Obermeyer C. M., Neuman M., Hardon A., Desclaux Alice, Wanyenze R., Ky-Zerbo O., Cherutich P., Namakhoma I. (2013). Socio-economic determinants of HIV testing and counselling : a comparative study in four African countries. Tropical Medicine and International Health, 18 (9), p. 1110-1118. ISSN 1360-2276.
Titre du document
Socio-economic determinants of HIV testing and counselling : a comparative study in four African countries
Obermeyer C. M., Neuman M., Hardon A., Desclaux Alice, Wanyenze R., Ky-Zerbo O., Cherutich P., Namakhoma I.
Source
Tropical Medicine and International Health, 2013,
18 (9), p. 1110-1118 ISSN 1360-2276
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.
