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Self-reported non-receipt of HIV test results: A silent barrier to HIV epidemic control in Mozambique


Autoři: Didier Mugabe aff001;  Nilesh Bhatt aff001;  James G. Carlucci aff002;  Eduardo S. Gudo aff001;  Wu Gong aff004;  Mohsin Sidat aff005;  Troy D. Moon aff002
Působiště autorů: National Institute of Health of Mozambique, Marracuene, Maputo, Mozambique aff001;  Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America aff002;  Department of Pediatrics, Division of Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America aff003;  Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America aff004;  Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique aff005
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0224102

Souhrn

Introduction

People living with HIV (PLHIV) and who are aware of their HIV status can access and benefit from antiretroviral therapy (ART) with subsequent individual and public health benefits; however, many PLHIV are unaware of their HIV status. We assessed the magnitude and determinants of self-reported non-receipt of HIV test results in adults aged 15–59 years old in Mozambique.

Methods

We performed a secondary analysis of data from the 2015 Mozambique Immunization indicators, Malaria and HIV/AIDS (IMASIDA 2015). Eligible adults (15–59 years) from each selected household were interviewed and data on sociodemographic characteristics, HIV knowledge, attitudes and behaviors, and HIV testing history were collected. Multivariable logistic regression assessed factors associated with self-reported non-receipt of HIV test results. Population representative estimates were calculated.

Results

13,028 (90.8%) of 14,343 eligible participants were interviewed. A total of 6,654 (51.1%) respondents had previously been tested for HIV and were included in the analysis. Of these, 308 (4.6%; 95% CI: 3.70–5.77) self-reported not having received HIV test results. In the multivariable analysis, previous sexually transmitted infection (aOR: 2.76; 95% CI: 1.44–5.31), HIV stigmatizing attitudes (aOR: 1.96; 95% CI: 1.14–3.37), and lack of decision-making power towards health care seeking (aOR: 2.51; 95% CI: 1.39–4.52) were associated with non-receipt of HIV test results. Whereas, secondary or higher education (aOR: 0.25; 95% CI: 0.12–0.54), higher HIV knowledge (aOR: 0.47; 95% CI: 0.26–0.86), and age between 30–34 and 35–39 years old (aOR 0.47; 95% CI: 0.28–0.80; and aOR: 0.49; 95% CI: 0.27–0.90, respectively), were associated with receipt of HIV test results.

Conclusions

In this nationally representative survey, self-reported non-receipt of HIV test results was high and of public health relevance. These findings suggest adaptation of HIV counseling and testing programs emphasizing individualized approaches that target the youngest, least educated and the poorest individuals, especially those living in rural areas.

Klíčová slova:

HIV diagnosis and management – Rural areas – Mozambique – Language – HIV epidemiology – HIV prevention


Zdroje

1. Instituto Nacional de Estatística (INE). Resultados Preliminares do IV Recenseamento Geral da População e Habitação 2017. Maputo, Mozambique: INE; 2017 Dezembro. http://www.ine.gov.mz/operacoes-estatisticas/censos/censo-2007/censo-2017/resultados-preliminares-iv-rgph-2017/view

2. Ministerio de Saude (MISAU), Instituto Nacional de Estatística, ICF International. Inquérito de Indicadores de Imunização, Malaria e HIV/SIDA em Moçambique (IMASIDA) 2015. Maputo, Moçambique: Rockville, Maryland, EUA: INS, INE, and ICF; 2018 Feb. http://dhsprogram.com/pubs/pdf/AIS12/AIS12.pdf

3. Ministerio de Saude (MISAU). Relatório Anual das Actividades Relacionadas ao HIV/SIDA 2013. Maputo, Moçambique: MISAU; 2014 Abril p. 50. http://www.misau.gov.mz/index.php/relatorios-anuais?download=88:relatorio-anual-hiv-2013-final

4. Ministerio de Saude (MISAU). Relatório Anual das Actividades Relacionadas ao HIV/SIDA 2017. Maputo, Moçambique: MISAU; 2018 Abril p. 96. http://www.misau.gov.mz/index.php/relatorios-anuais?download=145:relatorio-anual-hiv-2017-final

5. USA President’s Emergency Plan for AIDS Relief (PEPFAR). Mozambique Country Operational Plan (COP/ROP) 2017—Strategic -Strategic Direction Summary. Maputo, Mozambique; 2017 p. 152. https://www.pepfar.gov/documents/organization/272018.pdf

