Who is Reached by HIV Self-Testing? Individual Factors Associated With Self-Testing Within a Community-Based Program in Rural Malawi.

Adolescent Adult Delivery of Health Care Diagnostic Tests, Routine / statistics & numerical data Female HIV Infections / diagnosis Health Behavior Humans Malawi / epidemiology Male Rural Population Self-Testing Sexual Behavior Socioeconomic Factors Surveys and Questionnaires Unsafe Sex Young Adult

Journal

Journal of acquired immune deficiency syndromes (1999)

ISSN: 1944-7884

Titre abrégé: J Acquir Immune Defic Syndr

Pays: United States

ID NLM: 100892005

Informations de publication

Date de publication:
01 10 2020

Historique:

pubmed: 6 6 2020

medline: 31 3 2021

entrez: 6 6 2020

Statut: ppublish

Résumé

HIV self-testing (HIVST) is an alternative strategy for reaching population subgroups underserved by available HIV testing services. We assessed individual factors associated with ever HIVST within a community-based program. Malawi. We conducted secondary analysis of an end line survey administered under a cluster-randomized trial of community-based distribution of HIVST kits. We estimated prevalence differences and prevalence ratios (PRs) stratified by sex for the outcome: self-reported ever HIVST. Prevalence of ever HIVST was 45.0% (475/1055) among men and 40.1% (584/1456) among women. Age was associated with ever HIVST in both men and women, with evidence of a strong declining trend across categories of age. Compared with adults aged 25-39 years, HIVST was lowest among adults aged 40 years and older for both men [34.4%, 121/352; PR 0.74, 95% confidence interval (CI): 0.62 to 0.88] and women (30.0%, 136/454; PR 0.71, 95% CI: 0.6 to 0.84). Women who were married, had children, had higher levels of education, or were wealthier were more likely to self-test. Men who had condomless sex in the past 3 months (47.9%, 279/582) reported a higher HIVST prevalence compared with men who did not have recent condomless sex (43.1%, 94/218; adjusted PR 1.37, 95% CI: 1.06 to 1.76). Among men and women, the level of previous exposure to HIV testing and household HIVST uptake was associated with HIVST. Community-based HIVST reached men, younger age groups, and some at-risk individuals. HIVST was lowest among older adults and individuals with less previous exposure to HIV testing, suggesting the presence of ongoing barriers to HIV testing.

Identifiants

DOI: 10.1097/QAI.0000000000002412 PMID: 32501815 PMC: PMC7611247

pubmed: 32501815

doi: 10.1097/QAI.0000000000002412

pii: 00126334-202010010-00006

pmc: PMC7611247

mid: EMS127428

doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng