Socioeconomic determinants of HIV testing and counselling: A comparative study in four African countries
Identifieur interne : 002302 ( Main/Exploration ); précédent : 002301; suivant : 002303Socioeconomic determinants of HIV testing and counselling: A comparative study in four African countries
Auteurs : Carla Makhlouf Obermeyer [Liban] ; Melissa Neuman [Royaume-Uni] ; Anita Hardon [Pays-Bas] ; Alice Desclaux [Sénégal] ; Rhoda Wanyenze [Ouganda] ; Odette Kyzerbo [Burkina Faso] ; Peter Cherutich [Kenya] ; Ireen Namakhoma [Malawi]Source :
- Tropical medicine & international health : TM & IH [ 1360-2276 ] ; 2013.
Descripteurs français
- KwdFr :
- Acceptation des soins par le patient (), Acceptation des soins par le patient (ethnologie), Adolescent, Adulte, Adulte d'âge moyen, Burkina, Classe sociale, Comparaison interculturelle, Femelle, Humains, Jeune adulte, Kenya, Loi de Poisson, Malawi, Mâle, Niveau d'instruction, Ouganda, Répartition par âge, Sérodiagnostic du SIDA (), Sérodiagnostic du SIDA (économie), Études transversales.
- MESH :
- ethnologie : Acceptation des soins par le patient.
- économie : Sérodiagnostic du SIDA.
- Acceptation des soins par le patient, Adolescent, Adulte, Adulte d'âge moyen, Burkina, Classe sociale, Comparaison interculturelle, Femelle, Humains, Jeune adulte, Kenya, Loi de Poisson, Malawi, Mâle, Niveau d'instruction, Ouganda, Répartition par âge, Sérodiagnostic du SIDA, Études transversales.
- Wicri :
- geographic : Burkina Faso, Kenya, Malawi, Ouganda.
English descriptors
- KwdEn :
- AIDS Serodiagnosis (economics), AIDS Serodiagnosis (statistics & numerical data), Adolescent, Adult, Age Distribution, Burkina Faso, Cross-Cultural Comparison, Cross-Sectional Studies, Educational Status, Female, Humans, Kenya, Malawi, Male, Middle Aged, Patient Acceptance of Health Care (ethnology), Patient Acceptance of Health Care (statistics & numerical data), Poisson Distribution, Social Class, Uganda, Young Adult.
- MESH :
- geographic : Burkina Faso, Kenya, Malawi, Uganda.
- economics : AIDS Serodiagnosis.
- ethnology : Patient Acceptance of Health Care.
- statistics & numerical data : AIDS Serodiagnosis, Patient Acceptance of Health Care.
- Adolescent, Adult, Age Distribution, Cross-Cultural Comparison, Cross-Sectional Studies, Educational Status, Female, Humans, Male, Middle Aged, Poisson Distribution, Social Class, Young Adult.
Abstract
Research indicates that individuals tested for HIV have higher socioeconomic status than those not tested, but less is known about how socioeconomic 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.
Cross-sectional surveys were conducted at health facilities in Burkina Faso, Kenya, Malawi, and Uganda, as part of the MATCH (Multi-country African Testing and Counselling for HIV) study. 3,659 clients were asked about testing status, type of facility of most recent test, and socioeconomic status. Two outcome measures were analyzed: ever tested for HIV, and mode of testing. We compared VCT at standalone facilities and PITC, which includes Integrated facilities where testing is provided with medical care, and PMTCT (prevention of mother-to-child transmission) facilities. The determinants of ever testing and of using a particular mode of testing were analysed using modified Poisson regression and multinomial logistic analyses.
Higher socioeconomic status was associated with the likelihood of testing at VCT rather than other facilities or not testing. There were no significant differences in socioeconomic characteristics between those tested through PITC (integrated and PMTCT facilities) and those not tested.
Provider-initiated modes of testing make testing accessible to individuals from lower socioeconomic groups to a greater extent than traditional VCT. Expanding testing through PMTCT reduces socioeconomic obstacles, especially for women. Continued efforts are needed to encourage testing and counselling among men and the less affluent.