6. USA President’s Emergency Plan for AIDS Relief (PEPFAR). Mozambique Country Operational Plan 2018—Strategic Direction Summary. Maputo, Mozambique; 2018 p. 166. https://www.pepfar.gov/documents/organization/285858.pdf

7. Granich RM, Gilks CF, Dye C, De Cock KM, Williams BG. Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission: a mathematical model. The Lancet. 2009;373: 48–57. doi: 10.1016/S0140-6736(08)61697-9

8. Tanser F, Bärnighausen T, Grapsa E, Zaidi J, Newell M-L. High coverage of ART associated with decline in risk of HIV acquisition in rural KwaZulu-Natal, South Africa. Science. 2013;339: 966–971. doi: 10.1126/science.1228160 23430656

9. The INSIGHT START Study Group. Initiation of Antiretroviral Therapy in Early Asymptomatic HIV Infection. New England Journal of Medicine. 2015;373: 795–807. doi: 10.1056/NEJMoa1506816 26192873

10. The Voluntary HIV-1 Counseling and Testing Efficacy Study Group. Efficacy of voluntary HIV-1 counselling and testing in individuals and couples in Kenya, Tanzania, and Trinidad: a randomised trial. The Lancet. 2000;356: 103–112. doi: 10.1016/S0140-6736(00)02446-6

11. Crepaz N, Lyles CM, Wolitski RJ, Passin WF, Rama SM, Herbst JH, et al. Do prevention interventions reduce HIV risk behaviours among people living with HIV? A meta-analytic review of controlled trials: AIDS. 2006;20: 143–157. doi: 10.1097/01.aids.0000196166.48518.a0 16511407

12. Thierman S, Chi BH, Levy JW, Sinkala M, Goldenberg RL, Stringer JSA. Individual-level predictors for HIV testing among antenatal attendees in Lusaka, Zambia. Am J Med Sci. 2006;332: 13–17. doi: 10.1097/00000441-200607000-00003 16845236

13. Hensen B, Lewis JJ, Schaap A, Tembo M, Mutale W, Weiss HA, et al. Factors Associated with HIV-Testing and Acceptance of an Offer of Home-Based Testing by Men in Rural Zambia. AIDS Behav. 2015;19: 492–504. doi: 10.1007/s10461-014-0866-0 25096893

14. Hensen B, Lewis J, Schaap A, Tembo M, Vera-Hernández M, Mutale W, et al. Frequency of HIV-testing and factors associated with multiple lifetime HIV-testing among a rural population of Zambian men. BMC Public Health. 2015;15. doi: 10.1186/s12889-015-2259-3 26404638

15. Singh K, Luseno W, Haney E. Gender equality and education: Increasing the uptake of HIV testing among married women in Kenya, Zambia and Zimbabwe. AIDS Care. 2013;25: 1452–1461. doi: 10.1080/09540121.2013.774311 23438082

16. Tao G, Branson BM, Kassler WJ, Cohen RA. Rates of Receiving HIV Test Results: Data From the U.S. National Health Interview Survey for 1994 and 1995. Journal of Acquired Immune Deficiency Syndromes. 1999;22: 395–400. doi: 10.1097/00126334-199912010-00011 10634202

17. Gebregziabher M, Dai L, Vrana-Diaz C, Teklehaimanot A, Sweat M. Gender Disparities in Receipt of HIV Testing Results in Six Sub-Saharan African Countries. Health Equity. 2018;2: 384–394. doi: 10.1089/heq.2018.0060 30596190

18. Zambia Central Statistical Office, Ministry of Health, ICF International. Zambia Demographic and Health Survey 2013–14. Rockville, Maryland, USA: Central Statistical Office, Ministry of Health, and ICF International.; 2015. https://dhsprogram.com/publications/publication-FR304-DHS-Final-Reports.cfm

19. Swaziland Central Statistical Office, Macro International Inc. Swaziland Demographic and Health Survey 2006–07. Mbabane, Swaziland: Central Statistical Office and Macro International Inc; 2008. https://dhsprogram.com/publications/publication-FR202-DHS-Final-Reports.cfm

