Predictors of willingness to accept pre-marital HIV testing and intention to sero-sort marital partners; risks and consequences: Findings from a population-based study in Cameroon

The roles of churches in HIV prevention among youth at Nqutu in KwaZulu-Natal South Africa

BACKGROUND

 Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) is a crisis of massive economic, social, spiritual, as well as political magnitudes. Joint United Nations Programme on HIV/AIDS (UNAIDS) revealed that in 2018, there were 37.9 million individuals across the globe who lived with HIV and/or AIDS. The religion is an essential tool used by the pastors to help people living with HIV to come to terms with the illness. Therefore, it is imperative that religious leaders should be actively involved in the prevention of HIV epidemic among the youth.

OBJECTIVES

 The study objective was to explore and describe the roles of churches in HIV prevention among youth at Nqutu in KwaZulu-Natal.

METHOD

 A qualitative descriptive phenomenology design was employed. Data were collected from 18 to 35 years old participants who were purposefully sampled. Unstructured interviews were conducted to collect data, which was determined by saturation and analysed using Colaizzi's method of data analysis.

RESULTS

 The study revealed five major themes, which consisted of churches' contribution to HIV prevention; health awareness; churches' involvement in sexual education; churches' partnership with stakeholders, human and financial resources. It became evident that churches' contribution to HIV and/or AIDS prevention is beneficial to the youth.

CONCLUSION

 The study's findings revealed that churches play a significant role in HIV prevention among youths. Programmes available in churches play an important role among the youth in curbing the HIV epidemic.Contribution: The Department of Health should consider collaborating with church leaders to promote and prevent HIV and/or AIDS among youth.

Changing attitudes towards HIV testing and treatment among three generations of men in Cameroon: a qualitative analysis using the Fogg Behavior Model

INTRODUCTION

Men are less likely than women to test for HIV and promptly initiate antiretroviral treatment, resulting in advanced HIV disease and increased mortality rates among them.

METHODS

In-depth interviews were conducted with men and leaders in the west and central regions of Cameroon. Men were recruited from existing community groups and stratified by age: 21-30 years, 31-40 years, and 41 years and older. Community leaders were recommended by the community dialogue structure chairman. Interviews were conducted using a semi-structured guide in English or French, depending on the participant's preference. Transcripts were coded in the MAXQDA v.12 software and analyzed using thematic analysis and by age group. The Fogg Behavior Model was used to gain a deeper understanding of the different perceptions across all age groups.

RESULTS

Younger men (21-30 years) were generally more accepting of HIV testing, as it had become normative behavior. Although financial barriers could limit access, free testing was mentioned as a prompt to initiate HIV testing. The middle age men (31-40 years) had the most concerns about HIV testing interrupting their work day and recommended increasing testing locations and hours. The older men (41 + years) were the least motivated to get tested, citing worries about the impact on their social standing within the community. All age groups reported being motivated to begin treatment if they were found to be HIV-positive. Participants also provided insights regarding community HIV testing and treatment messaging. Younger and older men preferred to hear directly from qualified health professionals, but younger men noted that social media, radio, and TV could be utilized. Middle age men also identified TV and radio as effective mediums, if door-to-door messaging was not an option.

CONCLUSIONS

The study highlights important considerations when planning future information-sharing activities for HIV testing and treatment. Since lived experiences differ across generations and societal roles continue to change, not only should the content of messages differ among the generations, but the means of communication must also be considered to ensure the messages are conveyed through a trusted source.

Married women pre-marital HIV testing status in Ethiopia: Individual and community level factor analysis

Introduction

Marriage between serodiscordant individuals accounts for 65-85% of new infections. Pre-marital Human Immune Virus (HIV) testing opens the door for HIV infection prevention and control. There are no studies that have evaluated the coverage and factors influencing pre-marital HIV testing at the community level in Ethiopia.

Methods

This study was conducted using 10,008 samples of data extracted from Ethiopian demographic and health surveys (EDHS), 2016. To identify individual and community level factors a multi-level binary logistic regression model was used. Among fitted models, "full" model was taken as the best model. To declare the presence or absence of significant association with pre-marital HIV testing, a p-value < 0.05 with confidence interval (CI) was used.

