Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland.
PLoS One. 2013 Aug 21;8(8):e71922. doi: 10.1371/journal.pone.0071922. eCollection 2013.
This paper explores the effect of social relations and gender-based conflicts on the uptake of HIV testing in the South and Central provinces of Zambia. We conducted a community-based cross-sectional study of 1716 randomly selected individuals. Associations were examined using mixed-effect multivariable logistic regression. A total of 264 men (64%) and 268 women (56%) had never tested for HIV. The strongest determinants for not being tested were disruptive couple relationships (OR = 2.48 95% CI = 1.00-6.19); tolerance to gender-based violence (OR = 2.10 95% CI = 1.05-4.32) and fear of social rejection (OR = 1.48 95% CI = 1.23-1.80). In the Zambian context, unequal power relationships within the couple and the community seem to play a pivotal role in the decision to test which until now have been largely underestimated. Policies, programs and interventions to rapidly increase HIV testing need to urgently address gender-power inequity in relationships and prevent gender-based violence to reduce the negative impact on the lives of couples and families.
本文探讨了社会关系和基于性别的冲突对赞比亚中南部省份 HIV 检测率的影响。我们对 1716 名随机选择的个体进行了基于社区的横断面研究。使用混合效应多变量逻辑回归来检验相关性。共有 264 名男性（64%）和 268 名女性（56%）从未接受过 HIV 检测。未接受检测的最强决定因素是夫妻关系破裂（OR = 2.48，95%CI = 1.00-6.19）；对基于性别的暴力行为的容忍（OR = 2.10，95%CI = 1.05-4.32）和对社会排斥的恐惧（OR = 1.48，95%CI = 1.23-1.80）。在赞比亚的背景下，夫妻和社区内部不平等的权力关系似乎在检测决策中起着关键作用，而这一点迄今为止在很大程度上被低估了。需要迅速增加 HIV 检测的政策、方案和干预措施，迫切需要解决关系中的性别权力不平等问题，并预防基于性别的暴力行为，以减少其对夫妻和家庭生活的负面影响。
