Correlates of previous couples’ HIV counseling and testing uptake among married individuals in three HIV prevalence strata in Rakai, Uganda
Identifieur interne : 003118 ( Ncbi/Curation ); précédent : 003117; suivant : 003119Correlates of previous couples’ HIV counseling and testing uptake among married individuals in three HIV prevalence strata in Rakai, Uganda
Auteurs : Joseph K. B. Matovu [Ouganda] ; Jim Todd [Royaume-Uni] ; Rhoda K. Wanyenze [Ouganda] ; Fred Wabwire-Mangen [Ouganda] ; David Serwadda [Ouganda]Source :
- Global Health Action [ 1654-9716 ] ; 2015.
Abstract
Studies show that uptake of couples’ HIV counseling and testing (couples’ HCT) can be affected by individual, relationship, and socioeconomic factors. However, while couples’ HCT uptake can also be affected by background HIV prevalence and awareness of the existence of couples’ HCT services, this is yet to be documented. We explored the correlates of previous couples’ HCT uptake among married individuals in a rural Ugandan district with differing HIV prevalence levels.
This was a cross-sectional study conducted among 2,135 married individuals resident in the three HIV prevalence strata (low HIV prevalence: 9.7–11.2%; middle HIV prevalence: 11.4–16.4%; and high HIV prevalence: 20.5–43%) in Rakai district, southwestern Uganda, between November 2013 and February 2014. Data were collected on sociodemographic and behavioral characteristics, including previous receipt of couples’ HCT. HIV testing data were obtained from the Rakai Community Cohort Study. We conducted multivariable logistic regression analysis to identify correlates that are independently associated with previous receipt of couples’ HCT. Data analysis was conducted using STATA (statistical software, version 11.2).
Of the 2,135 married individuals enrolled, the majority (
Previous couples’ HCT uptake did not significantly differ by HIV prevalence setting. Longer marital duration and awareness of the existence of couples’ HCT services in the community were significantly correlated with previous receipt of couples’ HCT. These findings suggest a need for innovative demand–creation interventions to raise awareness about couples’ HCT service availability to improve couples’ HCT uptake among married individuals.
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DOI: 10.3402/gha.v8.27935
PubMed: 26058858
PubMed Central: 4461755
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Matovu</name><affiliation wicri:level="1"><nlm:aff id="AF0001">Department of Community Health and Behavioral Sciences, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Community Health and Behavioral Sciences, School of Public Health, Makerere University College of Health Sciences, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation></author><author><name sortKey="Todd, Jim" sort="Todd, Jim" uniqKey="Todd J" first="Jim" last="Todd">Jim Todd</name><affiliation wicri:level="3"><nlm:aff id="AF0002">Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Population Health, London School of Hygiene and Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Wanyenze, Rhoda K" sort="Wanyenze, Rhoda K" uniqKey="Wanyenze R" first="Rhoda K." last="Wanyenze">Rhoda K. Wanyenze</name><affiliation wicri:level="1"><nlm:aff id="AF0003">Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation></author><author><name sortKey="Wabwire Mangen, Fred" sort="Wabwire Mangen, Fred" uniqKey="Wabwire Mangen F" first="Fred" last="Wabwire-Mangen">Fred Wabwire-Mangen</name><affiliation wicri:level="1"><nlm:aff id="AF0004">Regional Center for Quality of Health Care, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Regional Center for Quality of Health Care, School of Public Health, Makerere University College of Health Sciences, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation></author><author><name sortKey="Serwadda, David" sort="Serwadda, David" uniqKey="Serwadda D" first="David" last="Serwadda">David Serwadda</name><affiliation wicri:level="1"><nlm:aff id="AF0003">Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26058858</idno><idno type="pmc">4461755</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4461755</idno><idno type="RBID">PMC:4461755</idno><idno type="doi">10.3402/gha.v8.27935</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000082</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000082</idno><idno type="wicri:Area/Pmc/Curation">000082</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000082</idno><idno type="wicri:Area/Pmc/Checkpoint">000E38</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000E38</idno><idno type="wicri:Area/Ncbi/Merge">003118</idno><idno type="wicri:Area/Ncbi/Curation">003118</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Correlates of previous couples’ HIV counseling and testing uptake among married individuals in three HIV prevalence strata in Rakai, Uganda</title><author><name sortKey="Matovu, Joseph K B" sort="Matovu, Joseph K B" uniqKey="Matovu J" first="Joseph K. B." last="Matovu">Joseph K. B. Matovu</name><affiliation wicri:level="1"><nlm:aff id="AF0001">Department of Community Health and Behavioral Sciences, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Community Health and Behavioral Sciences, School of Public Health, Makerere University College of Health Sciences, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation></author><author><name sortKey="Todd, Jim" sort="Todd, Jim" uniqKey="Todd J" first="Jim" last="Todd">Jim Todd</name><affiliation wicri:level="3"><nlm:aff id="AF0002">Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Population Health, London School of Hygiene and Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Wanyenze, Rhoda K" sort="Wanyenze, Rhoda