%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Obermeyer, C. M.
%A Neuman, M.
%A Hardon, A.
%A Desclaux, Alice
%A Wanyenze, R.
%A Ky-Zerbo, O.
%A Cherutich, P.
%A Namakhoma, I.
%T Socio-economic determinants of HIV testing and counselling : a comparative study in four African countries
%D 2013
%L fdi:010060557
%G ENG
%J Tropical Medicine and International Health
%@ 1360-2276
%K HIV ; testing ; sub-Saharan Africa ; socio-economic ; access ; voluntary counselling and testing ; provider-initiated testing and counselling
%K BURKINA FASO ; KENYA ; MALAWI ; UGANDA
%M ISI:000322981700012
%N 9
%P 1110-1118
%R 10.1111/tmi.12155
%U https://www.documentation.ird.fr/hor/fdi:010060557
%> https://www.documentation.ird.fr/intranet/publi/2013/09/010060557.pdf
%V 18
%W Horizon (IRD)
%X 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.
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