title: Barriers to HIV testing in Côte d'Ivoire: the role of individual characteristics and testing modalities.
abstract: BACKGROUND
  Expanding HIV testing requires a better understanding of barriers to its uptake. We investigated barriers to HIV testing in Côte d'Ivoire, taking into account test circumstances (client vs. provider-initiated).
  
  
  METHODS
  We used data from the 2005 nationally representative Demographic and Health Survey conducted in Côte d'Ivoire. Socio-demographic characteristics, sexual behaviour and knowledge and attitudes toward HIV/AIDS associated with recent (<2 years) HIV testing were identified using gender-specific univariate and multivariate logistic regressions. Among women, differential effects of barriers to testing according to test circumstance (whether they have been offered for a prenatal test or not) were assessed through interaction tests.
  
  
  RESULTS
  Recent HIV testing was reported by 6.1% of men and 9.5% of women (including 4.6% as part of antenatal care). Among men, having a low socioeconomic status, having a low HIV-related knowledge level and being employed [compared to those inactive: adjusted Odds Ratio (aOR) 0.46; 95% confidence interval (CI) 0.25-0.87] were associated with lower proportions of recent HIV testing. Among women without a prenatal HIV testing offer, living outside the capital (aOR 0.38; CI 0.19-0.77) and reporting a unique lifetime sexual partner constituted additional barriers to HIV testing. By contrast, among women recently offered to be tested in prenatal care, none of these variables was found to be associated with recent HIV testing.
  
  
  CONCLUSIONS
  Various dimensions of individuals' characteristics constituted significant barriers to HIV testing in Côte d'Ivoire in 2005, with gender specificities. Such barriers are substantially reduced when testing was proposed in the framework of antenatal care. This suggests that provider-initiated testing strategies may help overcome individual barriers to HIV testing.
authors: Epidemiology of Occupational and Social Determinants of Health-Center for Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France. kevin.jean@inserm.fr
authors: Kévin
authors: K
authors: Jean
authors: Xavier
authors: X
authors: Anglaret
authors: Raoul
authors: R
authors: Moh
authors: France
authors: F
authors: Lert
authors: Rosemary
authors: R
authors: Dray-Spira
mesh_terms: D015492:AIDS Serodiagnosis / Q000379:methods*; D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D003140:Communicable Disease Control / Q000379:methods; D007560:Cote d'Ivoire; D005260:Female; D015658:HIV Infections / Q000175:diagnosis*; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D012044:Regression Analysis; D012737:Sex Factors; D012923:Social Class