Sex differences in perceived risk and testing experience of HIV in an urban fishing setting in Ghana.
BACKGROUND
Understanding sex differences in willingness to test and testing experience could aid the design of focus interventions to enhance uptake and engagement with care, treatment and support services. This study determined differences in perceived risk of acquiring HIV, willingness to test and HIV testing experience in an urban fishing community.


METHODS
A cross-sectional community survey was conducted in 2013 among men and women in two fishing communities (Chorkor and James Town) in Accra. In all, 554 subjects (≥ 18 years) were involved, 264 in Chorkor and 290 in James Town. Data on demographic characteristics, perceived risk for HIV and willingness to test for HIV and testing experience were collected with a structured questionnaire. Descriptive statistics and Chi square test were used for the analysis at 95% significant level, using SPSS version 21.


RESULTS
Of 554 subjects, 329 (59.4%) were females, and median age was 32 years. Overall, only 91(40.4%) men and 118(35.9%) women perceived themselves to be at risk of acquiring HIV. A significant proportion of women were willing to test for HIV compared to men (86.3% vs. 80.0%, P = 0.048). Women were more likely to have ever tested for HIV compared to men (42.2% vs. 28.6%, P = 0.001) and more women had tested within 12 months prior to survey than men (49.6% vs. 40.6%, P = 0.230). Of the number who had tested for HIV infection, a higher proportion of men tested voluntarily 42(65.6%), while a higher proportion of women tested as part of healthcare service received 96(69.1%); (P = 0.001; indicating women vs. men).


CONCLUSIONS
Sex differences in risk perception and willingness to test need more focused public education and behaviour change communication strategies to achieve high coverage. Community-based strategies could improve HIV testing among men whilst more access to testing in health settings should be available to women in these communities.
Department of Community Health, University of Ghana Medical School, College of Health Sciences, P. O. Box 4236, Korle-Bu, Accra, Ghana. aeyawson@yahoo.com.
Alfred E
AE
Yawson
Department of Microbiology, Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana. appiahl@yahoo.com.
Labi K
LK
Appiah
Department of Anaesthesia Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana. anitaromeo1977@yahoo.com.
Anita O
AO
Yawson
Expanded Programme on Immunization, Public Health Division, Ghana Health Service, Accra, Ghana. gybonsu@yahoo.com.
George
G
Bonsu
Department of Community Health, University of Ghana Medical School, College of Health Sciences, P. O. Box 4236, Korle-Bu, Accra, Ghana. aluzeesh@hotmail.com.
Simon
S
Aluze-Ele
Department of Community Health, University of Ghana Medical School, College of Health Sciences, P. O. Box 4236, Korle-Bu, Accra, Ghana. nana.owusuamanhyia@gmail.com.
Nana A K Owusu
NA
Amanhyia
Department of Medicine and Therapeutics, University of Ghana Medical School, College of Health Sciences, Korle-Bu, Accra, Ghana. malart38@yahoo.com.
Margaret
M
Lartey
Office of Director of Research, University of Ghana, Legon, Accra, Ghana. andrewanthonyadjei@yahoo.com.
Andrew A
AA
Adjei
Department of Anatomy, University of Ghana Medical School, College of Health Sciences, Korle-Bu, Accra, Ghana. lantelawson@yahoo.com.
Aaron L
AL
Lawson
Alpert Medical School of Brown University, The Miriam Hospital, Providence, RI, USA. CBeckwith@Lifespan.org.
Curt
C
Beckwith
Alpert Medical School of Brown University, The Miriam Hospital, Providence, RI, USA. Awewura_Kwara@brown.edu.
Awewura
A
Kwara
Alpert Medical School of Brown University, The Miriam Hospital, Providence, RI, USA. TFlanigan@lifespan.org.
Timothy
T
Flanigan
D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D005869:Ghana; D015658:HIV Infections / Q000175:diagnosis* / Q000523:psychology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010465:Perception; D012306:Risk; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult