Temporal trends in socioeconomic inequalities in HIV testing: an analysis of cross-sectional surveys from 16 sub-Saharan African countries

Abstract

Background Overall increases in the uptake of HIV testing in the past two decades might hide discrepancies across socioeconomic groups. We used data from population-based surveys done in sub-Saharan Africa to quantify socioeconomic inequalities in uptake of HIV testing, and to establish trends in testing uptake in the past two decades.Methods We analysed data from 16 countries in sub-Saharan Africa where at least one Demographic and Health Survey was done before and after 2008. We assessed the country-specific and sex-specific proportions of participants who had undergone HIV testing in the previous 12 months across wealth and education groups, and quantified socioeconomic inequalities with both the relative and slope indices of inequalities. We assessed time trends in inequalities, and calculated mean results across countries with random-effects meta-analyses.

Covariates and Spatial Interpolation of HIV Screening in Mozambique: Insight from the 2015 AIDS Indicator Survey

“…Additionally, we found that people who are more educated, live in urban areas and who are from wealthy homes are more likely to get screened. The role of socioeconomic factors as a driver of HIV testing has been quite well-documented in sub-Saharan African countries [34,35]. These findings underscore the importance of attracting the most vulnerable and at-risk populations to HIV screenings.…”

Understanding the pathways leading to socioeconomic inequalities in HIV testing uptake in 18 sub-Saharan African countries: a mediation analysis

“…Health inequalities that favour the wealthiest subgroups have also persisted in most SSA countries, especially in WCA [6]. Studies found that people with higher socioeconomic position (SEP), and those who were employed, living in urban areas and had heard about HIV and AIDS were associated with better knowledge of HIV status and were more likely to seek testing [7][8][9][10][11][12][13].…”

“…Country sample was based on convenience sampling (data available as of February 2021) that was slightly extended from a previous study [6]. In total, we analysed 10 WCA countries (Burkina Faso, Cameroon, Côte d'Ivoire, Cameroon, Congo DR, Guinea, Liberia, Mali, Niger, Senegal and Sierra Leone) and eight ESA countries (Ethiopia, Kenya, Lesotho, Malawi, Rwanda, Tanzania, Zimbabwe and Zambia).…”

Test@Work Texts: Mobile Phone Messaging to Increase Awareness of HIV and HIV Testing in UK Construction Employees During the COVID-19 Pandemic

“…in sexual health services: chlamydia and gonorrhoea test results [24]). However, sexual health interventions rarely include working-age adults; they are often targeted to students and younger people, likely because they are seen to be vulnerable, lacking the associated health education and more likely to engage in high risk behaviours for contracting sexually transmitted infections [25].…”

“…poor diet, smoking, problem alcohol consumption, substance abuse) [27][28][29] and the prevalence of cardiovascular risk and mental ill-health is increasing in construction workers [30][31][32]. HIV infections in adults have long been associated with health inequality, often correlating with the aforementioned risk behaviours [25,33]. Construction workers may be at increased risk for HIV due to occupational hazards [34,35], and migrant workers in the industry may be particularly vulnerable if they are from countries of high HIV prevalence [36,37].…”