title: Factors Affecting the Uptake of HIV Testing among Men: A Mixed-Methods Study in Rural Burkina Faso.
abstract: BACKGROUND
  This study aimed to explore factors shaping the decision to undergo Human Immunodeficiency Virus (HIV) testing among men in rural Burkina Faso.
  
  
  METHODS
  The study took place in 2009 in the Nouna Health District and adopted a triangulation mixed methods design. The quantitative component relied on data collected through a structured survey on a representative sample of 1130 households. The qualitative component relied on 38 in-depth interviews, with men purposely selected to represent variation in testing decision, age, and place of residence. A two-part model was conducted, with two distinct outcome variables, i.e. "being offered an HIV test" and "having done an HIV test". The qualitative data analysis relied on inductive coding conducted by three independent analysts.
  
  
  RESULTS
  Of the 937 men, 357 had been offered an HIV test and 97 had taken the test. Younger age, household wealth, living in a village under demographic surveillance, and knowing that HIV testing is available at primary health facilities were all positively associated with the probability of being offered an HIV test. Household wealth and literacy were found to be positively associated, and distance was found to be negatively associated with the probability of having taken an HIV test. Qualitative findings indicated that the limited uptake of HIV testing was linked to poor knowledge on service availability and to low risk perceptions.
  
  
  CONCLUSIONS
  With only 10% of the total sample ever having tested for HIV, our study confirmed that male HIV testing remains unacceptably low in Sub-Saharan Africa. This results from a combination of health system factors, indicating general barriers to access, and motivational factors, such as one's own knowledge of service availability and risk perceptions. Our findings suggested that using antenatal care and curative services as the exclusive entry points into HIV testing may not be sufficient to reach large portions of the male population. Thus, additional strategies are urgently needed to increase service uptake.
authors.affiliation: Institute of Public Health, Faculty of Medicine, University of Heidelberg, Heidelberg, Germany.
authors.forename: Manuela
authors.initials: M
authors.lastname: De Allegri
authors.affiliation: University of Montreal School of Public Health (ESPUM), Montreal, Canada, Research Centre of the University of Montreal Hospital Centre (CRCHUM), Montreal, Canada.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Agier
authors.affiliation: Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso.
authors.forename: Justin
authors.initials: J
authors.lastname: Tiendrebeogo
authors.affiliation: Institute of Public Health, Faculty of Medicine, University of Heidelberg, Heidelberg, Germany.
authors.forename: Valerie Renée
authors.initials: VR
authors.lastname: Louis
authors.affiliation: Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso.
authors.forename: Maurice
authors.initials: M
authors.lastname: Yé
authors.affiliation: Institute of Public Health, Faculty of Medicine, University of Heidelberg, Heidelberg, Germany.
authors.forename: Olaf
authors.initials: O
authors.lastname: Mueller
authors.affiliation: James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh.
authors.forename: Malabika
authors.initials: M
authors.lastname: Sarker
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D002050:Burkina Faso; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D012424:Rural Population; D012698:Serologic Tests / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors