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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Who tests, who doesn't, and why? Uptake of mobile HIV counseling and testing in the kilimanjaro region of Tanzania
PLoS ONE, Volume 6, No. 1, Article e16488, Year 2011
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Description
Background: Optimally, expanded HIV testing programs should reduce barriers to testing while attracting new and highrisk 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. © 2011 Ostermann et al.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC3031571/bin/pone.0016488.s001.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC3031571/bin/pone.0016488.s002.doc
Authors & Co-Authors
Ostermann, Jan
United States, Durham
Duke University
Reddy, Elizabeth A.
United States, Durham
Duke University Medical Center
Shorter, Meghan M.
United States, Durham
Duke University Medical Center
Muiruri, Charles
United States, Durham
Duke University Medical Center
Mtalo, Antipas
Unknown Affiliation
Itemba, Dafrosa K.
Unknown Affiliation
Njau, Bernard Joseph
Tanzania, Moshi
Kilimanjaro Christian Medical Centre
Tanzania, Moshi
Kilimanjaro Christian Medical University College
Bartlett, John A.
United States, Durham
Duke University
United States, Durham
Duke University Medical Center
Tanzania, Moshi
Kilimanjaro Christian Medical Centre
Tanzania, Moshi
Kilimanjaro Christian Medical University College
Crump, John A.
United States, Durham
Duke University
United States, Durham
Duke University Medical Center
Tanzania, Moshi
Kilimanjaro Christian Medical Centre
Tanzania, Moshi
Kilimanjaro Christian Medical University College
Thielman, Nathan M.
United States, Durham
Duke University
United States, Durham
Duke University Medical Center
Statistics
Citations: 73
Authors: 10
Affiliations: 4
Identifiers
Doi:
10.1371/journal.pone.0016488
e-ISSN:
19326203
Research Areas
Health System And Policy
Infectious Diseases
Study Locations
Tanzania
Participants Gender
Male
Female