Voluntary counselling and testing: uptake, impact on sexual behaviour, and HIV incidence in a rural Zimbabwean cohort

Sherr, Lorraine; Lopman, Ben; Kakowa, Memory; Dube, Sabada; Chawira, Godwin; Nyamukapa, Constance; Oberzaucher, Nicole; Cremin, Íde; Gregson, Simon

doi:10.1097/qad.0b013e32805e8711

Cited by 190 publications

(191 citation statements)

References 27 publications

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“…21 People with higher education may have better access to health care services generally, and particularly more uptake of antenatal care among females with higher education. 48 Wealth may make it easy to afford payment of transport to go to testing centres consultation fees since health care services are paid for in Zimbabwe. 49 The results observed here show increased odds of having been tested for HIV among the wealthier than the poorer for males, and no association between wealth and HIV testing for females after controlling for community wealth/poverty.…”

Section: Key Findingsmentioning

confidence: 99%

A Multilevel Analysis of the Determinants of HIV Testing in Zimbabwe: Evidence from the Demographic and Health Surveys

Gazimbi

Magadi²

2017

HIV/AIDS Res Treat Open J

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Introduction: Zimbabwe is still burdened with HIV epidemic and the government has an ambitious aim in the post-2015 era to end the AIDS epidemic by 2030. To achieve this, the government has set up the 90-90-90 strategic milestones to be achieved by 2020. It is a daunting task to increase HIV testing uptake from the current estimate of 56% to 90% to meet these targets. The current government's initiative requires an understanding of determinants of HIV testing. Objectives: The specific objectives of this study are to: (i) identify the individual and communitylevel determinants of HIV testing, focussing on predisposing, enabling and perceived need factors (PREP); and (ii) establish gender differences. Most PREP factors associated with HIV testing are largely consistent with patterns in Southern Africa (e.g., higher uptake by women and those who are wealthier), but unique patterns have also emerged. In particular, results reveal important gender differences: rural residence is associated with lower uptake of HIV testing for women (OR=0.74) but higher for men (OR=1.16); community wealth is a more important factor in enabling HIV testing than household wealth for women, but the converse is true for men; and individual-level, rather than community-level stigma is important for women, while for men, it is community-level stigma that is important. Conclusion: Observed gender disparities in determinants of HIV testing calls for gender specific response. Couple-oriented HIV counselling and testing services where men accompany their spouse to HIV screening during pregnancy may help increase HIV testing uptake for males and reduce gender disparities.

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Section: Key Findingsmentioning

confidence: 99%

A Multilevel Analysis of the Determinants of HIV Testing in Zimbabwe: Evidence from the Demographic and Health Surveys

Gazimbi

Magadi²

2017

HIV/AIDS Res Treat Open J

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“…However, similar effects are not as convincing for the large proportion who test negative. A recent study found increased risk behaviors in HIV negative individuals after undergoing VCT (Sherr et al 2007) while a comparison of two VCT strategies in Zimbabwe found that despite improved acceptability of the trial VCT strategy, risk behaviors continued in individuals testing negative following their diagnosis (Corbett et al 2007). Although there has been a focus on increasing the number of people undergoing HIV testing and counseling, currently less than a quarter of HIV positive individuals in most countries in sub-Saharan Africa are aware of their status (WHO, UNAIDS and UNICEF 2007).…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with HIV Testing Among Public Sector Clinic Attendees in Johannesburg, South Africa

et al. 2008

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Uptake of VCT remains low in many sub-Saharan African countries. Men and women aged 15 and older were recruited from a family planning, STI, and VCT clinic in inner-city Johannesburg between 2004 and 2005 to take part in a cross-sectional survey on HIV testing (n = 198). Fourty-eight percent of participants reported previously testing for HIV and, of these, 86.9% reported disclosing their status to their sex partner. In multivariable analyses, individuals whose partners had been tested for HIV were more likely to have tested (AOR 2.92; 95% CI: 1.38-6.20). In addition, those who reported greater blame/ shame attitudes towards people living with HIV/AIDS were less likely to have tested (AOR 0.35; 95% CI: 0.16-0.77) while those reporting more equitable attitudes towards people living with HIV/AIDS were more likely to have tested (AOR 2.87; 95% CI: 1.20-6.86). Promotion of and increased access to couples HIV testing should be made available within the South African context. Abstract Uptake of VCT remains low in many subSaharan African countries. Men and women aged 15 and older were recruited from a family planning, STI, and VCT clinic in inner-city Johannesburg between 2004 and 2005 to take part in a cross-sectional survey on HIV testing (n = 198). Fourty-eight percent of participants reported previously testing for HIV and, of these, 86.9% reported disclosing their status to their sex partner. In multivariable analyses, individuals whose partners had been tested for HIV were more likely to have tested (AOR 2.92; 95% CI: 1.38-6.20). In addition, those who reported greater blame/ shame attitudes towards people living with HIV/AIDS were less likely to have tested (AOR 0.35; 95% CI: 0.16-0.77) while those reporting more equitable attitudes towards people living with HIV/AIDS were more likely to have tested (AOR 2.87; 95% CI: 1.20-6.86). Promotion of and increased access to couples HIV testing should be made available within the South African context.

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“…The quality of HIV counselling and testing is critical in ensuring the potential impact of risk reduction (Sherr et al 2007). The current pre-dominant counselling models such as the Egan model in South Africa and the TASO model in Uganda are seen as less structured to effect any behavioural change compared to the risk reduction model used in many other parts of the world (Van Rooyen et al 2010).…”

Section: Introductionmentioning

confidence: 99%

Quality of HIV Counselling in South Africa

Mohlabane

Peltzer

Mwisongo

et al. 2015

Journal of Psychology

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Voluntary counselling and testing: uptake, impact on sexual behaviour, and HIV incidence in a rural Zimbabwean cohort

Abstract: Motivation for VCT uptake was driven by knowledge and education rather than sexual risk. Increased sexual risk following receipt of a negative result may be a serious unintended consequence of VCT. It should be minimized with appropriate pre- and post-test counselling.

Cited by 190 publications

References 27 publications

A Multilevel Analysis of the Determinants of HIV Testing in Zimbabwe: Evidence from the Demographic and Health Surveys

A Multilevel Analysis of the Determinants of HIV Testing in Zimbabwe: Evidence from the Demographic and Health Surveys

Factors Associated with HIV Testing Among Public Sector Clinic Attendees in Johannesburg, South Africa

Quality of HIV Counselling in South Africa

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