K" uniqKey="Wanyenze R" first="Rhoda K." last="Wanyenze">Rhoda K. Wanyenze</name><affiliation wicri:level="1"><nlm:aff id="AF0003">Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation></author><author><name sortKey="Wabwire Mangen, Fred" sort="Wabwire Mangen, Fred" uniqKey="Wabwire Mangen F" first="Fred" last="Wabwire-Mangen">Fred Wabwire-Mangen</name><affiliation wicri:level="1"><nlm:aff id="AF0004">Regional Center for Quality of Health Care, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Regional Center for Quality of Health Care, School of Public Health, Makerere University College of Health Sciences, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation></author><author><name sortKey="Serwadda, David" sort="Serwadda, David" uniqKey="Serwadda D" first="David" last="Serwadda">David Serwadda</name><affiliation wicri:level="1"><nlm:aff id="AF0003">Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation></author></analytic><series><title level="j">Global Health Action</title><idno type="ISSN">1654-9716</idno><idno type="eISSN">1654-9880</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="st1"><title>Background</title><p>Studies show that uptake of couples’ HIV counseling and testing (couples’ HCT) can be affected by individual, relationship, and socioeconomic factors. However, while couples’ HCT uptake can also be affected by background HIV prevalence and awareness of the existence of couples’ HCT services, this is yet to be documented. We explored the correlates of previous couples’ HCT uptake among married individuals in a rural Ugandan district with differing HIV prevalence levels.</p></sec><sec id="st2"><title>Design</title><p>This was a cross-sectional study conducted among 2,135 married individuals resident in the three HIV prevalence strata (low HIV prevalence: 9.7–11.2%; middle HIV prevalence: 11.4–16.4%; and high HIV prevalence: 20.5–43%) in Rakai district, southwestern Uganda, between November 2013 and February 2014. Data were collected on sociodemographic and behavioral characteristics, including previous receipt of couples’ HCT. HIV testing data were obtained from the Rakai Community Cohort Study. We conducted multivariable logistic regression analysis to identify correlates that are independently associated with previous receipt of couples’ HCT. Data analysis was conducted using STATA (statistical software, version 11.2).</p></sec><sec id="st3"><title>Results</title><p>Of the 2,135 married individuals enrolled, the majority (<italic>n</italic>=1,783, 83.5%) had been married for five or more years while (<italic>n</italic>=1,460, 66%) were in the first-order of marriage. Ever receipt of HCT was almost universal (<italic>n</italic>=2,020, 95%); of those ever tested, (<italic>n</italic>=846, 41.9%) reported that they had ever received couples’ HCT. There was no significant difference in previous receipt of couples’ HCT between low (<italic>n</italic>=309, 43.9%), middle (<italic>n</italic>=295, 41.7%), and high (<italic>n</italic>=242, 39.7%) HIV prevalence settings (<italic>p</italic>=0.61). Marital order was not significantly associated with previous receipt of couples’ HCT. However, marital duration [five or more years vis-à-vis 1–2 years: adjusted odds ratio (aOR): 1.06; 95% confidence interval (95% CI): 1.04–1.08] and awareness about the existence of couples’ HCT services within the Rakai community cohort (aOR: 7.58; 95% CI: 5.63–10.20) were significantly associated with previous receipt of couples’ HCT.</p></sec><sec id="st4"><title>Conclusions</title><p>Previous couples’ HCT uptake did not significantly differ by HIV prevalence setting. Longer marital duration and awareness of the existence of couples’ HCT services in the community were significantly correlated with previous receipt of couples’ HCT. These findings suggest a need for innovative demand–creation interventions to raise awareness about couples’ HCT service availability to improve couples’ HCT uptake among married individuals.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Marks, G" uniqKey="Marks G">G Marks</name></author><author><name sortKey="Crepaz, N" uniqKey="Crepaz N">N Crepaz</name></author><author><name sortKey="Janssen, Rs" uniqKey="Janssen R">RS Janssen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Skarbinski, J" uniqKey="Skarbinski J">J Skarbinski</name></author><author><name sortKey="Rosenberg, E" uniqKey="Rosenberg E">E Rosenberg</name></author><author><name sortKey="Paz Bailey, G" uniqKey="Paz Bailey G">G Paz-Bailey</name></author><author><name sortKey="Hall, Hi" uniqKey="Hall H">HI Hall</name></author><author><name sortKey="Rose, Ce" uniqKey="Rose C">CE Rose</name></author><author><name sortKey="Viall, 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uniqKey="Makumbi F">F Makumbi</name></author><author><name sortKey="Sewankambo, Nk" uniqKey="Sewankambo N">NK Sewankambo</name></author><author><name sortKey="Serwadda, D" uniqKey="Serwadda D">D Serwadda</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Matovu, Jk" uniqKey="Matovu J">JK Matovu</name></author><author><name sortKey="Kigozi, G" uniqKey="Kigozi G">G Kigozi</name></author><author><name sortKey="Nalugoda, F" uniqKey="Nalugoda F">F Nalugoda</name></author><author><name sortKey="Wabwire Mangen, F" uniqKey="Wabwire Mangen F">F Wabwire-Mangen</name></author><author><name sortKey="Gray, Rh" uniqKey="Gray R">RH Gray</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Becker, S" uniqKey="Becker S">S Becker</name></author><author><name sortKey="Mlay, R" uniqKey="Mlay R">R Mlay</name></author><author><name sortKey="Schwandt, Hm" uniqKey="Schwandt H">HM Schwandt</name></author><author><name sortKey="Lyamuya, E" 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