Barriers to HIV Testing in Côte d'Ivoire: The Role of Individual Characteristics and Testing Modalities
Identifieur interne : 001847 ( Ncbi/Merge ); précédent : 001846; suivant : 001848Barriers to HIV Testing in Côte d'Ivoire: The Role of Individual Characteristics and Testing Modalities
Auteurs : Kévin Jean [France] ; Xavier Anglaret [Côte d'Ivoire, France] ; Raoul Moh [Côte d'Ivoire] ; France Lert [France] ; Rosemary Dray-Spira [France]Source :
- PLoS ONE [ 1932-6203 ] ; 2012.
Abstract
Expanding HIV testing requires a better understanding of barriers to its uptake. We investigated barriers to HIV testing in Côte d'Ivoire, taking into account test circumstances (client vs. provider-initiated).
We used data from the 2005 nationally representative Demographic and Health Survey conducted in Côte d'Ivoire. Socio-demographic characteristics, sexual behaviour and knowledge and attitudes toward HIV/AIDS associated with recent (<2 years) HIV testing were identified using gender-specific univariate and multivariate logistic regressions. Among women, differential effects of barriers to testing according to test circumstance (whether they have been offered for a prenatal test or not) were assessed through interaction tests.
Recent HIV testing was reported by 6.1% of men and 9.5% of women (including 4.6% as part of antenatal care). Among men, having a low socioeconomic status, having a low HIV-related knowledge level and being employed [compared to those inactive: adjusted Odds Ratio (aOR) 0.46; 95% confidence interval (CI) 0.25–0.87] were associated with lower proportions of recent HIV testing. Among women without a prenatal HIV testing offer, living outside the capital (aOR 0.38; CI 0.19–0.77) and reporting a unique lifetime sexual partner constituted additional barriers to HIV testing. By contrast, among women recently offered to be tested in prenatal care, none of these variables was found to be associated with recent HIV testing.
Various dimensions of individuals' characteristics constituted significant barriers to HIV testing in Côte d'Ivoire in 2005, with gender specificities. Such barriers are substantially reduced when testing was proposed in the framework of antenatal care. This suggests that provider-initiated testing strategies may help overcome individual barriers to HIV testing.
Url:
DOI: 10.1371/journal.pone.0041353
PubMed: 22815995
PubMed Central: 3399867
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sort="Jean, Kevin" uniqKey="Jean K" first="Kévin" last="Jean">Kévin Jean</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>Epidemiology of Occupational and Social Determinants of Health – Center for Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Epidemiology of Occupational and Social Determinants of Health – Center for Research in Epidemiology and Population Health, INSERM U1018, Villejuif</wicri:regionArea><wicri:noRegion>Villejuif</wicri:noRegion><wicri:noRegion>Villejuif</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>UMRS 1018, Université de Versailles Saint-Quentin, Villejuif, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>UMRS 1018, Université de Versailles Saint-Quentin, 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type="city">Bordeaux</settlement><settlement type="city">Bordeaux</settlement></placeName><orgName type="university">Université Bordeaux II</orgName></affiliation></author><author><name sortKey="Moh, Raoul" sort="Moh, Raoul" uniqKey="Moh R" first="Raoul" last="Moh">Raoul Moh</name><affiliation wicri:level="1"><nlm:aff id="aff3"><addr-line>PAC-CI Program, CHU de Treichville, Abidjan, Côte d'Ivoire</addr-line></nlm:aff><country xml:lang="fr">Côte d'Ivoire</country><wicri:regionArea>PAC-CI Program, CHU de Treichville, Abidjan</wicri:regionArea><wicri:noRegion>Abidjan</wicri:noRegion></affiliation></author><author><name sortKey="Lert, France" sort="Lert, France" uniqKey="Lert F" first="France" last="Lert">France Lert</name><affiliation wicri:level="1"><nlm:aff id="aff1"><addr-line>Epidemiology of Occupational and Social Determinants of Health – Center for Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France</addr-line></nlm:aff><country 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Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Epidemiology of Occupational and Social Determinants of Health – Center for Research in Epidemiology and Population Health, INSERM U1018, Villejuif</wicri:regionArea><wicri:noRegion>Villejuif</wicri:noRegion><wicri:noRegion>Villejuif</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2"><addr-line>UMRS 1018, Université de Versailles Saint-Quentin, Villejuif, France</addr-line></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>UMRS 1018, Université de Versailles Saint-Quentin, Villejuif</wicri:regionArea><wicri:noRegion>Villejuif</wicri:noRegion><wicri:noRegion>Villejuif</wicri:noRegion></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</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>Expanding HIV testing requires a better understanding of barriers to its uptake. We investigated barriers to HIV testing in Côte d'Ivoire, taking into account test circumstances (client vs. provider-initiated).