title: Failure to test for HIV in rural Ethiopia: knowledge and belief correlates and implications for universal test and treat strategies.
abstract: Goals of universal "test and treat" will never be fully realized if testing acceptance remains low, including rural areas, where HIV is increasingly recognized. We surveyed 250 randomly selected households from a rural Ethiopian town (Arba Minch) and surrounding villages about HIV testing experience, knowledge, and attitudes. Of the 558 adults, 45% were never HIV tested. Those never tested for HIV were more likely to be (P < .05) ≥45 years, rural villagers, and unaware of the benefits of antiretroviral therapy treatment and that persons with HIV can appear healthy; they were more likely to believe HIV-infected persons would be stigmatized and unsupported by their communities. Of those never tested, 70% were interested in HIV testing if offered. Despite recommendations that all persons be HIV tested, almost half of the adult residents in this rural community were never tested. Programs to increase HIV testing must include measures to address stigma/discrimination and knowledge deficits including benefits of early diagnosis and treatment.
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Alan R
authors.initials: AR
authors.lastname: Lifson
authors.forename: Workneh
authors.initials: W
authors.lastname: Demisse
authors.forename: Kassu
authors.initials: K
authors.lastname: Ketema
authors.forename: Alemayehu
authors.initials: A
authors.lastname: Tadesse
authors.forename: Randy
authors.initials: R
authors.lastname: May
authors.forename: Bereket
authors.initials: B
authors.lastname: Yakob
authors.forename: Lucy
authors.initials: L
authors.lastname: Slater
authors.forename: Tibebe
authors.initials: T
authors.lastname: Shenie
mesh_terms: D000328:Adult; D005002:Ethiopia; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000523:psychology*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000523:psychology / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care; D012424:Rural Population / Q000706:statistics & numerical data*; D057545:Social Stigma
keywords: HIV testing; rural populations; stigma; sub-Saharan Africa