Factors Affecting the Uptake of HIV Testing among Men: A Mixed-Methods Study in Rural Burkina Faso

Abstract

BackgroundThis study aimed to explore factors shaping the decision to undergo Human Immunodeficiency Virus (HIV) testing among men in rural Burkina Faso.MethodsThe study took place in 2009 in the Nouna Health District and adopted a triangulation mixed methods design. The quantitative component relied on data collected through a structured survey on a representative sample of 1130 households. The qualitative component relied on 38 in-depth interviews, with men purposely selected to represent variation in testing decision, age, and place of residence. A two-part model was conducted, with two distinct outcome variables, i.e. “being offered an HIV test” and “having done an HIV test”. The qualitative data analysis relied on inductive coding conducted by three independent analysts.ResultOf the 937 men, 357 had been offered an HIV test and 97 had taken the test. Younger age, household wealth, living in a village under demographic surveillance, and knowing that HIV testing is available at primary health facilities were all positively associated with the probability of being offered an HIV test. Household wealth and literacy were found to be positively associated, and distance was found to be negatively associated with the probability of having taken an HIV test. Qualitative findings indicated that the limited uptake of HIV testing was linked to poor knowledge on service availability and to low risk perceptions.ConclusionWith only 10% of the total sample ever having tested for HIV, our study confirmed that male HIV testing remains unacceptably low in Sub-Saharan Africa. This results from a combination of health system factors, indicating general barriers to access, and motivational factors, such as one’s own knowledge of service availability and risk perceptions. Our findings suggested that using antenatal care and curative services as the exclusive entry points into HIV testing may not be sufficient to reach large portions of the male population. Thus, additional strategies are urgently needed to increase service uptake.

The Call to Get More Men Tested for HIV: A Perspective on What Policy Makers Need to Know for Implementing and Scaling up HIV Self-Testing in Rwanda

“…Ensuring that individuals know their HIV status is the first step in controlling the HIV scourge; however, the uptake of HIV testing among men is still very low (De Allegri, Agier, Tiendrebeogo, Louis, Yé, Mueller, & Sarker, 2015;Justman, Hoos, ,Kalton, ,Nyirenda, Moyo, & Mugurungi, 2017;Mills, Beyrer, Birungi, & Dybul, 2012), which is the result of a number of factors. A study in Lesotho reported that, compared with women, men generally have very low HIV testing rates, less contact with HIV clinical settings, and less knowledge about HIV prevention (DiCarlo et al, 2014).…”

Determinants of HIV Testing Among Men Living in Rural Areas: Evidence from Ethiopian Population–Based Household Survey, 2016.

“…Since men are often the household head and play the role of major decision-maker (11), their utilization of HIV test might have a greater role in increasing HIV testing among both men and women (11), (13). Due to lack of awareness, men who have HIV continue to be engaged in unsafe sexual practices, which in turn, increases the risk of women's for HIV.…”

“…Due to lack of awareness, men who have HIV continue to be engaged in unsafe sexual practices, which in turn, increases the risk of women's for HIV. More often than not, PLWH who are unaware of their serostaus do not seek healthcare until the disease become worse (11). This delay in seeking care, especially testing for HIV, in ates the magnitude of mortality and morbidity related to HIV (11).…”

“…More often than not, PLWH who are unaware of their serostaus do not seek healthcare until the disease become worse (11). This delay in seeking care, especially testing for HIV, in ates the magnitude of mortality and morbidity related to HIV (11). National surveys of Ethiopia show that there is higher awareness about HIV/AIDS and interest to test but their comprehensive knowledge was still low (5).Therefore, to battle the spread of HIV/AIDS, was launched a separate HIV/AIDS policy, this gives high attention to voluntary HIV testing and counseling in 1998.…”

Perceived Cost Advantages and Disadvantages of Purchasing HIV Self-Testing Kits among Urban Tanzanian Men: An Inductive Content Analysis

“…The difference in HIV testing uptake between men and women is influenced by many factors, including the fact that many women test and initiate care during pregnancy in the context of antenatal services [2][3][4]. In general, men have less interaction with the health care system [5] and thus there are fewer opportunities to engage them in HCTS.…”