Community Influences on Married Men’s Uptake of HIV Testing in Eight African Countries

September 2013 - Structural Prevention

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Stephenson, R., Elfstrom, K.M., & Winter, A. AIDS and Behavior (September 2013), Vol. 17 No. 7, pp. 2352-2366.

The authors investigated associations among individual-, household-, and community-level factors and HIV testing uptake among men in eight African countries, using Demographic and Health Surveys (DHS) (from 2001-2006). The findings showed that a variety of site-specific community-level factors help to explain factors affecting men’s testing behavior. The proportion of men who reported having ever testing for HIV ranged from 7 percent to 29 percent, in Chad and Uganda, respectively. At the individual level, more education and media exposure were positively associated with HIV testing.  Factors associated with increased testing included higher levels of education among both men and women; larger proportions of men employed; greater knowledge of HIV prevention measures among both men and women; and larger proportions of men reporting condom use at last sex.  Associations between testing and other factors were mixed. For instance, the link between average number of sexual partners and testing behavior varied; in Zambia, Zimbabwe, and Nigeria, those with more sexual partners were more likely to report HIV testing. For Nigerian men, there was positive association between HIV testing and living in a community with higher tolerance for violence against women; however, this association was negative in Uganda. Further research on the determinants of testing uptake is critical, particularly in sub-Saharan Africa where heterosexual adults are at high HIV risk.

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