Uptake and correlates of HIV testing among men in Malawi: evidence from a national population–based household survey

Abstract

Background HIV testing is one of the key strategies in the HIV/AIDS prevention and control programmes. However, studies examining utilization of this service by men in Malawi are limited. The aim of this study was to assess the uptake and determinants of HIV testing among men in Malawi. Methods Secondary data analysis was conducted on cross–sectional household data for 7478 men aged 15 to 54 years drawn from the 2015–16 Malawi Demographic and Health Survey. Descriptive statistics, bivariate and multivariable logistic regression analyses were performed to identify the socio–demographic, behavioral and health service related factors that are associated with HIV testing service utilisation by men in Malawi. All analyses were performed using the complex sample analysis procedure of the Statistical Package for the Social Sciences version 22.0 to account for the multistage sampling used in Demographic Health Survey. Results Overall, 69.9% of the participants had ever been tested for HIV. The results indicate that age, region of residence, marital status, covered by health insurance, education and age at first sexual debut are significant predictors of HIV testing among men in Malawi. In particular, men who were in the age group 30–39 years (AOR = 3.00; 95% CI = 2.35–3.82), married (AOR = 3.03; 95% CI = 2.51–3.65), those with secondary or above education (AOR = 3.02; 95% CI = 2.33–3.91), and those who had health insurance (AOR = 1.66; 95% CI = 1.05–2.63) were likely to utilise HIV testing service than their counterparts. Conclusion The findings suggest that HIV testing services and programmes need to target younger unmarried men aged 15–19, men with low level or no education and expand HIV testing services to the central and southern regions of Malawi. Targeting the undiagnosed men living with HIV in a timely manner is a crucial and necessary step not only for achieving the UNAIDS’ 90–90–90 targets but for individuals to benefit from antiretroviral treatment and to sustainably reduce population–level HIV transmission.

HIV Voluntary Counseling and Testing Uptake and Associated Factors among Sexually Active Men in Ethiopia: Evidence from the 2016 EDHS Using Multilevel Modeling

“…Compared to those who have never been in a union, the odds of up taking HIV/AIDS VCT for married and other males were higher by more than two folds for both categories of the married status. This nding is concordant with the results of secondary DHS data analyses from Cambodia and Malawi where married men were more likely opted in HIV VCT uptake as compared to those who were unmarried (10,15). Other studies were done in rural Tanzania and South Africa also showed that married men were more likely to opt-in HIV VCT as compared to their unmarried counterparts (17,30).…”

“…This study identi ed that health insurance coverage status for Ethiopian males was found statistically signi cant in that males covered by health insurance were more likely to be tested than those who were not covered. This result is in line with the recent nding on DHS from Malawi (10). The result seems to be reasonable as people with health insurance covered are very likely to visit health facilities to get health services because they don't worry about the cost of the services as the insurance is expected to cover.…”

“…The magnitude of our study is greater than many ndings done in Burkina Faso, Ethiopia, Cambodia, and South Africa (9,15,(20)(21)(22)(23). But the current gure is less than the result drawn from the study done in Malawi (10). Most of the studies reviewed clari ed that the majorities of the gures were less than that of the result obtained by the current study and this may have linkage with the duration when the studies were conducted meaning that they were mostly done before the year of this study since in the most recent times the VCT for HIV uptake is expected to increase.…”

“…The secondary data analysis from Zimbabwe showed that the odds of up taking HIV VCT increases educational level increases (29). Many different studies (10,15,16,32) also showed that people with higher educational levels were more likely to receive HIV VCT than those with lower educational status. Educated people might have a better knowledge of HIV than those who are not educated and may better accept HIV VCT than their counterparts.…”

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

“…Studies conducted in different countries on up taking of HIV testing indicate that men's age(5)-(7), 13,[15][16][17][18], Education status (7-8, 13, 15, 18-19), region of residence (18), Marital status (7,13,(15)(16)(17)(18)20), employment status (20), occupation (15)(16)(17)(18),wealth status of the family (7-8, 13, 15, 18, 21), sex experience(5), number of life time sex partner (9,15,18), condom usage (15,18), age at rst sex (18), perceiver risk of HIV (17), level of knowledge about HIV (17), stigma (17) and having insurance coverage were association with HIV testing.…”