From the Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC.
Section of Infectious Disease, Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA.
Sex Transm Dis. 2019 Sep;46(9):588-593. doi: 10.1097/OLQ.0000000000001037.
Higher gender equality is associated with many human immunodeficiency virus (HIV) preventive behaviors, including HIV testing. HIV self-testing is a relatively new testing technology that could assist with HIV prevention. However, there are no studies examining gender equality and HIV self-testing. We examined the associations between gender equality and couples' uptake of HIV self-testing among heterosexual couples expecting a child in central Kenya.
This analysis used data from a HIV self-testing randomized intervention trial among pregnant women attending antenatal care and their male partners. The primary exposures were gender equality (measured by the male partner's attitudes toward intimate partner violence, and the woman's report on her household decision making power), and the primary outcome was couples' uptake of HIV self-testing. Generalized linear mixed models framework was used to account for site-level clustering.
In comparison to male partners reporting high acceptance of intimate partner violence, couples with male partners reporting medium acceptance (odds ratio, 2.36; 95% confidence interval, 0.99-5.63) or low acceptance (odds ratio, 2.50; 95% confidence interval, 1.20-5.21) were significantly more likely to use HIV self-testing. Gender equality measured by decision making power was not associated with couples' uptake of HIV self-testing.
This study is the first of its kind to examine the association between gender equality and couples' HIV self-testing. This holds important implications for HIV self-testing as we strive to achieve the United Nations Programme on HIV/acquired immune deficiency syndrome goal that 90% of individuals living with HIV should know their status.
更高的性别平等与许多人类免疫缺陷病毒（HIV）预防行为相关，包括 HIV 检测。HIV 自我检测是一种相对较新的检测技术，可用于 HIV 预防。然而，目前还没有研究探讨性别平等与 HIV 自我检测之间的关系。我们在肯尼亚中部对即将生育的异性恋夫妇进行了一项 HIV 自我检测随机干预试验，调查了性别平等与夫妇接受 HIV 自我检测的关系。
本分析使用了参加产前保健的孕妇及其男性伴侣参与的 HIV 自我检测随机干预试验的数据。主要暴露因素为性别平等（通过男性伴侣对亲密伴侣暴力的态度以及女性对家庭决策权的报告来衡量），主要结局为夫妇接受 HIV 自我检测的情况。使用广义线性混合模型框架来考虑地点水平的聚类。
与报告高度接受亲密伴侣暴力的男性伴侣相比，报告接受程度为中度（比值比，2.36；95%置信区间，0.99-5.63）或低度（比值比，2.50；95%置信区间，1.20-5.21）的男性伴侣的夫妇更有可能使用 HIV 自我检测。以决策权衡量的性别平等与夫妇接受 HIV 自我检测的情况无关。
这项研究首次探讨了性别平等与夫妇 HIV 自我检测之间的关系。这对 HIV 自我检测具有重要意义，因为我们努力实现联合国艾滋病毒/艾滋病规划署的目标，即 90%的艾滋病毒感染者应了解自己的状况。
