Stigma, sexual risk and desire for HIV tests in Ghana

Sexual Health ◽  
2011 ◽  
Vol 8 (1) ◽  
pp. 110 ◽  
Author(s):  
Emmanuel F. Koku
Keyword(s):  
Hiv Prevention ◽  
Hiv Testing ◽  
Treatment Programs ◽  
Negative Interaction ◽  
Sexual Behaviours ◽  
Hiv Test ◽  
Related Stigma ◽  
Risky Sexual Behaviours ◽  
Positive Effect

Background: Although various HIV prevention and treatment programs have been implemented in Ghana since 2003, desire for and uptake of HIV testing is still low, owing largely to HIV-related stigma. This study examined the effect of stigma on desire for HIV testing, while controlling for socio-demographic and other influences. Method: The study used data from the 2003 Ghana Demographic and Health Survey to regress desire for an HIV test on levels of stigma while controlling for selected socio-demographic, socio-cognitive and socio-behavioural covariates. Results: The study revealed significant associations between several socio-demographic and socio-cognitive variables and the desire for an HIV test. For example, both male (adjusted odds ratio (AOR) = 0.41; 95% confidence interval (CI) = 0.24–0.72) and female (AOR = 0.62; 95% CI = 0.41–0.93) respondents in the wealthiest households, and those who know someone infected with HIV (AOR = 0.65; 95% CI = 0.43–1.00) have lower odds of desiring an HIV test. The study showed a significant but negative interaction between risky sexual behaviours and community stigma (AOR = 0.44; 95% CI = 0.19–0.67), indicating that the positive effect of risky sex on HIV testing is attenuated among females who live in communities with high levels of stigma. Conclusion: Since community-level education and risk reduction programs have demonstrable influences on reducing HIV stigma, it is imperative that the Ghana government’s ongoing anti-stigma campaigns and other HIV prevention programs recognise the role of community stigma in influencing HIV testing decisions, especially in the context of risky sexual behaviours.

Perceived barriers and facilitators to HIV testing in South African communities

2016 ◽  
Vol 23 (12) ◽  
pp. 1635-1645 ◽  
Author(s):  
Henri De Wet ◽  
Ashraf Kagee
Keyword(s):  
Hiv Testing ◽  
South African ◽  
Unprotected Sex ◽  
Perceived Barriers ◽  
Hiv Positive ◽  
South Africans ◽  
Hiv Test ◽  
Related Stigma ◽  
The Media

We interviewed 15 South Africans seeking HIV testing to understand the factors that influenced their seeking an HIV test. Reasons in favour of testing included having had unprotected sex, availability of social support if testing HIV positive and modelling test-seeking behaviour to others. Reasons against seeking testing included fear testing HIV positive, the possibility of receiving treatment too late, HIV-related stigma and long distances to testing sites. Participants also discussed ways to increase the uptake of HIV testing, such as workplace testing, the role of the media and the role of cultural rituals such as male circumcision.

scholarly journals A randomized group antenatal care pilot showed increased partner communication and partner HIV testing during pregnancy in Malawi and Tanzania

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rohan D. Jeremiah ◽  
Dhruvi R. Patel ◽  
Ellen Chirwa ◽  
Esnath Kapito ◽  
Xiaohan Mei ◽  
...  
Keyword(s):  
Health Promotion ◽  
Hiv Prevention ◽  
Reproductive Health ◽  
Antenatal Care ◽  
Hiv Testing ◽  
Late Pregnancy ◽  
Sub Saharan Africa ◽  
Partner Communication ◽  
Logistic Regression Models ◽  
Hiv Test

Abstract Background HIV testing at antenatal care (ANC) is critical to achieving zero new infections in sub-Saharan Africa. Although most women are tested at ANC, they remain at risk for HIV exposure and transmission to their infant when their partners are not tested. This study evaluates how an HIV-enhanced and Centering-based group ANC model-Group ANC+ that uses interactive learning to practice partner communication is associated with improvements in partner HIV testing during pregnancy. Methods A randomized pilot study conducted in Malawi and Tanzania found multiple positive outcomes for pregnant women (n = 218) assigned to Group ANC+ versus individual ANC. This analysis adds previously unpublished results for two late pregnancy outcomes: communication with partner about three reproductive health topics (safer sex, HIV testing, and family planning) and partner HIV testing since the first antenatal care visit. Multivariate logistic regression models were used to assess the effect of type of ANC on partner communication and partner testing. We also conducted a mediation analysis to assess whether partner communication mediated the effect of type of care on partner HIV testing. Results Nearly 70% of women in Group ANC+ reported communicating about reproductive health with their partner, compared to 45% of women in individual ANC. After controlling for significant covariates, women in group ANC were twice as likely as those in individual ANC to report that their partner got an HIV test (OR 1.99; 95% CI: 1.08, 3.66). The positive effect of the Group ANC + model on partner HIV testing was fully mediated by increased partner communication. Conclusions HIV prevention was included in group ANC health promotion without compromising services and coverage of standard ANC topics, demonstrating that local high-priority health promotion needs can be integrated into ANC using a Group ANC+. These findings provide evidence that greater partner communication can promote healthy reproductive behaviors, including HIV prevention. Additional research is needed to understand the processes by which group ANC allowed women to discuss sensitive topics with partners and how these communications led to partner HIV testing.

