Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
Institute for Global Health, University College London, London, UK.
Trop Med Int Health. 2013 Sep;18(9):1110-1118. doi: 10.1111/tmi.12155.
Research indicates that individuals tested for HIV have higher socio-economic status than those not tested, but less is known about how socio-economic status is associated with modes of testing. We compared individuals tested through provider-initiated testing and counselling (PITC), those tested through voluntary counselling and testing (VCT) and those never tested.
Cross-sectional surveys were conducted at health facilities in Burkina Faso, Kenya, Malawi and Uganda, as part of the Multi-country African Testing and Counselling for HIV (MATCH) study. A total of 3659 clients were asked about testing status, type of facility of most recent test and socio-economic status. Two outcome measures were analysed: ever tested for HIV and mode of testing. We compared VCT at stand-alone facilities and PITC, which includes integrated facilities where testing is provided with medical care, and prevention of mother-to-child transmission (PMTCT) facilities. The determinants of ever testing and of using a particular mode of testing were analysed using modified Poisson regression and multinomial logistic analyses.
Higher socio-economic status was associated with the likelihood of testing at VCT rather than other facilities or not testing. There were no significant differences in socio-economic characteristics between those tested through PITC (integrated and PMTCT facilities) and those not tested.
Provider-initiated modes of testing make testing accessible to individuals from lower socio-economic groups to a greater extent than traditional VCT. Expanding testing through PMTCT reduces socio-economic obstacles, especially for women. Continued efforts are needed to encourage testing and counselling among men and the less affluent.
研究表明，接受 HIV 检测的个体比未接受检测的个体具有更高的社会经济地位，但对于社会经济地位如何与检测模式相关联，人们知之甚少。我们比较了通过医生主动提供的检测和咨询（PITC）、自愿咨询和检测（VCT）以及从未接受过检测的个体。
横断面调查在布基纳法索、肯尼亚、马拉维和乌干达的卫生机构进行，作为多国非洲 HIV 检测和咨询（MATCH）研究的一部分。共有 3659 名患者被问及检测状况、最近一次检测的医疗机构类型和社会经济地位。分析了两种结果衡量标准：是否曾接受过 HIV 检测和检测模式。我们比较了独立 VCT 设施和 PITC，后者包括与医疗服务相结合提供检测的综合设施以及预防母婴传播（PMTCT）设施。使用修正泊松回归和多项逻辑回归分析来分析曾经接受过检测和使用特定检测模式的决定因素。
较高的社会经济地位与在 VCT 而不是其他医疗机构或未接受检测的情况下接受检测的可能性相关。通过 PITC（综合和 PMTCT 设施）接受检测和未接受检测的个体在社会经济特征方面没有显著差异。
与传统的 VCT 相比，医生主动提供的检测模式更能让社会经济地位较低的个体更容易接受检测。通过 PMTCT 扩大检测范围可以减少社会经济障碍，特别是对妇女而言。需要继续努力鼓励男性和不太富裕的人群接受检测和咨询。
