Informal, interpersonal communication within a community about HIV and AIDS, or lack of such communication, may influence community members' uptake of voluntary counseling and testing. Drawing from Noelle-Neumann's spiral of silence theory, this study examined the association between communication about HIV/AIDS and prior HIV testing in communities in Tanzania, Zimbabwe, South Africa, and Thailand. Participants (N=14,818) in 48 communities across 5 sites throughout the 4 countries completed a behavioral survey assessing communication, prior VCT uptake, social norms, stigma, and sexual risk. Site-specific logistic regression models demonstrated that frequent conversations about HIV were significantly associated with prior HIV testing at every site. Odds ratios for each site ranged from 1.885 to 3.085, indicating a roughly doubled or tripled chance of past VCT uptake. Results indicate that verbal communication may be an important mechanism for increasing health behaviors and inclusion in future interventions should be considered.

Several depths suitable for infinite-dimensional functional data that are available in the literature are of the form of an integral of a finite-dimensional depth function. These functionals are characterized by projecting functions into low-dimensional spaces, taking finitedimensional depths of the projected quantities, and finally integrating these projected marginal depths over a preset collection of projections. In this paper, a general class of integrated depths for functions is considered. Several depths for functional data proposed in the literature during the last decades are members of this general class. A comprehensive study of its most important theoretical properties, including measurability and consistency, is given. It is shown that many, but not all, properties of the integrated depth are shared with the finite-dimensional depth that constitutes its building block. Some pending measurability issues connected with all integrated depth functionals are resolved, a broad new notion of symmetry for functional data is proposed, and difficulties with respect to consistency results are identified. A general universal consistency result for the sample depth version, and for the generalized median, for integrated depth for functions is derived.

A major drawback of many established depth functionals is their ineffectiveness in identifying functions outlying merely in shape. Herein, a simple modification of functional depth is proposed to provide a remedy for this difficulty. The modification is versatile, widely applicable, and introduced without imposing any assumptions on the data, such as differentiability. It is shown that many favourable attributes of the original depths for functions, including consistency properties, remain preserved for the modified depths. The powerfulness of the new approach is demonstrated on a number of examples for which the known depths fail to identify the outlying functions.

Zimbabwe’s HIV epidemic is amongst the worst in the world, and disproportionately effects poorer rural areas. Access to almost all health services in Zimbabwe includes some form of cost to the client. In recent years, the socio-economic and employment status of many Zimbabweans has suffered a serious decline, creating additional barriers to HIV treatment and care. We aimed to assess the impact of i) socio-economic status (SES) and ii) employment status on the utilization of health services in rural Zimbabwe. Data were collected from a random probability sample household survey conducted in the Mutoko district of north-western Zimbabwe in 2005. We selected variables that described the economic status of the respondent, including: being paid to work, employment status, and SES by assets. Respondents were also asked about where they most often utilized healthcare when they or their family was sick or hurt. Of 2,874 respondents, all forms of healthcare tended to be utilized by those of high or medium-high SES (65%), including private (65%), church-based (61%), traditional (67%), and other providers (66%) (P=0.009). Most respondents of low SES utilized government providers (74%) (P=0.009). Seventy-one percent of respondents utilizing health services were employed. Government (71%), private (72%), church (71%), community-based (78%) and other (64%) health services tended to be utilized by employed respondents (P=0.000). Only traditional health services were equally utilized by unemployed respondents (50%) (P=0.000). A wide range of health providers are utilized in rural Zimbabwe. Utilization is strongly associated with SES and employment status, particularly for services with user fees, which may act as a barrier to HIV treatment and care access. Efforts to improve access in low-SES, high HIV-prevalence settings may benefit from the subsidization of the health care payment system, efforts to improve SES levels, political reform, and the involvement of traditional providers.