</p></sec><sec><title>Methods</title><p>We used data from the 2005 nationally representative Demographic and Health Survey conducted in Côte d'Ivoire. Socio-demographic characteristics, sexual behaviour and knowledge and attitudes toward HIV/AIDS associated with recent (<2 years) HIV testing were identified using gender-specific univariate and multivariate logistic regressions. Among women, differential effects of barriers to testing according to test circumstance (whether they have been offered for a prenatal test or not) were assessed through interaction tests.</p></sec><sec><title>Results</title><p>Recent HIV testing was reported by 6.1% of men and 9.5% of women (including 4.6% as part of antenatal care). Among men, having a low socioeconomic status, having a low HIV-related knowledge level and being employed [compared to those inactive: adjusted Odds Ratio (aOR) 0.46; 95% confidence interval (CI) 0.25–0.87] were associated with lower proportions of recent HIV testing. Among women without a prenatal HIV testing offer, living outside the capital (aOR 0.38; CI 0.19–0.77) and reporting a unique lifetime sexual partner constituted additional barriers to HIV testing. By contrast, among women recently offered to be tested in prenatal care, none of these variables was found to be associated with recent HIV testing.</p></sec><sec><title>Conclusions</title><p>Various dimensions of individuals' characteristics constituted significant barriers to HIV testing in Côte d'Ivoire in 2005, with gender specificities. Such barriers are substantially reduced when testing was proposed in the framework of antenatal care. This suggests that provider-initiated testing strategies may help overcome individual barriers to HIV testing.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Denison, Ja" uniqKey="Denison J">JA Denison</name></author><author><name sortKey="O Reilly, Kr" uniqKey="O Reilly K">KR O'Reilly</name></author><author><name sortKey="Schmid, Gp" uniqKey="Schmid G">GP Schmid</name></author><author><name sortKey="Kennedy, Ce" uniqKey="Kennedy C">CE Kennedy</name></author><author><name sortKey="Sweat, Md" uniqKey="Sweat M">MD Sweat</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cremin, I" uniqKey="Cremin I">I Cremin</name></author><author><name sortKey="Nyamukapa, C" uniqKey="Nyamukapa C">C Nyamukapa</name></author><author><name sortKey="Sherr, L" uniqKey="Sherr L">L Sherr</name></author><author><name sortKey="Hallett, Tb" uniqKey="Hallett T">TB Hallett</name></author><author><name sortKey="Chawira, 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<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id><journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id><journal-id journal-id-type="publisher-id">plos</journal-id><journal-id journal-id-type="pmc">plosone</journal-id><journal-title-group><journal-title>PLoS ONE</journal-title></journal-title-group><issn pub-type="epub">1932-6203</issn><publisher><publisher-name>Public Library of Science</publisher-name><publisher-loc>San Francisco, USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">22815995</article-id><article-id pub-id-type="pmc">3399867</article-id><article-id pub-id-type="publisher-id">PONE-D-12-10957</article-id><article-id pub-id-type="doi">10.1371/journal.pone.0041353</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Medicine</subject><subj-group><subject>Epidemiology</subject><subj-group><subject>Social Epidemiology</subject></subj-group></subj-group><subj-group><subject>Infectious Diseases</subject><subj-group><subject>Sexually Transmitted Diseases</subject><subj-group><subject>AIDS</subject></subj-group></subj-group><subj-group><subject>Viral Diseases</subject><subj-group><subject>HIV</subject><subj-group><subject>HIV diagnosis and management</subject><subject>HIV epidemiology</subject></subj-group></subj-group></subj-group></subj-group><subj-group><subject>Non-Clinical Medicine</subject><subj-group><subject>Health Care Policy</subject><subj-group><subject>Health Education and Awareness</subject><subject>Sexual and Gender Issues</subject></subj-group></subj-group></subj-group><subj-group><subject>Obstetrics and Gynecology</subject><subj-group><subject>Genitourinary Infections</subject><subj-group><subject>HIV</subject></subj-group></subj-group></subj-group><subj-group><subject>Public Health</subject><subj-group><subject>Socioeconomic Aspects of Health</subject></subj-group></subj-group><subj-group><subject>Urology</subject><subj-group><subject>Genitourinary Infections</subject><subj-group><subject>HIV</subject></subj-group></subj-group></subj-group></subj-group></article-categories><title-group><article-title>Barriers to HIV Testing in Côte d'Ivoire: The Role of Individual Characteristics and Testing Modalities</article-title><alt-title alt-title-type="running-head">Barriers to HIV Testing in Côte d'Ivoire</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Jean</surname><given-names>Kévin</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="aff" rid="aff2"><sup>2</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author"><name><surname>Anglaret</surname><given-names>Xavier</given-names></name><xref ref-type="aff" rid="aff3"><sup>3</sup></xref><xref ref-type="aff" rid="aff4"><sup>4</sup></xref></contrib><contrib contrib-type="author"><name><surname>Moh</surname><given-names>Raoul</given-names></name><xref ref-type="aff" rid="aff3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Lert</surname><given-names>France</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Dray-Spira</surname><given-names>Rosemary</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib></contrib-group><aff