Factors associated with adherence to HIV testing guidelines among HIV-negative female sex workers in Kampala, Uganda

Lydia Atuhaire; Constance S Shumba; Lovemore Mapahla; Innocent Maposa; Peter S Nyasulu

doi:10.1016/j.ijregi.2022.05.008

Factors associated with adherence to HIV testing guidelines among HIV-negative female sex workers in Kampala, Uganda

IJID Reg. 2022 May 28:4:25-32. doi: 10.1016/j.ijregi.2022.05.008. eCollection 2022 Sep.

Authors

Lydia Atuhaire^{1

2}, Constance S Shumba^{3

4}, Lovemore Mapahla¹, Innocent Maposa⁵, Peter S Nyasulu^{1

6}

Affiliations

¹ Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
² Makerere University/UVRI Infection and Immunity Research Training Programme, Entebbe, Uganda.
³ School of Nursing and Midwifery, Aga Khan University, Nairobi, Kenya.
⁴ Department of Population Health, Aga Khan University, Nairobi, Kenya.
⁵ Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
⁶ School of Public Health, Faculty of Medicine and Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Abstract

Background: Frequent human immunodeficiency virus (HIV) testing is recommended among female sex workers. This study examined the extent to which HIV-negative female sex workers (FSWs) in Kampala adhere to the HIV testing guidelines, and identified associated factors.

Methods: This cross-sectional study used a simple random sampling method to select 12 sex work hotspots. Two hundred participants were allocated proportionally in each hotspot. Frequencies were used to describe categorical characteristics of FSWs, and a multivariable logistic regression model was used to determine the factors associated with adherence to the HIV testing guidelines.

Results: Eighty-eight percent of the 200 study participants reported their HIV testing status; of these, 56% had tested three or more times in the 12 months preceding the survey. Attaining a secondary education was associated with adherence to the HIV testing guidelines [odds ratio (OR) 1.86, 95% confidence interval (CI) 1.01-3.44; P=0.047]. Sexually transmitted infection testing in the preceding 3 months (OR 2.13, 95% CI 0.95-4.74; P=0.065) and accessing HIV testing at a drop-in centre (OR 5.90, 95% CI 0.71-49.1; P=0.101) were associated with higher odds of adherence to the HIV testing guidelines.

Conclusion: Adherence to the HIV testing guidelines was suboptimal, indicating the need to scale up interventions to improve access to HIV testing, including rigorous behaviour change communication.

Keywords: Adherence; Female sex workers; HIV testing guidelines; Kampala.