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Social inequality and HIV-testing

Author

Listed:
  • Alexander A. Weinreb

    (University of Texas at Austin)

  • Guy Stecklov

    (University of British Columbia)

Abstract

The plan to increase HIV testing is a cornerstone of the international health strategy against the HIV/AIDS epidemic, particularly in sub-Saharan Africa. This paper highlights a problematic aspect of that plan: the reliance on clinic- rather than home-based testing. First, drawing on DHS data from across Africa, we demonstrate the substantial differences in socio-demographic and economic profiles between those who report having ever had an HIV test, and those who report never having had one. Then, using data from a random household survey in rural Malawi, we show that substituting home-based for clinic-based testing may eliminate this source of inequality between those tested and those not tested. This result, which is stable across modeling frameworks, has important implications for accurately and equitably addressing the counseling and treatment programs that comprise the international health strategy against AIDS, and that promise to shape the future trajectory of the epidemic in Africa and beyond.

Suggested Citation

  • Alexander A. Weinreb & Guy Stecklov, 2009. "Social inequality and HIV-testing," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 21(21), pages 627-646.
    • Handle: RePEc:dem:demres:v:21:y:2009:i:21
    DOI: 10.4054/DemRes.2009.21.21
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    References listed on IDEAS

    as
    1. Smith, Kirsten P. & Watkins, Susan Cotts, 2005. "Perceptions of risk and strategies for prevention: responses to HIV/AIDS in rural Malawi," Social Science & Medicine, Elsevier, vol. 60(3), pages 649-660, February.
    2. Kirsten P. Smith & Susan Cotts Watkins, 2005. "Perceptions of Risk and Strategies for Prevention: Responses to HIV/AIDS in Rural Malawi," PGDA Working Papers 0305, Program on the Global Demography of Aging.
    3. Simona Bignami & Georges Reniers & Alexander A. Weinreb, 2003. "An Assessment of the KDICP and MDICP Data Quality," Demographic Research Special Collections, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 1(2), pages 31-76.
    4. Susan Cotts Watkins, 2004. "Navigating the AIDS Epidemic in Rural Malawi," Population and Development Review, The Population Council, Inc., vol. 30(4), pages 673-705, December.
    5. Alexander A. Weinreb, 2001. "First Politics, Then Culture: Accounting for Ethnic Differences in Demographic Behavior in Kenya," Population and Development Review, The Population Council, Inc., vol. 27(3), pages 437-467, September.
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    More about this item

    Keywords

    HIV/AIDS; inequality; Malawi; home-based testing;
    All these keywords.

    JEL classification:

    • J1 - Labor and Demographic Economics - - Demographic Economics
    • Z0 - Other Special Topics - - General

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