20. South Africa National Department of Health (NDoH), Statistics South Africa (Stats SA), South African Medical Research Council (SAMRC), ICF International. South Africa Demographic and Health Survey 2016. Pretoria, South Africa, and Rockville, Maryland, USA: NDoH, Stats SA, SAMRC, and ICF; 2019. https://dhsprogram.com/publications/publication-FR337-DHS-Final-Reports.cfm

21. Tanzania Commission for AIDS (TACAIDS), Zanzibar AIDS Commission (ZAC), National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS), ICF International. Tanzania HIV/AIDS and Malaria Indicator Survey 2011–12. Dar es Salaam, Tanzania: TACAIDS, ZAC, NBS, OCGS, and ICF International.; 2013. https://dhsprogram.com/publications/publication-AIS11-AIS-Final-Reports.cfm

22. Instituto Nacional de Estatística (INE). III Recenseamento Geral Da População e Habitação 2007—Resultados Definitivos. http://197.249.4.187/imismoz/censos/censo2007/censohtml/index.htm

23. United Nations General Assembly. United Nations General Assembly resolution 70/1 –Transforming our world: The 2030 Agenda for Sustainable Development. Sep 2015. http://www.un.org/ga/search/view_doc.asp?symbol=A/RES/70/1&Lang=E

24. Joint United Nations Programme on HIV/AIDS (UNAIDS). 90-90-90 An ambitious treatment target to help end the AIDS epidemic. 2014 Oct p. 40. http://www.unaids.org/sites/default/files/media_asset/90-90-90_en_0.pdf

25. Lépine A, Terris-Prestholt F, Vickerman P. Determinants of HIV testing among Nigerian couples: a multilevel modelling approach. Health Policy Plan. 2015;30: 579–592. doi: 10.1093/heapol/czu036 24906362

26. Gazimbi MM, Magadi MA. A Multilevel Analysis of the Determinants of HIV Testing in Zimbabwe: Evidence from the Demographic and Health Surveys. HIV/AIDS Research and Treatment—Open Journal. 2017;4: 14–31. doi: 10.17140/HARTOJ-4-124

27. Qiao S, Zhang Y, Li X, Menon JA. Facilitators and barriers for HIV-testing in Zambia: A systematic review of multi-level factors. PLoS One. 2018;13. doi: 10.1371/journal.pone.0192327 29415004

28. Musheke M, Merten S, Bond V. Why do marital partners of people living with HIV not test for HIV? A qualitative study in Lusaka, Zambia. BMC Public Health. 2016;16. doi: 10.1186/s12889-016-3396-z 27561332

29. Mohlabane N, Tutshana B, Peltzer K, Mwisongo A. Barriers and facilitators associated with HIV testing uptake in South African health facilities offering HIV Counselling and Testing. Health SA Gesondheid. 2016;21: 86–95–95.

30. Strauss M, Rhodes B, George G. A qualitative analysis of the barriers and facilitators of HIV counselling and testing perceived by adolescents in South Africa. BMC Health Serv Res. 2015;15. doi: 10.1186/s12913-015-0922-0 26123133

31. Nabukenya AM, Matovu JKB. Correlates of HIV status awareness among older adults in Uganda: results from a nationally representative survey. BMC Public Health. 2018;18. doi: 10.1186/s12889-018-6027-z 30223821

32. Ngangue P, Bedard E, Ngueta G, Adiogo D, Gagnon M-P. Failure to Return for Posttest Counseling and HIV Test Results at the Prevention and Voluntary Testing and Counseling Centers of Douala, Cameroon: An Evaluation of a Routine Five-Year Program. AIDS Res Treat. 2016;2016. doi: 10.1155/2016/9720148 26925261

33. Defo D, Kouotou EA, Nansseu JR. Failure to return to receive HIV-test results: the Cameroon experience. BMC Res Notes. 2017;10. doi: 10.1186/s13104-017-2632-7 28738886

34. Instituto Nacional de Estatística (INE), Ministério da Saúde (MINSA, Ministério do Planeamento e do Desenvolvimento Territorial (MINPLAN), ICF International. Angola Inquérito de Indicadores Múltiplos e de Saúde (IIMS) 2015–2016. Luanda, Angola e Rockville, Maryland, EUA: INE, MINSA, MINPLAN e ICF; 2017. https://dhsprogram.com/publications/publication-FR327-DHS-Final-Reports.cfm


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