Results

In Ethiopia, 21.4% (95% CI: 20.6, 22.2%) of study participants had pre-marital HIV testing. Age 35-49 years (AOR = 0.25; 95% CI: 0.09, 0.66), educated (AOR = 1.76; 95% CI: 1.17, 2.79), rich (AOR = 1.95; 95% CI: 1.13, 3.55), having media exposure (AOR = 1.54; 95% CI: 1.30, 4.71), and high community level literacy (AOR = 0.38; 95% CI: 0.22, 0.66) were factors significantly associated with pre-marital HIV testing.

Conclusion

The low coverage of pre-marital HIV testing in Ethiopia is insufficient to have a significant influence on the HIV/Acquired Immune Deficiency Syndrome (AIDS) epidemic. Information dissemination to create awareness about human rights and public health implications of pre-marital HIV testing áre necessary while it is made mandatory.

HIV Testing among sexually active Ghanaians: an examination of the rural-urban correlates

HIV testing is critical in reducing the risk of HIV transmission. We investigated the rural-urban correlates of HIV testing amongst sexually active Ghanaians using data from the 2017/2018 Ghana Multiple Indicator Cluster Survey Six (GMICS 6). Robust Poisson models (reporting Adjusted Prevalence Ratios (APR) and 95% Confidence Intervals (CIs)) were used to achieve this aim. About 46% of the participants had ever tested for HIV. According to the results, approximately 52% and 39% of urban and rural dwellers, respectively, have undergone HIV testing. HIV knowledge, HIV stigma, gender, age, education, marital status, childbirth history, sexual history, health insurance coverage, media exposure, household wealth, and region of residence were significantly related to HIV testing with observed variations across rural-urban areas. The findings call for the expansion of advocacy efforts towards encouraging HIV testing, targeting sexually active Ghanaians particularly in rural areas.

Comprehensive HIV/AIDS knowledge and HIV testing among men in sub-Saharan Africa: a multilevel modelling

This study investigated the association between comprehensive HIV/AIDS knowledge and HIV testing among men in sub-Saharan Africa (SSA). Data were taken from the most recent (2010-2019) Demographic and Health Survey men's recode files of 29 countries in SSA. A total of 104,398 men who had complete information on all the variables of interest were included in the study. The outcome variable was HIV testing. A multilevel logistic regression analysis was conducted to determine the association between comprehensive HIV/AIDS knowledge and HIV testing. The results of the fixed effects model were presented as adjusted odds ratios (AORs) with 95% confidence intervals (CIs). The average prevalences of HIV testing and comprehensive HIV/AIDS knowledge among men in SSA were 53.5% and 50.8% respectively. Rwanda and Niger recorded the highest (93.6%) and lowest prevalences (9.8%) respectively. The prevalence of comprehensive HIV/AIDS knowledge among men in the 29 countries was 50.8%, with the highest in Rwanda (76.4%) and the lowest in Benin (31.1%). Men who had no comprehensive HIV/AIDS knowledge were less likely to test for HIV compared with those who had comprehensive HIV/AIDS knowledge (AOR=0.59, CI: 0.57-0.60). Men who were older than 20 years, married or cohabiting, with at least secondary education, in the richest wealth quintile, exposed to mass media, used condoms and with multiple sexual partners were more likely to test for HIV. To improve HIV testing among men in SSA, this study recommends that policymakers and stakeholders step up comprehensive HIV/AIDS knowledge sensitization and education using effective tools such as mass media.

Geographical variations and factors associated with recent HIV testing prevalence in Ghana: spatial mapping and complex survey analyses of the 2014 demographic and health surveys

OBJECTIVE

To examine the factors associated with recent HIV testing and to develop an HIV testing prevalence surface map using spatial interpolation techniques to identify geographical areas with low and high HIV testing rates in Ghana.

DESIGN

Secondary analysis of Demographic and Health Survey.

SETTING

Rural and urban Ghana PARTICIPANTS: The study sample comprised 9380 women and 3854 men of 15-49 years.

