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Comparative Study
. 2013 Sep;18(9):1110-1118.
doi: 10.1111/tmi.12155.

Socio-economic determinants of HIV testing and counselling: a comparative study in four African countries

Carla Makhlouf Obermeyer  1 , Melissa Neuman  2 , Anita Hardon  3 , Alice Desclaux  4 , Rhoda Wanyenze  5 , Odette Ky-Zerbo  6 , Peter Cherutich  7 , Ireen Namakhoma  8
Affiliations
Comparative Study

Socio-economic determinants of HIV testing and counselling: a comparative study in four African countries

Carla Makhlouf Obermeyer et al. Trop Med Int Health. 2013 Sep.

Abstract

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 Burkina Faso, Kenya, Malawi and Uganda, as part of the Multi-country African Testing and Counselling 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 Poisson 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.

Keywords: HIV; access; provider-initiated testing and counselling; socio-economic; sub-Saharan Africa; testing; voluntary counselling and testing.

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References

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