scholarly journals Dimensions of HIV-related stigma in rural communities in Kenya and Uganda at the start of a large HIV ‘test and treat’ trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0249462
Author(s):  
Cecilia Akatukwasa ◽  
Monica Getahun ◽  
Alison M. El Ayadi ◽  
Judith Namanya ◽  
Irene Maeri ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Physical Violence ◽  
Marital Dissolution ◽  
Care Seeking ◽  
Internalized Stigma ◽  
Test And Treat ◽  
Hiv Test ◽  
Related Stigma ◽  
Enacted Stigma ◽  
Anticipated Stigma

HIV-related stigma is a frequently cited barrier to HIV testing and care engagement. A nuanced understanding of HIV-related stigma is critical for developing stigma-reduction interventions to optimize HIV-related outcomes. This qualitative study documented HIV-related stigma across eight communities in east Africa during the baseline year of a large HIV test-and-treat trial (SEARCH, NCT: 01864603), prior to implementation of widespread community HIV testing campaigns and efforts to link individuals with HIV to care and treatment. Findings revealed experiences of enacted, internalized and anticipated stigma that were highly gendered, and more pronounced in communities with lower HIV prevalence; women, overwhelmingly, both held and were targets of stigmatizing attitudes about HIV. Past experiences with enacted stigma included acts of segregation, verbal discrimination, physical violence, humiliation and rejection. Narratives among women, in particular, revealed acute internalized stigma including feelings of worthlessness, shame, embarrassment, and these resulted in anxiety and depression, including suicidality among a small number of women. Anticipated stigma included fears of marital dissolution, verbal and physical abuse, gossip and public ridicule. Anticipated stigma was especially salient for women who held internalized stigma and who had experienced enacted stigma from their partners. Anticipated stigma led to care avoidance, care-seeking at remote facilities, and hiding of HIV medications. Interventions aimed at reducing individual and community-level forms of stigma may be needed to improve the lives of PLHIV and fully realize the promise of test-and-treat strategies.

scholarly journals What happens after HIV self-testing? Results from a longitudinal cohort of Chinese men who have sex with men

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Weiming Tang ◽  
Wenting Huang ◽  
Haidong Lu ◽  
Bolin Cao ◽  
Dan Wu ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Condom Use ◽  
Hiv Testing ◽  
Consistent Condom ◽  
Consistent Condom Use ◽  
Longitudinal Cohort ◽  
Prevention Services ◽  
Self Testing ◽  
Hiv Test ◽  
Sex With Men

Abstract Background HIV self-testing (HIVST) is a promising approach to expand HIV testing. HIVST is a process in which a person performs an HIV test and interprets the result. Negative HIVST results may encourage men who have sex with men (MSM) to use HIV prevention services. The objective of this study was to examine behaviors (e.g., facility-based HIV testing, condom use) after a negative HIVST test result among Chinese MSM. Methods We collected data from MSM in eight Chinese cities over a 12-month period. This is a secondary analysis of longitudinal cohort data collected as part of an intervention trial to increase HIV testing. Men completed a survey that described sociodemographic information, sexual behaviors, HIV self-testing, and facility-based HIV testing. Men who completed at least one follow-up survey were included in this analysis. Generalized linear mixed models were used to evaluate whether HIVST increased subsequent facility-based HIV testing and consistent condom use. Results We included 1219 men. Most men (78.7%) were under 30 years old and had never been married (87.0%). 755 (61.9%) men tested for HIV and 593 (49.3%) men self-tested during the study period. At baseline, among men who had never been tested for HIV, 44.9% (314/699) initiated HIVST during the study period. HIVST was associated with subsequent facility-based testing (aOR of 1.87, 95% CI: 1.47–2.37). HIVST was also associated with subsequent consistent condom use (aOR = 1.53, 95% CI: 1.13–2.06). Conclusion HIVST was associated with subsequent facility-based HIV testing and consistent condom use. HIVST may enhance uptake of related HIV prevention services at facilities, suggesting the need for more implementation research.