Url:
DOI: 10.1111/tmi.12155
PubMed: 23937702
PubMed Central: 3808878
Affiliations:
- Burkina Faso, Kenya, Liban, Malawi, Ouganda, Pays-Bas, Royaume-Uni, Sénégal
- Angleterre, Grand Londres
- Londres
- University College de Londres
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University of Beirut, Lebanon</nlm:aff><country xml:lang="fr">Liban</country><wicri:regionArea>Faculty of Health Sciences, American University of Beirut</wicri:regionArea><wicri:noRegion>American University of Beirut</wicri:noRegion></affiliation></author><author><name sortKey="Neuman, Melissa" sort="Neuman, Melissa" uniqKey="Neuman M" first="Melissa" last="Neuman">Melissa Neuman</name><affiliation wicri:level="4"><nlm:aff id="A2">Institute for Global Health, University College London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Institute for Global Health, University College London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><orgName type="university">University College de Londres</orgName></affiliation></author><author><name sortKey="Hardon, Anita" sort="Hardon, Anita" uniqKey="Hardon A" first="Anita" last="Hardon">Anita Hardon</name><affiliation wicri:level="1"><nlm:aff id="A3">University of Amsterdam, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>University of Amsterdam</wicri:regionArea></affiliation></author><author><name sortKey="Desclaux, Alice" sort="Desclaux, Alice" uniqKey="Desclaux A" first="Alice" last="Desclaux">Alice Desclaux</name><affiliation wicri:level="1"><nlm:aff id="A4">Institut de Recherches sur le Développement, Dakar, Senegal</nlm:aff><country xml:lang="fr">Sénégal</country><wicri:regionArea>Institut de Recherches sur le Développement, Dakar</wicri:regionArea><wicri:noRegion>Dakar</wicri:noRegion></affiliation></author><author><name sortKey="Wanyenze, Rhoda" sort="Wanyenze, Rhoda" uniqKey="Wanyenze R" first="Rhoda" last="Wanyenze">Rhoda Wanyenze</name><affiliation wicri:level="1"><nlm:aff id="A5">Makerere University School of Public Health, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Makerere University School of Public Health, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation></author><author><name sortKey="Kyzerbo, Odette" sort="Kyzerbo, Odette" uniqKey="Kyzerbo O" first="Odette" last="Kyzerbo">Odette Kyzerbo</name><affiliation wicri:level="1"><nlm:aff id="A6">Programme d’Appui au Monde Associatif et Communautaire, Ouagadougou, Burkina Faso</nlm:aff><country xml:lang="fr">Burkina Faso</country><wicri:regionArea>Programme d’Appui au Monde Associatif et Communautaire, Ouagadougou</wicri:regionArea><wicri:noRegion>Ouagadougou</wicri:noRegion></affiliation></author><author><name sortKey="Cherutich, Peter" sort="Cherutich, Peter" uniqKey="Cherutich P" first="Peter" last="Cherutich">Peter Cherutich</name><affiliation wicri:level="1"><nlm:aff id="A7">National AIDS Control Program, Nairobi, Kenya</nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>National AIDS Control Program, Nairobi</wicri:regionArea><wicri:noRegion>Nairobi</wicri:noRegion></affiliation></author><author><name sortKey="Namakhoma, Ireen" sort="Namakhoma, Ireen" uniqKey="Namakhoma I" first="Ireen" last="Namakhoma">Ireen Namakhoma</name><affiliation wicri:level="1"><nlm:aff id="A8">Reach Trust, Lilongwe, Malawi</nlm:aff><country xml:lang="fr">Malawi</country><wicri:regionArea>Reach Trust, Lilongwe</wicri:regionArea><wicri:noRegion>Lilongwe</wicri:noRegion></affiliation></author></analytic><series><title level="j">Tropical medicine & international health : TM & IH</title><idno type="ISSN">1360-2276</idno><idno type="eISSN">1365-3156</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>AIDS Serodiagnosis (economics)</term><term>AIDS Serodiagnosis (statistics & numerical data)</term><term>Adolescent</term><term>Adult</term><term>Age Distribution</term><term>Burkina Faso</term><term>Cross-Cultural Comparison</term><term>Cross-Sectional Studies</term><term>Educational Status</term><term>Female</term><term>Humans</term><term>Kenya</term><term>Malawi</term><term>Male</term><term>Middle Aged</term><term>Patient Acceptance of Health Care (ethnology)</term><term>Patient Acceptance of Health Care (statistics & numerical data)</term><term>Poisson Distribution</term><term>Social Class</term><term>Uganda</term><term>Young Adult</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Acceptation des soins par le patient ()</term><term>Acceptation des soins par le patient (ethnologie)</term><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Burkina</term><term>Classe sociale</term><term>Comparaison interculturelle</term><term>Femelle</term><term>Humains</term><term>Jeune adulte</term><term>Kenya</term><term>Loi de Poisson</term><term>Malawi</term><term>Mâle</term><term>Niveau d'instruction</term><term>Ouganda</term><term>Répartition par âge</term><term>Sérodiagnostic du SIDA ()</term><term>Sérodiagnostic du SIDA (économie)</term><term>Études transversales</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Burkina Faso</term><term>Kenya</term><term>Malawi</term><term>Uganda</term></keywords><keywords scheme="MESH" qualifier="economics" xml:lang="en"><term>AIDS