id="aff1"><label>1</label><addr-line>Epidemiology of Occupational and Social Determinants of Health – Center for Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France</addr-line></aff><aff id="aff2"><label>2</label><addr-line>UMRS 1018, Université de Versailles Saint-Quentin, Villejuif, France</addr-line></aff><aff id="aff3"><label>3</label><addr-line>PAC-CI Program, CHU de Treichville, Abidjan, Côte d'Ivoire</addr-line></aff><aff id="aff4"><label>4</label><addr-line>INSERM U897, Université Bordeaux Segalen, Bordeaux, France</addr-line></aff><contrib-group><contrib contrib-type="editor"><name><surname>Braitstein</surname><given-names>Paula</given-names></name><role>Editor</role><xref ref-type="aff" rid="edit1"></xref></contrib></contrib-group><aff id="edit1">Indiana University and Moi University, United States of America</aff><author-notes><corresp id="cor1">* E-mail: <email>kevin.jean@inserm.fr</email></corresp><fn fn-type="con"><p>Conceived and designed the experiments: KJ FL RDS. Analyzed the data: KJ. Wrote the paper: KJ FL RDS. Reviewed and edited the manuscript: XA RM.</p></fn></author-notes><pub-date pub-type="collection"><year>2012</year></pub-date><pub-date pub-type="epub"><day>18</day><month>7</month><year>2012</year></pub-date><volume>7</volume><issue>7</issue><elocation-id>e41353</elocation-id><history><date date-type="received"><day>17</day><month>4</month><year>2012</year></date><date date-type="accepted"><day>20</day><month>6</month><year>2012</year></date></history><permissions><copyright-statement>Jean et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</copyright-statement><copyright-year>2012</copyright-year></permissions><abstract><sec><title>Background</title><p>Expanding HIV testing requires a better understanding of barriers to its uptake. We investigated barriers to HIV testing in Côte d'Ivoire, taking into account test circumstances (client vs. provider-initiated).</p></sec><sec><title>Methods</title><p>We used data from the 2005 nationally representative Demographic and Health Survey conducted in Côte d'Ivoire. Socio-demographic characteristics, sexual behaviour and knowledge and attitudes toward HIV/AIDS associated with recent (<2 years) HIV testing were identified using gender-specific univariate and multivariate logistic regressions. Among women, differential effects of barriers to testing according to test circumstance (whether they have been offered for a prenatal test or not) were assessed through interaction tests.</p></sec><sec><title>Results</title><p>Recent HIV testing was reported by 6.1% of men and 9.5% of women (including 4.6% as part of antenatal care). Among men, having a low socioeconomic status, having a low HIV-related knowledge level and being employed [compared to those inactive: adjusted Odds Ratio (aOR) 0.46; 95% confidence interval (CI) 0.25–0.87] were associated with lower proportions of recent HIV testing. Among women without a prenatal HIV testing offer, living outside the capital (aOR 0.38; CI 0.19–0.77) and reporting a unique lifetime sexual partner constituted additional barriers to HIV testing. By contrast, among women recently offered to be tested in prenatal care, none of these variables was found to be associated with recent HIV testing.</p></sec><sec><title>Conclusions</title><p>Various dimensions of individuals' characteristics constituted significant barriers to HIV testing in Côte d'Ivoire in 2005, with gender specificities. Such barriers are substantially reduced when testing was proposed in the framework of antenatal care. This suggests that provider-initiated testing strategies may help overcome individual barriers to HIV testing.</p></sec></abstract><counts><page-count count="9"></page-count></counts></article-meta></front></pmc><affiliations><list><country><li>Côte d'Ivoire</li><li>France</li></country><region><li>Aquitaine</li><li>Nouvelle-Aquitaine</li></region><settlement><li>Bordeaux</li></settlement><orgName><li>Université Bordeaux II</li></orgName></list><tree><country name="France"><noRegion><name sortKey="Jean, Kevin" sort="Jean, Kevin" uniqKey="Jean K" first="Kévin" last="Jean">Kévin Jean</name></noRegion><name sortKey="Anglaret, Xavier" sort="Anglaret, Xavier" uniqKey="Anglaret X" first="Xavier" last="Anglaret">Xavier Anglaret</name><name sortKey="Dray Spira, Rosemary" sort="Dray Spira, Rosemary" uniqKey="Dray Spira R" first="Rosemary" last="Dray-Spira">Rosemary Dray-Spira</name><name sortKey="Dray Spira, Rosemary" sort="Dray Spira, Rosemary" uniqKey="Dray Spira R" first="Rosemary" last="Dray-Spira">Rosemary Dray-Spira</name><name sortKey="Jean, Kevin" sort="Jean, Kevin" uniqKey="Jean K" first="Kévin" last="Jean">Kévin Jean</name><name sortKey="Lert, France" sort="Lert, France" uniqKey="Lert F" first="France" last="Lert">France Lert</name><name sortKey="Lert, France" sort="Lert, France" uniqKey="Lert F" first="France" last="Lert">France Lert</name></country><country name="Côte d'Ivoire"><noRegion><name sortKey="Anglaret, Xavier" sort="Anglaret, Xavier" uniqKey="Anglaret X" first="Xavier" last="Anglaret">Xavier Anglaret</name></noRegion><name sortKey="Moh, Raoul" sort="Moh, Raoul" uniqKey="Moh R" first="Raoul" last="Moh">Raoul Moh</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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