HIV testing in an urgent-care clinic

Sexual Health ◽  
2005 ◽  
Vol 2 (4) ◽  
pp. 245 ◽  
Author(s):  
Keith Murphy ◽  
Oscar Grusky ◽  
Kathleen Johnston Roberts ◽  
Aimee-Noelle Swanson
Keyword(s):  
Hiv Prevention ◽  
Hiv Testing ◽  
Urgent Care ◽  
Medical Setting ◽  
Structured Interviews ◽  
Care Clinic ◽  
Health Maintenance ◽  
Hiv Test ◽  
Study Results ◽  
Urgent Care Clinic

Background: Early detection of HIV is increasingly important in light of advances in HIV research and treatment. Although treatment advances offer the potential to curtail HIV incidence and seroprevalence, the full benefits remain unrealised because many infected individuals remain unaware of their serostatus. An intensive observational study of HIV testing and counselling was undertaken in a large health maintenance organisation’s urgent-care clinic (UCC) for non-threatening illnesses and non-traumatic injuries in order to better understand the HIV testing process in a medical setting. Methods: Multiple data collection strategies, including observation, semi-structured interviews and document and policy analyses, were used in order to identify key factors influencing HIV testing. The study examined physicians’, nurses’ and physician’s assistants’ relationships with patients in the UCC. Results: It was found that HIV testing in the UCC is highly variable because some patients are asked about their sexual risk histories and given HIV prevention education materials and others are not. Moreover, for those patients who do receive these components of testing, the content of both the risk assessments and HIV prevention counselling varies from patient to patient. Findings also highlight the problematic nature of providing HIV test results in an UCC. Conclusions: A number of implementation issues were found to be relevant to the new US Centers for Disease Control and Prevention (CDC) policy of making HIV testing a routine feature of medical care. The study results suggest the need for organisationally fine-tuned interventions designed to improve the process of testing patients for HIV in medical settings.

scholarly journals INDIVIDUAL- AND COMMUNITY-LEVEL DETERMINANTS OF ANTENATAL HIV TESTING IN ZIMBABWE

2018 ◽  
Vol 51 (2) ◽  
pp. 203-224 ◽  
Author(s):  
Martin Marufu Gazimbi ◽  
Monica Akinyi Magadi
Keyword(s):  
Socioeconomic Status ◽  
Hiv Testing ◽  
Community Level ◽  
Demographic And Health Surveys ◽  
Hiv Status ◽  
Individual Level ◽  
Hiv Test ◽  
Wide Range ◽  
Related Stigma ◽  
Hiv Awareness

SummaryThis study contributes to the dialogue on the prevention of mother-to-child HIV transmission (PMTCT) through the use of HIV and antenatal care (ANC) integrated services. The determinants of antenatal HIV testing in Zimbabwe were explored. Multilevel logistic regression models were applied to data for 8471 women from 406 clusters who gave birth in the 5 years preceding Zimbabwe Demographic and Health Surveys conducted in 2005/6 and 2010/11. The uptake of antenatal HIV testing was found to be determined by a wide range of individual-level factors relating to women’s economic and demographic status, as well as HIV-related factors, including HIV awareness and stigma within the community. Important individual-level enabling and perceived need factors included high socioeconomic status, not having observed HIV-related stigma and knowledge of HIV status (based on a previous HIV test), such that these groups of individuals had a significantly higher likelihood of being tested for HIV during pregnancy than their counterparts of lower socioeconomic status, and who had observed HIV-related stigma or did not know their HIV status. The results further revealed that community HIV awareness is important for improving antenatal HIV testing, while stigma is associated with reduced testing uptake. Most contextual community-level factors were not found to have much effect on the uptake of antenatal HIV testing. Therefore, policies should focus on individual-level predisposing and enabling factors to improve the uptake of antenatal HIV testing in Zimbabwe.

