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Who Tests, Who Doesn't, and Why? Uptake of Mobile HIV Counseling and Testing in the Kilimanjaro Region of Tanzania

Author

Listed:
  • Jan Ostermann
  • Elizabeth A Reddy
  • Meghan M Shorter
  • Charles Muiruri
  • Antipas Mtalo
  • Dafrosa K Itemba
  • Bernard Njau
  • John A Bartlett
  • John A Crump
  • Nathan M Thielman

Abstract

Background: Optimally, expanded HIV testing programs should reduce barriers to testing while attracting new and high-risk testers. We assessed barriers to testing and HIV risk among clients participating in mobile voluntary counseling and testing (MVCT) campaigns in four rural villages in the Kilimanjaro Region of Tanzania. Methods: Between December 2007 and April 2008, 878 MVCT participants and 506 randomly selected community residents who did not access MVCT were surveyed. Gender-specific logistic regression models were used to describe differences in socioeconomic characteristics, HIV exposure risk, testing histories, HIV related stigma, and attitudes toward testing between MVCT participants and community residents who did not access MVCT. Gender-specific logistic regression models were used to describe differences in socioeconomic characteristics, HIV exposure risk, testing histories, HIV related stigma, and attitudes toward testing, between the two groups. Results: MVCT clients reported greater HIV exposure risk (OR 1.20 [1.04 to 1.38] for males; OR 1.11 [1.03 to 1.19] for females). Female MVCT clients were more likely to report low household expenditures (OR 1.47 [1.04 to 2.05]), male clients reported higher rates of unstable income sources (OR 1.99 [1.22 to 3.24]). First-time testers were more likely than non-testers to cite distance to testing sites as a reason for not having previously tested (OR 2.17 [1.05 to 4.48] for males; OR 5.95 [2.85 to 12.45] for females). HIV-related stigma, fears of testing or test disclosure, and not being able to leave work were strongly associated with non-participation in MVCT (ORs from 0.11 to 0.84). Conclusions: MVCT attracted clients with increased exposure risk and fewer economic resources; HIV related stigma and testing-related fears remained barriers to testing. MVCT did not disproportionately attract either first-time or frequent repeat testers. Educational campaigns to reduce stigma and fears of testing could improve the effectiveness of MVCT in attracting new and high-risk populations.

Suggested Citation

  • Jan Ostermann & Elizabeth A Reddy & Meghan M Shorter & Charles Muiruri & Antipas Mtalo & Dafrosa K Itemba & Bernard Njau & John A Bartlett & John A Crump & Nathan M Thielman, 2011. "Who Tests, Who Doesn't, and Why? Uptake of Mobile HIV Counseling and Testing in the Kilimanjaro Region of Tanzania," PLOS ONE, Public Library of Science, vol. 6(1), pages 1-8, January.
    • Handle: RePEc:plo:pone00:0016488
    DOI: 10.1371/journal.pone.0016488
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    1. Elizabeth L Corbett & Ethel Dauya & Ronnie Matambo & Yin Bun Cheung & Beauty Makamure & Mary T Bassett & Steven Chandiwana & Shungu Munyati & Peter R Mason & Anthony E Butterworth & Peter Godfrey-Faus, 2006. "Uptake of Workplace HIV Counselling and Testing: A Cluster-Randomised Trial in Zimbabwe," PLOS Medicine, Public Library of Science, vol. 3(7), pages 1-1, July.
    2. Genberg, Becky L. & Hlavka, Zdenek & Konda, Kelika A. & Maman, Suzanne & Chariyalertsak, Suwat & Chingono, Alfred & Mbwambo, Jessie & Modiba, Precious & Van Rooyen, Heidi & Celentano, David D., 2009. "A comparison of HIV/AIDS-related stigma in four countries: Negative attitudes and perceived acts of discrimination towards people living with HIV/AIDS," Social Science & Medicine, Elsevier, vol. 68(12), pages 2279-2287, June.
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    1. Kévin Jean & Xavier Anglaret & Raoul Moh & France Lert & Rosemary Dray-Spira, 2012. "Barriers to HIV Testing in Côte d'Ivoire: The Role of Individual Characteristics and Testing Modalities," PLOS ONE, Public Library of Science, vol. 7(7), pages 1-9, July.
    2. Ingrid V Bassett & Darshini Govindasamy & Alison S Erlwanger & Emily P Hyle & Katharina Kranzer & Nienke van Schaik & Farzad Noubary & A David Paltiel & Robin Wood & Rochelle P Walensky & Elena Losina, 2014. "Mobile HIV Screening in Cape Town, South Africa: Clinical Impact, Cost and Cost-Effectiveness," PLOS ONE, Public Library of Science, vol. 9(1), pages 1-11, January.
    3. Jürgensen, Marte & Sandøy, Ingvild F. & Michelo, Charles & Fylkesnes, Knut & Mwangala, Sheila & Blystad, Astrid, 2013. "The seven Cs of the high acceptability of home-based VCT: Results from a mixed methods approach in Zambia," Social Science & Medicine, Elsevier, vol. 97(C), pages 210-219.
    4. Josephine Agu & Roanna Lobo & Gemma Crawford & Bethwyn Chigwada, 2016. "Migrant Sexual Health Help-Seeking and Experiences of Stigmatization and Discrimination in Perth, Western Australia: Exploring Barriers and Enablers," IJERPH, MDPI, vol. 13(5), pages 1-22, May.

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