Who tests, who doesn't, and why? Uptake of mobile HIV counseling and testing in the Kilimanjaro Region of Tanzania.

Ostermann, Jan

Reddy, Elizabeth A

Shorter, Meghan M

Muiruri, Charles

Mtalo, Antipas

Itemba, Dafrosa K

Njau, Bernard

Bartlett, John A

Crump, John A

Thielman, Nathan M

Myer, Landon

United States

2012-10-30T18:19:31Z

2011-01-31

BACKGROUND: Optimally, expanded HIV testing programs should reduce barriers to testing while attracting new and high-risk testers. We assessed barriers to testing and HIV risk among clients participating in mobile voluntary counseling and testing (MVCT) campaigns in four rural villages in the Kilimanjaro Region of Tanzania. METHODS: Between December 2007 and April 2008, 878 MVCT participants and 506 randomly selected community residents who did not access MVCT were surveyed. Gender-specific logistic regression models were used to describe differences in socioeconomic characteristics, HIV exposure risk, testing histories, HIV related stigma, and attitudes toward testing between MVCT participants and community residents who did not access MVCT. Gender-specific logistic regression models were used to describe differences in socioeconomic characteristics, HIV exposure risk, testing histories, HIV related stigma, and attitudes toward testing, between the two groups. RESULTS: MVCT clients reported greater HIV exposure risk (OR 1.20 [1.04 to 1.38] for males; OR 1.11 [1.03 to 1.19] for females). Female MVCT clients were more likely to report low household expenditures (OR 1.47 [1.04 to 2.05]), male clients reported higher rates of unstable income sources (OR 1.99 [1.22 to 3.24]). First-time testers were more likely than non-testers to cite distance to testing sites as a reason for not having previously tested (OR 2.17 [1.05 to 4.48] for males; OR 5.95 [2.85 to 12.45] for females). HIV-related stigma, fears of testing or test disclosure, and not being able to leave work were strongly associated with non-participation in MVCT (ORs from 0.11 to 0.84). CONCLUSIONS: MVCT attracted clients with increased exposure risk and fewer economic resources; HIV related stigma and testing-related fears remained barriers to testing. MVCT did not disproportionately attract either first-time or frequent repeat testers. Educational campaigns to reduce stigma and fears of testing could improve the effectiveness of MVCT in attracting new and high-risk populations.

http://www.ncbi.nlm.nih.gov/pubmed/21304973

1932-6203

https://hdl.handle.net/10161/5955

eng

Public Library of Science (PLoS)

PLoS One

10.1371/journal.pone.0016488

PLoS One

Counseling

Female

HIV Infections

Humans

Male

Sex Factors

Tanzania

Who tests, who doesn't, and why? Uptake of mobile HIV counseling and testing in the Kilimanjaro Region of Tanzania.

Journal article

Muiruri, Charles|0000-0003-0213-0362

Crump, John A|0000-0002-4529-102X

Thielman, Nathan M|0000-0001-8152-2879

1

6

http://www.ncbi.nlm.nih.gov/pubmed/21304973

e16488

1

Clinical Science Departments

Duke

Duke Cancer Institute

Duke Science & Society

Faculty

Global Health Institute

Initiatives

Institutes and Centers

Institutes and Provost's Academic Units

Medicine

Medicine, Infectious Diseases

Pathology

School of Medicine

School of Nursing

School of Nursing - Secondary Group

University Institutes and Centers

Published online

6