HIV-Related Stigma Moderates the Relation Between Perceived Susceptibility and HIV Testing Intention Among Heterosexual (but Not Sexual Minority) College Students

2021 ◽  
pp. 152483992110249
Author(s):  
Alyssa Berger ◽  
Tyler G. James ◽  
Sadie J. Ryan
Keyword(s):  
College Students ◽  
Hiv Testing ◽  
Sexual Minority ◽  
Perceived Susceptibility ◽  
Related Stigma ◽  
At Risk Populations ◽  
Minority College Students ◽  
Moderating Role ◽  
Priority Population

HIV-related stigma remains a considerable barrier to engaging at-risk populations in HIV testing and prevention programs. We assessed the moderating role of HIV-related stigma on the relation between perceived susceptibility to HIV and HIV testing intention among college students. We hypothesized that the moderating role of HIV-related stigma would be differential between heterosexual and sexual minority college students. We administered a survey focused on HIV-related knowledge, attitudes, and behaviors in spring 2016 ( N = 2,159). We used multigroup path analysis to analyze the hypothesized moderation. HIV-related stigma moderated the relation between perceived susceptibility and testing intention for heterosexual but not sexual minority college students. Specifically, higher HIV-related stigma decreased the association between perceived susceptibility and testing intention. These results demonstrate the importance of priority population segmentation for HIV testing campaigns.

scholarly journals The Drive to Take an HIV Test in Rural Uganda: A Risk to Prevention for Young People?

2021 ◽  
pp. 265-276
Author(s):  
Sarah Bernays ◽  
Allen Asiimwe ◽  
Edward Tumwesige ◽  
Janet Seeley
Keyword(s):  
Young People ◽  
Hiv Prevention ◽  
Hiv Testing ◽  
Daily Lives ◽  
Hiv Test ◽  
The Social ◽  
Hiv Acquisition ◽  
Prevention Methods ◽  
Biomedical Interventions

AbstractA key component of current global HIV prevention efforts is widespread HIV testing. This strategy in part reflects the focus on the broader global targets to eliminate AIDS by achieving high rates of viral suppression. In this chapter we look at young people’s engagement with HIV prevention options in South-West Uganda. Taking a qualitative approach, using repeat in-depth interviews and participatory workshops with 50 young people aged 16–24 years old, we reflect on their accounts of how they navigate risks and opportunities within their daily lives. These risks include HIV-acquisition, but also the harms of economic precarity. Within a context in which using HIV prevention methods, such as condoms or abstinence, were for various reasons severely compromised by their contextual realities, some young people reported relying on irregular HIV testing as their singular method. The young people’s accounts demonstrate that an unintended consequence of the ‘push’ for HIV testing may be the justification of its replacement of other behavioural prevention strategies. This case study illustrates what impact such biomedical interventions may have if implemented as a priority and in isolation from the structural drivers of vulnerability: the social context of young people’s lives.

scholarly journals Explaining utilization of HIV prevention and testing services among university students in Mozambique: results from a mixed methods study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anneka Hooft ◽  
Sarah Pfeil ◽  
Josina Mussengue ◽  
Eunice Jetha ◽  
Feng He ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Hiv Prevention ◽  
University Students ◽  
Condom Use ◽  
Hiv Testing ◽  
Sexual Behaviors ◽  
Hiv Transmission ◽  
Sexual Encounter ◽  
The Past ◽  
Hiv Test

Abstract Background In Mozambique, HIV infection disproportionately affects young adults, particularly women. Despite awareness and knowledge of HIV transmission, many university students have not received HIV testing and continue to engage in high-risk sexual behaviors, including inconsistent condom use. Further understanding of patterns of engagement with HIV prevention and testing is key to reducing HIV transmission in this at-risk population. Methods This study used a sequential mixed methods approach to examine patterns of engagement and perceptions of HIV prevention and testing services among higher education students in Mozambique. Survey data were collected from a representative sample of 501 students from Universidade Eduardo Mondlane (UEM) in Maputo, Mozambique to assess the primary outcomes of 1) HIV testing within the last 12 months; and 2) condom use during last sexual encounter. We employed univariate and multivariate regression models. The survey was followed by qualitative interviews with 70 survey participants which were analyzed using an inductive, content-focused analysis to further explain and contextualize survey findings. Results Over 85% of students reported to be sexually active, among these 74% reported condom use during their last sexual encounter, and 64.2% reported an HIV test within the past 12 months. Females were more likely to have had HIV testing in the past 12 months in comparison to their male peers (aOR 1.82, 95% CI 1.11, 2.99), but were half as likely to have used a condom with their last sexual encounter (aOR 0.52, 95% CI 0.33, 0.83), when controlling for other factors. Qualitative data suggests that these discrepancies may be explained by differential perceptions in risk and trust/mistrust, with women being more concerned about infidelity by their male partner(s) and assuming more responsibility for knowing their own serostatus. Women were also subject to negative stereotypes for possessing condoms in comparison to men, which could explain lower propensity for use. Conclusion Given gendered differences in uptake of condom use and HIV testing, and perceived HIV risk, interventions tailored specifically to male and female students may impact engagement with HIV prevention and testing and empower informed choices about sexual behaviors.

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