Reaching the 'First 90': Gaps in Coverage of HIV Testing among People Living with HIV in 16 African Countries
Staveteig, S., Croft, T.N., Kampa, K.T., and Head, S.K. PLOS ONE (October 2017), e0186316, doi:10.1371/journal.pone.0186316.
This study used Demographic and Health Surveys and AIDS Indicator Surveys in 16 sub-Saharan African countries to measure the proportion of people living with HIV (PLHIV) who know their status, and to identify associations between background and behavioral characteristics and gaps in testing. The proportion of respondents who had ever tested for HIV ranged from 34 percent in Sierra Leonne to 94 percent in Rwanda. In the average country, 54 percent of PLHIV knew their status; women of reproductive age comprised the majority of PLHIV in every country. In 10 countries, the majority of PLHIV reside in urban areas. PLHIV tended to be wealthier than their HIV-negative counterparts, and in half of countries, at least 50 percent of PLHIV were in the top third of wealth. Most PLHIV reported two to three lifetime sexual partners. In 12 countries, adolescents and individuals who had not had sex were less likely to be tested for HIV. In nine countries, HIV-positive men were less likely than HIV-positive women to ever have been tested. In nine countries, PLHIV in the lowest third of wealth and those without education were less likely to be tested. The authors concluded that testing interventions should be targeted toward men, adolescents, and those with no to minimal education.