Worku Misganaw Gebrie, Tesema Getayeneh Antehunegn, Teshale Achamyeleh Birhanu
Department of Human Anatomy, College of Medicine and Health Science, School of Medicine, University of Gondar, Gondar, Ethiopia.
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
BMC Public Health. 2021 Jun 29;21(1):1262. doi: 10.1186/s12889-021-11292-9.
Despite efforts made to reduce the spread of the human immune-deficiency virus (HIV), its testing coverage remains low in low and middle-income countries (LMIC). Besides, information on factors associated with HIV counseling and testing among reproductive-age women is not sufficiently available. Therefore, this study was aimed to determine the pooled prevalence and factors associated with HIV testing among reproductive-age women in eastern Africa.
Secondary data analysis was conducted based on the Demographic and Health Surveys (DHS) data conducted in East African countries. We pooled the most recent DHS surveys done in 11 East African countries. A total weighted sample of 183,411 reproductive-age women was included for this study. Both bivariable and multivariable multilevel logistic regression models were fitted. Variables with a p-value ≤0.2 in the bivariable analysis were selected for multivariable analysis. Finally, in the multivariable analysis, variables with a p-value ≤0.05 were considered as significant factors affecting HIV testing.
The pooled prevalence of HIV testing in eastern Africa was 66.92% (95%CI: 66.70, 67.13%). In the multivariable multilevel analysis factors such as the age of respondent, marital status, educational level, HIV knowledge, HIV stigma indicator, risky sexual behavior and women who visit a health facility were positively associated with HIV testing coverage among reproductive-age women. While women from rich and richest households, having multiple sexual partners, being from rural dwellers, late initiation of sex and higher community illiteracy level had a lower chance of being tested for HIV.
The pooled prevalence of HIV testing in eastern Africa was higher than most previous studies. Age of respondent, residence, wealth index, marital status, educational level, HIV knowledge, stigma indicator, risky sexual behavior, women who visit a health facility, multiple sexual partnerships, early initiation of sex and community illiteracy level were significantly associated with HIV testing. There should be an integrated strategic plan to give education about methods of HIV transmission and the implication of HIV testing and counseling. So all the stakeholders should have an integrated approach by giving special attention to the factors that hinder HIV testing to increase awareness regarding the benefit of HIV testing and counseling to control the spread of HIV/AIDS.
尽管为减少人类免疫缺陷病毒（HIV）的传播做出了努力，但在低收入和中等收入国家（LMIC），其检测覆盖率仍然很低。此外，关于育龄妇女中与HIV咨询和检测相关因素的信息并不充分。因此，本研究旨在确定东非育龄妇女中HIV检测的合并患病率及相关因素。
基于在东非国家进行的人口与健康调查（DHS）数据进行二次数据分析。我们汇总了在11个东非国家进行的最新DHS调查。本研究纳入了183,411名育龄妇女的总加权样本。拟合了双变量和多变量多水平逻辑回归模型。在双变量分析中p值≤0.2的变量被选入多变量分析。最后，在多变量分析中，p值≤0.05的变量被视为影响HIV检测的显著因素。
东非HIV检测的合并患病率为66.92%（95%CI：66.70，67.13%）。在多变量多水平分析中，诸如受访者年龄、婚姻状况、教育水平、HIV知识、HIV耻辱感指标、危险性行为以及前往医疗机构就诊的女性等因素与育龄妇女中的HIV检测覆盖率呈正相关。而来自富裕和最富裕家庭的女性、有多个性伴侣的女性、农村居民、初次性行为较晚以及社区文盲率较高的女性接受HIV检测的机会较低。
东非HIV检测的合并患病率高于以往大多数研究。受访者年龄、居住地、财富指数、婚姻状况、教育水平、HIV知识、耻辱感指标、危险性行为、前往医疗机构就诊的女性、多个性伴侣、初次性行为较早以及社区文盲率与HIV检测显著相关。应制定综合战略计划，开展关于HIV传播方式以及HIV检测和咨询意义的教育。因此，所有利益相关者应采取综合方法，特别关注阻碍HIV检测的因素，以提高对HIV检测和咨询益处的认识，从而控制HIV/AIDS的传播。
