Knowledge of HIV status prior to a community HIV counseling and testing intervention in a rural district of south Africa: results of a community based survey
Identifieur interne : 003304 ( Main/Curation ); précédent : 003303; suivant : 003305Knowledge of HIV status prior to a community HIV counseling and testing intervention in a rural district of south Africa: results of a community based survey
Auteurs : Hanani Tabana [Afrique du Sud, Suède] ; Tanya Doherty [Afrique du Sud] ; Sonja Swanevelder [Afrique du Sud] ; Carl Lombard [Afrique du Sud] ; Debra Jackson [Afrique du Sud] ; Wanga Zembe [Afrique du Sud] ; Reshma Naik [Afrique du Sud, États-Unis]Source :
- BMC Infectious Diseases [ 1471-2334 ] ; 2012.
Abstract
The low uptake of facility-based HIV counseling and testing (HCT) in South Africa, particularly amongst men and youth has hindered attempts to increase access to effective treatment and prevention strategies. Many barriers to HIV testing have been described including long waiting times, transport to reach facilities, fear of lack of confidentiality and health systems factors such as stock outs of HIV test kits. The aim of this study was to undertake a community survey to determine rates of HCT in a rural area in order to plan a community intervention.
A community-based survey was undertaken in 16 communities in Sisonke district, KwaZulu-Natal between September and November 2008. A total of 5821 individuals participated in the survey of which 66% were females. Gender specific mixed effects logistic regression models were used to describe differences in socio-economic characteristics, and their association with HIV testing histories.
Overall 1833 (32%) individuals in this rural area knew their HIV status. Prior testing was higher amongst women (39%) than amongst men (17%). Older men (> 24 years) were more likely to report having tested for HIV previously, with the highest likelihood (adjusted OR = 4.02; 95% CI: 2.71-5.99) among men in age group, 35-49 years. For women, age group 25-34 years had the highest likelihood of having been previously tested (adjusted OR = 1.30; 95% CI: 1.05-1.66). Being currently pregnant (adjusted OR 3.31; 95% CI: 2.29 - 4.78) or having a child under five (adjusted OR 7.00; 95% CI: 5.84 - 8.39) were also associated with prior HIV testing amongst women.
Overall, knowledge of HIV status in this rural sub-district is low. The relatively higher uptake of HIV testing among women is encouraging as it shows that PMTCT services are well functioning. However, these data suggest that there is an urgent need for scaling up HIV testing services in rural communities specifically targeting men and youth.
Url:
DOI: 10.1186/1471-2334-12-73
PubMed: 22458410
PubMed Central: 3338079
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prior to a community HIV counseling and testing intervention in a rural district of south Africa: results of a community based survey</title><author><name sortKey="Tabana, Hanani" sort="Tabana, Hanani" uniqKey="Tabana H" first="Hanani" last="Tabana">Hanani Tabana</name><affiliation wicri:level="1"><nlm:aff id="I1">Medical Research Council, Francie van Zyl Drive, Parrow, Cape Town, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Medical Research Council, Francie van Zyl Drive, Parrow, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="I3">Division of Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Nobels vag 9 5-171 77, Stockholm, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Division of Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Nobels vag 9 5-171 77, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Doherty, Tanya" sort="Doherty, Tanya" uniqKey="Doherty T" first="Tanya" last="Doherty">Tanya Doherty</name><affiliation wicri:level="1"><nlm:aff id="I1">Medical Research Council, Francie van Zyl Drive, Parrow, Cape Town, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Medical Research Council, Francie van Zyl Drive, Parrow, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">University of the Western Cape, Modderdam Road, Bellville, Cape Town, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>University of the Western Cape, Modderdam Road, Bellville, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Swanevelder, Sonja" sort="Swanevelder, Sonja" uniqKey="Swanevelder S" first="Sonja" last="Swanevelder">Sonja Swanevelder</name><affiliation wicri:level="1"><nlm:aff id="I1">Medical Research Council, Francie van Zyl Drive, Parrow, Cape Town, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Medical Research Council, Francie van Zyl Drive, Parrow, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Lombard, Carl" sort="Lombard, Carl" uniqKey="Lombard C" first="Carl" last="Lombard">Carl