples by enzyme-linked immunosorbent assay. A high HIV prevalence (17.6%) and low HCV prevalence (0.22%) were observed among the suspected cases. Notably, we found decreased HIV positive rates among the suspected cases over the course of the epidemic. This suggests a potentially beneficial effect of an improved public health system after assistance from the World Health Organization and other international aid organizations.

CONCLUSIONS

This EVD epidemic had a considerable impact on the public health system and influenced the prevalence of HIV found among suspected cases in Sierra Leone, but also provided an opportunity to establish a better surveillance network for infectious diseases.

High Prevalence of Late-Stage Disease in Newly Diagnosed Human Immunodeficiency Virus Patients in Sierra Leone

A high prevalence of late-stage disease (75.4%) and severe immunosuppression (23.3%) was observed in 155 newly diagnosed human immunodeficiency virus patients in Freetown, Sierra Leone during August to November 2017. Within the late-stage diagnosis group, a significantly high proportion of patients reported fever (84.2% vs 65.2%; P = .01), weight loss (82.2% vs 63.5%; P = .01), and malaise (89.7% vs 71.7%; P = .05). Fever was identified as the only independent predictor of late-stage disease in this study.

"He Told Me to Check My Health": A Qualitative Exploration of Social Network Influence on Men's HIV Testing Behavior and HIV Self-Testing Willingness in Tanzania

Men continue to test for HIV at a low rate in sub-Saharan Africa. Recent quantitative evidence from sub-Saharan Africa indicates that encouragement to test for HIV from men’s network members is associated with higher previous HIV testing and HIV self-testing (HIVST) willingness. Leveraging this positive network influence to promote HIVST among men is a promising strategy that could increase HIV testing. This study investigated the reasons and strategies men used to encourage their peers to test for HIV and the outcomes in order to inform the development of a social network-based HIVST intervention for men called STEP (Self-Testing Education and Promotion). Twenty-three men from networks locally referred to as “camps” were interviewed to explore reasons for encouraging HIV testing, strategies to encourage HIV testing, and outcomes of HIV testing encouragement. Reasons men reported for encouraging their peers to test for HIV included awareness of their peers’ risky sexual behavior, knowing an HIV-positive peer, and having HIV testing experience. Strategies for encouraging testing included engaging in formal and informal conversations and accompanying friends to the clinic. Encouragement outcomes included HIV testing for some men while others remained untested due to lack of privacy in the clinic and fear of HIV stigma. Willingness to self-test for HIV and an interest to educate peers about HIVST were other outcomes of HIV testing encouragement. These findings underscore the potential of leveraging men’s existing HIV testing encouragement strategies to promote HIVST among their peers.

Prevalence and correlates of HIV testing among adolescents 10-19 years in a post-conflict pastoralist community of Karamoja region, Uganda

Background

Adolescents are a priority group in HIV prevention and treatment. This study sought to determine the prevalence and correlates of HIV testing services (HTS) among adolescents in the pastoralist post-conflict area of Karamoja sub region, Uganda.

Methods

A cross sectional study of 1439 adolescents aged 10–19 years, attending nine public health facilities in five of the seven districts of Karamoja, was conducted between August to September 2016. Adolescents were consecutively selected and interviewed using structured interviewer administered questionnaires. All respondents who had never tested for HIV were offered HTS. The main outcome was ever tested for HIV. Correlates of ever tested were analysed using multivariate logistic regression model.

Results

Of the 1439 adolescents, 904 (62.8%) were females, 1203 (83.6%) were aged 15–19 years, 618 (43.0%) had attained primary education and 885 (61.5%) had ever had sex. Overall 1177 (81.8%) had ever tested and received HIV results. Older age (15–19 years) (adj.OR = 2.71, 95% CI: 1.85–3.96), secondary level education or higher (adj.OR = 2.33, 95% CI: 1.33–4.10), and ever had sex (adj.OR = 2.03, 95% CI: 1.42–2.90) were associated with higher odds of HIV testing. Of the 262 who had never tested, 169 (64.5%) accepted testing and 2.4% were HIV positive. Reasons for not accepting the test included fear of being tested and not ready for an HIV test because of perceived suffering HIV positive clients go through.

Conclusion

Awareness of HIV status and uptake of HTS among adolescents in this hard-to-reach post-conflict region was high and close to the global UNAIDS target of 90%. However, the HIV prevalence of 2.4% among the non-testers who accepted to be tested was high and emphasises the need for targeted testing to reach the undiagnosed HIV infected adolescents in this region.

Uptake of HIV testing in Burkina Faso: an assessment of individual and community-level determinants

Background

Previous studies have highlighted a range of individual determinants associated with HIV testing but few have assessed the role of contextual factors. The objective of this paper is to examine the influence of both individual and community-level determinants of HIV testing uptake in Burkina Faso.

Methods

Using nationally representative cross-sectional data from the 2010 Demographic and Health Survey, the determinants of lifetime HIV testing were examined for sexually active women (n = 14,656) and men (n = 5680) using modified Poisson regression models.

Results

One third of women (36%; 95% Confidence Interval (CI): 33–37%) reported having ever been tested for HIV compared to a quarter of men (26%; 95% CI: 24–27%). For both genders, age, education, religious affiliation, household wealth, employment, media exposure, sexual behaviors, and HIV knowledge were associated with HIV testing. After adjustment, women living in communities where the following characteristics were higher than the median were more likely to report uptake of HIV testing: knowledge of where to access testing (Prevalence Ratio [PR] = 1.41; 95% CI: 1.34–1.48), willing to buy food from an infected vendor (PR = 2.06; 95% CI: 1.31–3.24), highest wealth quintiles (PR = 1.18; 95% CI: 1.10–1.27), not working year-round (PR = 0.90; 95% CI: 0.84–0.96), and high media exposure (PR = 1.11; 95% CI: 1.03–1.19). Men living in communities where the proportion of respondents were more educated (PR = 1.23; 95% CI: 1.07–1.41) than the median were more likely to be tested.

Conclusions

This study shed light on potential mechanisms through which HIV testing could be increased in Burkina Faso. Both individual and contextual factors should be considered to design effective strategies for scaling-up HIV testing.

Equity issues were not fully addressed in Cochrane human immunodeficiency virus systematic reviews

OBJECTIVE

To describe and summarize equity reporting in human immunodeficiency virus (HIV) systematic reviews and explore the extent to which equity issues are addressed and reported in HIV reviews using the PROGRESS Plus framework.

STUDY DESIGN AND SETTING

Application of the PROGRESS Plus framework to a bibliometric analysis of HIV reviews in the Cochrane Database of Systematic Reviews.

RESULTS

The analysis included 103 reviews published as of March 2014, with a median of five studies per review (first quartile; Q1 = 2; third quartile; Q3 = 11). Reporting of PROGRESS Plus factors was as follows: Place of residence (low, middle, and high income; 55.3%), place of residence (urban or rural; 24.3%), race or ethnicity (20.4%), occupation (10.7%), gender (65.0%), religion (1.9%), education (7.8%), socioeconomic position (10.7%), social networks and capital (1.0%), age (1.9%), and sexual orientation (3.8%).

CONCLUSION

Gaps in the reporting of relevant equity indicators were identified within Cochrane HIV systematic review indicating that research is not consistently conducted through an equity lens. There is a need to incorporate PROGRESS Plus factors into both primary and secondary studies.