RESULTS

We found that 13% of women and 6% of men of Ghana had tested for HIV in the past 12 months. For women, being within the age groups of 15-39 years, being currently married, attainment of post-secondary education, having only one sexual partner and dwelling in certain regions with reference to greater Accra (Volta, Eastern, Upper West and Upper East) were associated with a higher likelihood of HIV testing. For men, being older than 19 years, attainment of post-secondary education and dwelling in the Upper East region with reference to the greater Accra region were significantly associated with a higher likelihood of HIV testing. The surface map further revealed intra-regional level differences in HIV testing estimates.

CONCLUSION

Given the results, HIV testing must be expanded with equitable testing resource allocation that target areas within the regions in Ghana with low HIV testing prevalence. Men should be encouraged to be tested for HIV.

Propensity score matching evaluation of psychological stress and hair cortisol among people living with HIV in China

To compare the psychological stress level and hair cortisol level of people living with HIV (PLWH) with those without HIV in China, a total of 220 participants were initially enrolled in the study, including 200 PLWH and 20 people living without HIV. Psychological stress level, including quality of life, anxiety, perceived stress and psychological resilience, was self-reported in both groups with related scales. The cortisol in hair was extracted and assessed by LC-APCI-MS/MS method. Propensity score matching analysis was performed to balance the baseline covariates of the two groups, whereas the difference in psychological stress level and hair cortisol level between the two groups was compared. Furthermore, the associations between psychological stress level and cortisol level were examined. Two comparison groups were matched by 1:3 propensity score matching, which yielding 20 people living without HIV and 60 PLWH. Ultimately, in regarding to the psychological stress, the levels of the anxiety (34 vs. 26, p < 0.001), perceived stress (38.5 vs. 33, p = 0.001) and psychological resilience (31 vs. 26, p = 0.004) were higher among PLWH than those living without HIV, but the people without HIV showed higher quality of life (109 vs.116, p < 0. 001). The hair cortisol level (34.66 vs. 21.61, p = 0.002) in PLWH was higher than those living without HIV. However, there were no significant associations between psychological stress level and cortisol level (p > 0.05). The PLWH showed higher level of psychological stress and cortisol than those without HIV. No relationship was seen between psychological stress level and cortisol level in PLWH.

Factors associated with premarital HIV testing among married women in Ethiopia

Background

Premarital HIV testing is the key entry point in prevention, care, treatment, and support services, in which people learn their HIV status and its implications to make informed decisions about their health. This study was, therefore, conducted to identify factors associated with premarital HIV testing among married women in Ethiopia.

Methods

A cross-sectional study design was used, and secondary data analysis was done using 2016 Ethiopian demographic health survey (EDHS). Two-stage stratified cluster sampling technique was used. The data were analyzed by using SPSS version 20. Frequencies and weighted percentage of the variables, and second-order Rao-Scott statistic were computed. Multivariate logistic regression analysis was performed to control confounders and to identify predictors of premarital HIV testing. Adjusted odds ratio with 95% confidence interval was considered to declare statistically significant associations.

Result

The total sample comprised 9602 married women. In this study, the odds of premarital HIV testing were associated with being urban residents (AOR: 1.81; 95% CI: 2.74–5.20), attended primary education (AOR:1.54; 95%:1.27–1.87), secondary education (AOR:2.34; 95% CI:1.70–3.23), higher education (AOR:2.92; 95% CI:1.90–4.50), access to media (AOR: 1.44; 95% CI:1.20–1.76), being rich (AOR: 1.52; 95%CI:1.12–2.07), andrichest (AOR: 1.67;95%CI:1.15–2.44), known the place of HIV testing (AOR: 4.95; 95% CI:3.44–7.11), discriminatory attitude to PLHIV (AOR: 1.47; 95%CI:1.23–1.76), being khat chewer(AOR: 1.60;95%CI:1.11–2.31), and alcohol drinker (AOR: 1.55; 95% CI:1.27–1.90).

Conclusion

It is possible to conclude that being urban resident, attending education (primary, secondary, higher), media access, improved wealth index, knowing the places for HIV testing, chewing khat, drinking alcohol, and having discriminatory attitude towards PLHIV were positively associated with premarital HIV testing. The Ethiopian government needs to step up efforts to expand education for all Women. Advancing access to HIV testing for rural women may also increase premarital HIV testing services uptake. Further qualitative researches need to be done to assess the relationship between discriminatory attitude towards PLHIV and premarital HIV testing.