Understanding the intention to undergo regular HIV testing among female sex workers in Benin: a key issue for entry into HIV care.
BACKGROUND
HIV testing constitutes an entry point for HIV prevention and access to care. Although access to tests has increased in most low- and middle-income countries in recent years, regular HIV testing among high-risk populations remains a challenge. Understanding the determinants of regular HIV testing is the key to improving treatment-as-prevention programs and access to care. This study aimed to identify psychosocial factors associated with the intention to be HIV tested every 3 months among female sex workers (FSWs) in Benin.


METHODS
We developed an interview questionnaire based on the Theory of Planned Behavior and other theoretical variables. We interviewed 450 FSWs in their work place. Using Amos software, we applied structural equation modeling to identify the determinants of intention.


RESULTS
Previous testing was reported by 87% of FSWs, 40% of whom reported having been tested in the last 3 months. More than half of the FSWs (69%) showed a strong intention to be HIV tested during the next 3 months. The structural model indicates that 55% of the variance in intention is explained in descending order of importance (standardized coefficient weight, β) by perceived control, descriptive norms, control beliefs, habits, attitude, risk perception, and normative beliefs.


CONCLUSIONS
This is the first theoretically based study identifying determinants of intention to undergo regular HIV testing among FSWs in sub-Saharan Africa. The results can inform development of interventions to maintain and increase regular HIV testing among FSWs, thus reinforcing primary prevention and supporting early access to care.
*Axe santé des populations et pratiques optimales en santé, Research Centre of the Centre Hospitalier Universitaire de Québec, Quebec City, Quebec, Canada; †Faculty of Nursing, Université Laval, Quebec City, Quebec, Canada; ‡Centre de Santé Cotonou 1, Dispensaire IST, Cotonou, Bénin; §Department of Social and Preventive Medicine, Université Laval, Quebec City, Quebec, Canada; and ‖Institut national de santé publique du Québec, Quebec City, Quebec, Canada.
Georges
G
Batona
Marie-Pierre
MP
Gagnon
David A
DA
Simonyan
Fernand A
FA
Guedou
Michel
M
Alary
D001541:Benin / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D015438:Health Behavior; D006801:Humans; D033182:Intention; D060386:Sex Workers / Q000523:psychology*; D011795:Surveys and Questionnaires