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. 2018 Feb;22(2):569-579.
doi: 10.1007/s10461-017-1807-5.

Age-Related Differences in Socio-demographic and Behavioral Determinants of HIV Testing and Counseling in HPTN 043/NIMH Project Accept

N Salazar-Austin  1 , M Kulich  2 , A Chingono  3 , S Chariyalertsak  4 , K Srithanaviboonchai  4 , G Gray  5   6 , L Richter  6 , H van Rooyen  7 , S Morin  8 , M Sweat  9 , J Mbwambo  10 , G Szekeres  11 , T Coates  12 , D Celentano  13 ; NIMH Project Accept (HPTN 043) Study Team
Collaborators, Affiliations

Age-Related Differences in Socio-demographic and Behavioral Determinants of HIV Testing and Counseling in HPTN 043/NIMH Project Accept

N Salazar-Austin et al. AIDS Behav. 2018 Feb.

Abstract
in English, Spanish

Youth represent a large proportion of new HIV infections worldwide, yet their utilization of HIV testing and counseling (HTC) remains low. Using the post-intervention, cross-sectional, population-based household survey done in 2011 as part of HPTN 043/NIMH Project Accept, a cluster-randomized trial of community mobilization and mobile HTC in South Africa (Soweto and KwaZulu Natal), Zimbabwe, Tanzania and Thailand, we evaluated age-related differences among socio-demographic and behavioral determinants of HTC in study participants by study arm, site, and gender. A multivariate logistic regression model was developed using complete individual data from 13,755 participants with recent HIV testing (prior 12 months) as the outcome. Youth (18-24 years) was not predictive of recent HTC, except for high-risk youth with multiple concurrent partners, who were less likely (aOR 0.75; 95% CI 0.61-0.92) to have recently been tested than youth reporting a single partner. Importantly, the intervention was successful in reaching men with site specific success ranging from aOR 1.27 (95% CI 1.05-1.53) in South Africa to aOR 2.30 in Thailand (95% CI 1.85-2.84). Finally, across a diverse range of settings, higher education (aOR 1.67; 95% CI 1.42, 1.96), higher socio-economic status (aOR 1.21; 95% CI 1.08-1.36), and marriage (aOR 1.55; 95% CI 1.37-1.75) were all predictive of recent HTC, which did not significantly vary across study arm, site, gender or age category (18-24 vs. 25-32 years).

Los jóvenes representan una gran proporción de nuevas infecciones por el VIH en todo el mundo, sin embargo, su utilización de las pruebas de detección del VIH y el asesoramiento (HTC) sigue siendo baja. Utilizando la encuesta de población transversal de la población realizada en 2011 como parte del proyecto HPTN 043 / NIMH Project Accept, un ensayo aleatorizado por grupos de movilización comunitaria y HTC móvil en Sudáfrica (Soweto y KwaZulu Natal), Zimbabwe, Tanzania y Tailandia, evaluamos las diferencias relacionadas con la edad entre los determinantes sociodemográficos y conductuales de HTC en los participantes del estudio por brazo de estudio, sitio y sexo. Se desarrolló un modelo multivariado de regresión logística utilizando datos individuales completos de 13,755 participantes con pruebas de VIH recientes (antes de 12 meses) como resultado. Los jóvenes (18-24 años) no eran predictivos de HTC recientes, excepto los jóvenes de alto riesgo con múltiples parejas concurrentes, que eran menos probables (aOR 0,75; IC del 95%: 0,61-0,92) compañero. Es importante destacar que la intervención fue exitosa en hombres con éxito específico en el sitio, desde aOR 1,27 (IC 95% 1,05-1,53) en Sudáfrica hasta aOR 2,30 en Tailandia (IC 95%: 1,85-2,84). Por último, en una amplia gama de contextos, la educación superior (aO 1,67; IC del 95%: 1,42; 1,96); mayor estatus socioeconómico (aOR 1,21; IC del 95%: 1,08-1,36) y matrimonio (aOR 1,55; IC del 95%: 1,37 -1.75) eran todos predictivos de HTC recientes, que no variaron significativamente entre brazo de estudio, sitio, sexo o categoría de edad (18-24 vs 25-32 años).

Keywords: Determinants HTC; High-risk sexual behavior; Mobile HIV testing and counseling; Project accept; Youth.

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Conflict of interest statement

Conflict of interest

Authors declare that they have no conflict of interest.

Ethical Approval

All surveys and participant consents were approved by all involved US institutions and by local ethics committees including the Johns Hopkins University Committee on Human Research (Thailand), the Chiang Mai University Research Institute for Health Sciences (Thailand), the Ministry of Public Health (Thailand), the Medical University of South Carolina Institutional Review Board for Human Research (Tanzania), the institutional review board of Muhimbili University of Health and Allied Sciences (Tanzania), the institutional review board of the National Institute of Medical Research (Tanzania), the University of California San Francisco Committee on Human Research (Zimbabwe), the Medical Research Council of Zimbabwe (Zimbabwe), the University of the Witwatersrand, Johannesburg Human Research Ethics Committee (Soweto, South Africa) and the Human Science Research Council Research Ethics Committee (Vulindlela, South Africa). This sub-study was considered exempt from IRB review by the Johns Hopkins School of Public Health Institutional Review Board.

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