Factors Associated with Ever Being HIV-Tested in Zimbabwe: An Extended Analysis of the Zimbabwe Demographic and Health Survey (2010-2011)

Kudakwashe Collin Takarinda; Lydia Kudakwashe Madyira; Mutsa Mhangara; Victor Makaza; Memory Maphosa-Mutsaka; Simbarashe Rusakaniko; Peter H Kilmarx; Tsitsi Mutasa-Apollo; Getrude Ncube; Anthony David Harries

doi:10.1371/journal.pone.0147828

Factors Associated with Ever Being HIV-Tested in Zimbabwe: An Extended Analysis of the Zimbabwe Demographic and Health Survey (2010-2011)

PLoS One. 2016 Jan 25;11(1):e0147828. doi: 10.1371/journal.pone.0147828. eCollection 2016.

Affiliations

¹ AIDS and TB Department, Ministry of Health and Child Care, Harare, Zimbabwe.
² International Union Against Tuberculosis and Lung Disease, Paris, France.
³ National AIDS Council, Harare, Zimbabwe.
⁴ Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
⁵ Centre for Research and Training in Clinical Epidemiology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
⁶ Division of Global HIV/AIDS, Centers for Disease Control and Prevention (CDC), Harare, Zimbabwe.
⁷ Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom.

Abstract

Introduction: Zimbabwe has a high human immunodeficiency virus (HIV) burden. It is therefore important to scale up HIV-testing and counseling (HTC) as a gateway to HIV prevention, treatment and care.

Objective: To determine factors associated with being HIV-tested among adult men and women in Zimbabwe.

Methods: Secondary analysis was done using data from 7,313 women and 6,584 men who completed interviewer-administered questionnaires and provided blood specimens for HIV testing during the Zimbabwe Demographic and Health Survey (ZDHS) 2010-11. Factors associated with ever being HIV-tested were determined using multivariate logistic regression.

Results: HIV-testing was higher among women compared to men (61% versus 39%). HIV-infected respondents were more likely to be tested compared to those who were HIV-negative for both men [adjusted odds ratio (AOR) = 1.53; 95% confidence interval (CI) (1.27-1.84)] and women [AOR = 1.42; 95% CI (1.20-1.69)]. However, only 55% and 74% of these HIV-infected men and women respectively had ever been tested. Among women, visiting antenatal care (ANC) [AOR = 5.48, 95% CI (4.08-7.36)] was the most significant predictor of being tested whilst a novel finding for men was higher odds of testing among those reporting a sexually transmitted infection (STI) in the past 12 months [AOR = 1.86, 95%CI (1.26-2.74)]. Among men, the odds of ever being tested increased with age ≥ 20 years, particularly those 45-49 years [AOR = 4.21; 95% CI (2.74-6.48)] whilst for women testing was highest among those aged 25-29 years [AOR = 2.01; 95% CI (1.63-2.48)]. Other significant factors for both sexes were increasing education level, higher wealth status and currently/formerly being in union.

Conclusions: There remains a high proportion of undiagnosed HIV-infected persons and hence there is a need for innovative strategies aimed at increasing HIV-testing, particularly for men and in lower-income and lower-educated populations. Promotion of STI services can be an important gateway for testing more men whilst ANC still remains an important option for HIV-testing among pregnant women.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

AIDS Serodiagnosis / statistics & numerical data*
Adolescent
Adult
Female
Health Surveys*
Humans
Male
Middle Aged
Young Adult
Zimbabwe

Grants and funding

This paper is based on extended analysis of the Zimbabwe Demographic and Health Survey 2010–11. This research is carried out with support provided by the United States Agency for International Development (USAID) through the MEASURE DHS project (#GPO-C-00-08-00008-00) and the Centers for Disease Control and Prevention (CDC) under the President’s Emergency Plan for AIDS Relief. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.