title: Factors associated with HIV-testing and acceptance of an offer of home-based testing by men in rural Zambia.
abstract: The objective of this study is to describe HIV-testing among men in rural Lusaka Province, Zambia, using a population-based survey for a cluster-randomized trial. Households (N = 120) were randomly selected from each of the 42 clusters, defined as a health facility catchment area. Individuals aged 15-60 years were invited to complete questionnaires regarding demographics and HIV-testing history. Men testing in the last year were defined as recent-testers. After questionnaire completion adults were offered home-based rapid HIV-testing. Of the 2,828 men, 53 % reported ever-testing and 25 % recently-testing. Factors independently associated with ever- and recent-testing included age 20+ years, secondary/higher education, being married or widowed, a history of TB-treatment and higher socioeconomic position. 53 % of never-testers and 57 % of men who did not report a recent-test accepted home-based HIV-testing. Current HIV-testing approaches are inadequate in this high prevalence setting. Alternative strategies, including self-testing, mobile- or workplace-testing, may be required to complement facility-based services.
authors.affiliation: Department of Social and Environmental Health Research, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK, Bernadette.hensen@lshtm.ac.uk.
authors.forename: B
authors.initials: B
authors.lastname: Hensen
authors.forename: J J
authors.initials: JJ
authors.lastname: Lewis
authors.forename: A
authors.initials: A
authors.lastname: Schaap
authors.forename: M
authors.initials: M
authors.lastname: Tembo
authors.forename: W
authors.initials: W
authors.lastname: Mutale
authors.forename: H A
authors.initials: HA
authors.lastname: Weiss
authors.forename: J
authors.initials: J
authors.lastname: Hargreaves
authors.forename: H
authors.initials: H
authors.lastname: Ayles
mesh_terms: D015492:AIDS Serodiagnosis / Q000379:methods / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D016000:Cluster Analysis; D004522:Educational Status; D015658:HIV Infections / Q000175:diagnosis* / Q000523:psychology; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D015995:Prevalence; D015397:Program Evaluation; D019035:Rural Health Services; D012424:Rural Population; D012648:Self Care / Q000523:psychology / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D015024:Zambia / Q000453:epidemiology