Lombard</name><affiliation wicri:level="1"><nlm:aff id="I1">Medical Research Council, Francie van Zyl Drive, Parrow, Cape Town, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Medical Research Council, Francie van Zyl Drive, Parrow, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Jackson, Debra" sort="Jackson, Debra" uniqKey="Jackson D" first="Debra" last="Jackson">Debra Jackson</name><affiliation wicri:level="1"><nlm:aff id="I2">University of the Western Cape, Modderdam Road, Bellville, Cape Town, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>University of the Western Cape, Modderdam Road, Bellville, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Zembe, Wanga" sort="Zembe, Wanga" uniqKey="Zembe W" first="Wanga" last="Zembe">Wanga Zembe</name><affiliation wicri:level="1"><nlm:aff id="I1">Medical Research Council, Francie van Zyl Drive, Parrow, Cape Town, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Medical Research Council, Francie van Zyl Drive, Parrow, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Naik, Reshma" sort="Naik, Reshma" uniqKey="Naik R" first="Reshma" last="Naik">Reshma Naik</name><affiliation wicri:level="1"><nlm:aff id="I1">Medical Research Council, Francie van Zyl Drive, Parrow, Cape Town, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Medical Research Council, Francie van Zyl Drive, Parrow, Cape Town</wicri:regionArea><wicri:noRegion>Cape Town</wicri:noRegion></affiliation><affiliation wicri:level="2"><nlm:aff id="I4">School of Public Health, Boston University, 715 Albany Street, Boston 02118, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>School of Public Health, Boston University, 715 Albany Street, Boston 02118, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author></analytic><series><title level="j">BMC Infectious Diseases</title><idno type="eISSN">1471-2334</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>The low uptake of facility-based HIV counseling and testing (HCT) in South Africa, particularly amongst men and youth has hindered attempts to increase access to effective treatment and prevention strategies. Many barriers to HIV testing have been described including long waiting times, transport to reach facilities, fear of lack of confidentiality and health systems factors such as stock outs of HIV test kits. The aim of this study was to undertake a community survey to determine rates of HCT in a rural area in order to plan a community intervention.</p></sec><sec><title>Methods</title><p>A community-based survey was undertaken in 16 communities in Sisonke district, KwaZulu-Natal between September and November 2008. A total of 5821 individuals participated in the survey of which 66% were females. Gender specific mixed effects logistic regression models were used to describe differences in socio-economic characteristics, and their association with HIV testing histories.</p></sec><sec><title>Results</title><p>Overall 1833 (32%) individuals in this rural area knew their HIV status. Prior testing was higher amongst women (39%) than amongst men (17%). Older men (> 24 years) were more likely to report having tested for HIV previously, with the highest likelihood (adjusted OR = 4.02; 95% CI: 2.71-5.99) among men in age group, 35-49 years. For women, age group 25-34 years had the highest likelihood of having been previously tested (adjusted OR = 1.30; 95% CI: 1.05-1.66). Being currently pregnant (adjusted OR 3.31; 95% CI: 2.29 - 4.78) or having a child under five (adjusted OR 7.00; 95% CI: 5.84 - 8.39) were also associated with prior HIV testing amongst women.</p></sec><sec><title>Conclusions</title><p>Overall, knowledge of HIV status in this rural sub-district is low. The relatively higher uptake of HIV testing among women is encouraging as it shows that PMTCT services are well functioning. However, these data suggest that there is an urgent need for scaling up HIV testing services in rural communities specifically targeting men and youth.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="De Cock, Km" uniqKey="De Cock K">KM De Cock</name></author><author><name sortKey="Marum, E" uniqKey="Marum E">E Marum</name></author><author><name sortKey="Mbori Ngacha, D" uniqKey="Mbori Ngacha D">D Mbori-Ngacha</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Matovu, Jkb" uniqKey="Matovu J">JKB Matovu</name></author><author><name sortKey="Makumbi, Fe" uniqKey="Makumbi F">FE Makumbi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Helleringer, S" uniqKey="Helleringer S">S Helleringer</name></author><author><name sortKey="Kohler, H" uniqKey="Kohler H">H Kohler</name></author><author><name sortKey="Frimpong, Ja" uniqKey="Frimpong J">JA 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