Revista brasileira de epidemiologia = Brazilian journal of epidemiology · 2017
Individual- and contextual-level factors associated with client-initiated HIV testing.
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Barros Claudia Renata Dos Santos, Zucchi Eliana Miura, Schraiber Lilia Blima, França Ivan
Аннотация
BACKGROUND: Knowing the reasons for seeking HIV testing is central for HIV prevention. Despite the availability of free HIV counseling and testing in Brazil, coverage remains lacking.
METHODS: Survey of 4,760 respondents from urban areas was analyzed. Individual-level variables included sociodemographic characteristics; sexual and reproductive health; HIV/AIDS treatment knowledge and beliefs; being personally acquainted with a person with HIV/AIDS; and holding discriminatory ideas about people living with HIV. Contextual-level variables included the Human Development Index (HDI) of the municipality; prevalence of HIV/AIDS; and availability of local HIV counseling and testing (CT) services. The dependent variable was client-initiated testing. Multilevel Poisson regression models with random intercepts were used to assess associated factors.
RESULTS: Common individual-level variables among men and women included being personally acquainted with a person with HIV/AIDS and age; whereas discordant variables included those related to sexual and reproductive health and experiencing sexual violence. Among contextual-level factors, availability of CT services was variable associated with client-initiated testing among women only. The contextual-level variable "HDI of the municipality" was associated with client-initiated testing among women.
CONCLUSION: Thus, marked gender differences in HIV testing were found, with a lack of HIV testing among married women and heterosexual men, groups that do not spontaneously seek testing.
METHODS: Survey of 4,760 respondents from urban areas was analyzed. Individual-level variables included sociodemographic characteristics; sexual and reproductive health; HIV/AIDS treatment knowledge and beliefs; being personally acquainted with a person with HIV/AIDS; and holding discriminatory ideas about people living with HIV. Contextual-level variables included the Human Development Index (HDI) of the municipality; prevalence of HIV/AIDS; and availability of local HIV counseling and testing (CT) services. The dependent variable was client-initiated testing. Multilevel Poisson regression models with random intercepts were used to assess associated factors.
RESULTS: Common individual-level variables among men and women included being personally acquainted with a person with HIV/AIDS and age; whereas discordant variables included those related to sexual and reproductive health and experiencing sexual violence. Among contextual-level factors, availability of CT services was variable associated with client-initiated testing among women only. The contextual-level variable "HDI of the municipality" was associated with client-initiated testing among women.
CONCLUSION: Thus, marked gender differences in HIV testing were found, with a lack of HIV testing among married women and heterosexual men, groups that do not spontaneously seek testing.