Serodiagnosis</term></keywords><keywords scheme="MESH" qualifier="ethnologie" xml:lang="fr"><term>Acceptation des soins par le patient</term></keywords><keywords scheme="MESH" qualifier="ethnology" xml:lang="en"><term>Patient Acceptance of Health Care</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>AIDS Serodiagnosis</term><term>Patient Acceptance of Health Care</term></keywords><keywords scheme="MESH" qualifier="économie" xml:lang="fr"><term>Sérodiagnostic du SIDA</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Age Distribution</term><term>Cross-Cultural Comparison</term><term>Cross-Sectional Studies</term><term>Educational Status</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Poisson Distribution</term><term>Social Class</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Acceptation des soins par le patient</term><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Burkina</term><term>Classe sociale</term><term>Comparaison interculturelle</term><term>Femelle</term><term>Humains</term><term>Jeune adulte</term><term>Kenya</term><term>Loi de Poisson</term><term>Malawi</term><term>Mâle</term><term>Niveau d'instruction</term><term>Ouganda</term><term>Répartition par âge</term><term>Sérodiagnostic du SIDA</term><term>Études transversales</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Burkina Faso</term><term>Kenya</term><term>Malawi</term><term>Ouganda</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objectives</title><p id="P1">Research indicates that individuals tested for HIV have higher socioeconomic status than those not tested, but less is known about how socioeconomic 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.</p></sec><sec id="S2"><title>Methods</title><p id="P2">Cross-sectional surveys were conducted at health facilities in Burkina Faso, Kenya, Malawi, and Uganda, as part of the MATCH (Multi-country African Testing and Counselling for HIV) study. 3,659 clients were asked about testing status, type of facility of most recent test, and socioeconomic status. Two outcome measures were analyzed: ever tested for HIV, and mode of testing. We compared VCT at standalone facilities and PITC, which includes Integrated facilities where testing is provided with medical care, and PMTCT (prevention of mother-to-child transmission) facilities. The determinants of ever testing and of using a particular mode of testing were analysed using modified Poisson regression and multinomial logistic analyses.</p></sec><sec id="S3"><title>Results</title><p id="P3">Higher socioeconomic status was associated with the likelihood of testing at VCT rather than other facilities or not testing. There were no significant differences in socioeconomic characteristics between those tested through PITC (integrated and PMTCT facilities) and those not tested.</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">Provider-initiated modes of testing make testing accessible to individuals from lower socioeconomic groups to a greater extent than traditional VCT. Expanding testing through PMTCT reduces socioeconomic obstacles, especially for women. Continued efforts are needed to encourage testing and counselling among men and the less affluent.</p></sec></div></front></TEI><affiliations><list><country><li>Burkina Faso</li><li>Kenya</li><li>Liban</li><li>Malawi</li><li>Ouganda</li><li>Pays-Bas</li><li>Royaume-Uni</li><li>Sénégal</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement><orgName><li>University College de Londres</li></orgName></list><tree><country name="Liban"><noRegion><name sortKey="Obermeyer, Carla Makhlouf" sort="Obermeyer, Carla Makhlouf" uniqKey="Obermeyer C" first="Carla Makhlouf" last="Obermeyer">Carla Makhlouf Obermeyer</name></noRegion></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Neuman, Melissa" sort="Neuman, Melissa" uniqKey="Neuman M" first="Melissa" last="Neuman">Melissa Neuman</name></region></country><country name="Pays-Bas"><noRegion><name sortKey="Hardon, Anita" sort="Hardon, Anita" uniqKey="Hardon A" first="Anita" last="Hardon">Anita Hardon</name></noRegion></country><country name="Sénégal"><noRegion><name sortKey="Desclaux, Alice" sort="Desclaux, Alice" uniqKey="Desclaux A" first="Alice" last="Desclaux">Alice Desclaux</name></noRegion></country><country name="Ouganda"><noRegion><name sortKey="Wanyenze, Rhoda" sort="Wanyenze, Rhoda" uniqKey="Wanyenze R" first="Rhoda" last="Wanyenze">Rhoda Wanyenze</name></noRegion></country><country name="Burkina Faso"><noRegion><name sortKey="Kyzerbo, Odette" sort="Kyzerbo, Odette" uniqKey="Kyzerbo O" first="Odette" last="Kyzerbo">Odette Kyzerbo</name></noRegion></country><country name="Kenya"><noRegion><name sortKey="Cherutich, Peter" sort="Cherutich, Peter" uniqKey="Cherutich P" first="Peter" last="Cherutich">Peter Cherutich</name></noRegion></country><country name="Malawi"><noRegion><name sortKey="Namakhoma, Ireen" sort="Namakhoma, Ireen" uniqKey="Namakhoma I" first="Ireen" last="Namakhoma">Ireen Namakhoma</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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