Department of Nursing, College of Health Sciences, Makerere University, Kampala, Uganda.
Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.
AIDS Res Ther. 2019 Sep 18;16(1):28. doi: 10.1186/s12981-019-0244-0.
Limited data are available regarding correlates of regular sexually transmitted infections (STIs) and HIV screening among female sex workers (FSW) in Sub-Saharan Africa. In this study, we aimed to assess the frequency of regular syphilis and HIV screening and the psychosocial correlates associated with screening among FSW in Uganda.
This cross-sectional correlational study was conducted among 441 FSW, aged 17-49 years. We enrolled FSW through peer referrals and ascertained self-reported data on number of serological tests for HIV, syphilis and other STIs in the prior 12 months using an interviewer-administered questionnaire. In addition, we assessed attitudes, norms, social influences and self-efficacy towards 3-monthly Syphilis and 6-monthly HIV testing. We estimated the correlates of regular STI and HIV testing using negative binomial regression.
Of the respondents 420 (95.2%) reported to have ever taken an HIV test with 297 (67.4%) testing two or more times in the prior 12 months. Over half of the respondents (59%) reported ever taking a syphilis test with only 62 (14.1%) reporting testing three or more times in the prior 12 months. After adjusting for socio-demographics, attitude and norms, high perceived self-efficacy was associated with a 33% increase in the likelihood of repeated HIV testing [prevalence ratio (PR), 1.33, 95% confidence interval (CI) 1.15-1.53] while low perceived confidence was associated with a 25% decrease in the likelihood of repeated HIV testing (PR, 0.75, 95% CI 0.63-0.89). Similarly low attitudes and norms were associated with a decrease of 52.6% (PR, 0.47, 95% CI 0.37-0.61) and 47% (PR, 0.53, 95% CI 0.41-0.69) in the likelihood of repeated syphilis testing respectively.
Compared to HIV, uptake of repeated syphilis testing was very low. Correlates of HIV testing include; perceived self-efficacy amidst barriers and perceived confidence for HIV and low attitudes and accepting norms for syphilis. Health campaigns should emphasize overcoming barriers to HIV testing while promoting attitudes and norms including integration of serological syphilis testing and other STIs into HIV services.
撒哈拉以南非洲地区女性性工作者（FSW）定期进行性传播感染（STI）和艾滋病毒筛查的相关数据有限。本研究旨在评估乌干达 FSW 定期进行梅毒和艾滋病毒筛查的频率以及与筛查相关的社会心理因素。
这是一项横断面相关性研究，对象为 441 名年龄在 17-49 岁之间的 FSW。我们通过同伴推荐招募 FSW，并通过访谈者管理的问卷确定了过去 12 个月中 HIV、梅毒和其他 STI 的血清学检测次数。此外，我们评估了对每 3 个月进行梅毒检测和每 6 个月进行 HIV 检测的态度、规范、社会影响和自我效能。我们使用负二项回归估计了定期进行 STI 和 HIV 检测的相关因素。
在受访者中，420 人（95.2%）报告曾接受过 HIV 检测，其中 297 人（67.4%）在过去 12 个月中进行了两次或两次以上的检测。超过一半的受访者（59%）报告曾接受过梅毒检测，但只有 62 人（14.1%）报告在过去 12 个月中进行了三次或三次以上的检测。在调整了社会人口统计学、态度和规范因素后，高感知自我效能与重复 HIV 检测的可能性增加 33%相关[流行比（PR），1.33，95%置信区间（CI）1.15-1.53]，而低感知信心与重复 HIV 检测的可能性降低 25%相关（PR，0.75，95%CI 0.63-0.89）。同样，低态度和规范与重复梅毒检测的可能性降低 52.6%（PR，0.47，95%CI 0.37-0.61）和 47%（PR，0.53，95%CI 0.41-0.69）相关。
与 HIV 相比，重复进行梅毒检测的比例非常低。HIV 检测的相关因素包括：克服 HIV 检测障碍的感知自我效能、对 HIV 的感知信心以及对梅毒的低态度和接受规范。健康宣传活动应强调克服 HIV 检测障碍，同时促进态度和规范，包括将血清学梅毒检测和其他 STI 纳入 HIV 服务。
