AEGiS-14IAC: Removing barriers to knowing HIV status: A comparison of testers and non-testers in Sub-Saharan Africa.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Removing barriers to knowing HIV status: A comparison of testers and non-testers in Sub-Saharan Africa.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. LbPeD9042)

Mutevedzi T, Routh J, Khumalo-Sakutukwa G, Fritz K, Morin S
University of Zimbabwe-University of California San Francisco (UZ-UCSF), Harare, Zimbabwe

BACKGROUND: Voluntary HIV Counseling and Testing(VCT) is an effective method of promoting behavior change and reducing stigma in sub-Saharan Africa. However, utilization of VCT is still low in African communities with a high prevalence of HIV. As part of a demonstration study of mobile VCT(MVCT) in Epworth, Zimbabwe, a peri-urban community near Harare, we examined facilitators and barriers to MVCT.

METHODS: The MVCT team provided free, anonymous VCT using rapid HIV testing, and distributed educational materials and condoms in the community. Data on barriers to VCT were collected from a random sub-sample of MVCT clients(testers, n=148) and from a convenience sample of people declining MVCT(non-testers, n=60).

RESULTS: Among those with no prior HIV test, MVCT testers cited logistical barriers such as limited VCT center hours of operation(53% vs. 16%, p <.01) and center location(53% vs. 21%, p<.05) as the primary reason for no prior HIV test compared to non-testers. Anxiety over being recognized was surprisingly low in both groups(4% testers vs. 10% non-testers). While also low, worry about being labeled HIV positive when using MVCT was higher in non-testers(8% vs. 1%, p<.01), as was the worry that a spouse/partner would discover use of MVCT(8% vs. 1%, p <.01). Testers had significantly more knowledge about HIV/AIDS than non-testers(p<.01), although only 43% of those tested had perfect knowledge scores vs. 23% of non-testers. Although number of partners and soliciting sex were not associated with MVCT use, lack of condom use with regular partners(69% vs. 53%, p< .05) and casual partners(25% vs. 12%, p <.05) influenced testing behavior, as did recent STD symptoms(15% vs. 3%, p<.01). Demographic characteristics of age, gender, income and marital status did not differ significantly between testers and non-testers.

CONCLUSION: Barriers to HIV testing in Sub-Saharan Africa are often logistical and can be removed through community outreach programs such as mobile VCT.

Keywords: AEGIS, HIV Infections, Counseling, Acquired Immunodeficiency Syndrome, AIDS Serodiagnosis, Prevalence, Condoms, Laboratory Techniques and Procedures, Zimbabwe, Africa South of the Sahara, Human

020707
LbPeD9042