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. 2021 Aug 1;87(Suppl 1):S97-S106.
doi: 10.1097/QAI.0000000000002708.

Unawareness of HIV Infection Among Men Aged 15-59 Years in 13 Sub-Saharan African Countries: Findings From the Population-Based HIV Impact Assessments, 2015-2019

Christine A West  1 , Gregory C Chang  1   2 , Dustin W Currie  1 , Rachel Bray  3 , Steve Kinchen  1 , Stephanie Behel  1 , Rachel McCullough-Sanden  2   4 , Andrea Low  3   5 , Anne Bissek  6 , Judith D Shang  4 , Clement B Ndongmo  4   7 , Emily K Dokubo  4 , Shirish Balachandra  8 , Legre R Lobognon  8 , Lenhle Dube  9 , Harriet Nuwagaba-Biribonwoha  10 , Michelle Li  11 , Munyaradzi Pasipamire  11 , Yimam Getaneh  12 , Sileshi Lulseged  13 , Frehywot Eshetu  14 , Leonard Kingwara  15 , Emily Zielinski-Gutierrez  16 , Mphotleng Tlhomola  17 , Puleng Ramphalla  18 , Thokozani Kalua  19 , Andrew F Auld  20 , Daniel B Williams  21 , Eric Remera  22 , Gallican N Rwibasira  22 , Veronicah Mugisha  23   24 , Samuel S Malamba  25 , Jeremiah Mushi  26 , Mohamed F Jalloh  27 , George S Mgomella  27 , Wilford L Kirungi  28 , Sam Biraro  29 , Anna C Awor  30 , Danielle T Barradas  7 , Owen Mugurungi  31 , John H Rogers  32 , Megan Bronson  1 , Stephane M Bodika  1 , Aderonke Ajiboye  1 , Nicholas Gaffga  1 , Carole Moore  1 , Hetal K Patel  1 , Andrew C Voetsch  1
Affiliations

Unawareness of HIV Infection Among Men Aged 15-59 Years in 13 Sub-Saharan African Countries: Findings From the Population-Based HIV Impact Assessments, 2015-2019

Christine A West et al. J Acquir Immune Defic Syndr. .

Abstract

Background: Identifying men living with HIV in sub-Saharan Africa (SSA) is critical to end the epidemic. We describe the underlying factors of unawareness among men aged 15-59 years who ever tested for HIV in 13 SSA countries.

Methods: Using pooled data from the nationally representative Population-based HIV Impact Assessments, we fit a log-binomial regression model to identify characteristics related to HIV positivity among HIV-positive unaware and HIV-negative men ever tested for HIV.

Results: A total of 114,776 men were interviewed and tested for HIV; 4.4% were HIV-positive. Of those, 33.7% were unaware of their HIV-positive status, (range: 20.2%-58.7%, in Rwanda and Cote d'Ivoire). Most unaware men reported they had ever received an HIV test (63.0%). Age, region, marital status, and education were significantly associated with HIV positivity. Men who had HIV-positive sexual partners (adjusted prevalence ratio [aPR]: 5.73; confidence interval [95% CI]: 4.13 to 7.95) or sexual partners with unknown HIV status (aPR: 2.32; 95% CI: 1.89 to 2.84) were more likely to be HIV-positive unaware, as were men who tested more than 12 months compared with HIV-negative men who tested within 12 months before the interview (aPR: 1.58; 95% CI: 1.31 to 1.91). Tuberculosis diagnosis and not being circumcised were also associated with HIV positivity.

Conclusion: Targeting subgroups of men at risk for infection who once tested negative could improve yield of testing programs. Interventions include improving partner testing, frequency of testing, outreach and educational strategies, and availability of HIV testing where men are accessing routine health services.

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Conflict of interest statement

The authors have no funding or conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Flowchart of interview completion and blood sampling among men aged 15–59 years in 13 sub-Saharan countries, 2015–2019*
Figure 2.
Figure 2.
Flowchart of awareness/unawareness status and testing characteristics among HIV positive men aged 15–59 years, in 13 sub-Saharan countries, 2015–2019*
See this image and copyright information in PMC

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