title: The associations of voluntary counseling and testing acceptance and the perceived likelihood of being HIV-infected among men with multiple sex partners in a South African township.
abstract: This paper examines the socio-demographic factors and sexual risk behaviors (condom use, number of sexual partners, STI symptoms) associated with voluntary counselling and testing (VCT) acceptance and self-perceived risk of being HIV-infected among black men with multiple and younger sex partners in a South African township outside of Cape Town. Using respondent driven sampling, we interviewed 421 men, of whom 409 (97.3%) consented to provide a dried blood spot, 12.3% were HIVinfected (95% confidence intervals [CI.] 8.3, 16.9) and 47.2% (CI. 41.1, 53.6) accepted on site VCT. Twenty six percent (CI. 20.2, 30.7) reported having an HIV test in the past year. Few men perceived themselves as very likely to be infected with HIV (15.6%; CI. 10.4, 20.5). VCT acceptance was significantly associated with being older, married or living with a partner, having higher education, having four to six partners in the past three months and testing HIV positive. Self-perceived likelihood of being HIV infected was significantly associated with low condom use and having seven or more partners in the past three months, and testing HIV positive. These findings indicate that men correctly understand that engaging in certain HIV risk behaviors increases the likelihood of HIV-infection. However, those who perceive themselves at high risk of having HIV do not seek testing. Further investigation into the psychological and cultural barriers to reducing risky sexual behaviors and accessing VCT and other HIV services is recommended.
authors.affiliation: Department of International Health & Development, Center for Global Health Equity, Tulane University School of Public Health & Tropical Medicine, New Orleans, LA, USA. lsjohnston.global@gmail.com
authors.forename: Lisa
authors.initials: L
authors.lastname: Johnston
authors.forename: Heidi
authors.initials: H
authors.lastname: O'Bra
authors.forename: Mickey
authors.initials: M
authors.lastname: Chopra
authors.forename: Cathy
authors.initials: C
authors.lastname: Mathews
authors.forename: Loraine
authors.initials: L
authors.lastname: Townsend
authors.forename: Keith
authors.initials: K
authors.lastname: Sabin
authors.forename: Mark
authors.initials: M
authors.lastname: Tomlinson
authors.forename: Carl
authors.initials: C
authors.lastname: Kendall
mesh_terms: D000293:Adolescent; D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data; D003376:Counseling / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D015995:Prevalence; D012306:Risk; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology*; D012747:Sexual Partners; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology; D055815:Young Adult