title: Factors Associated with Ever Being HIV-Tested in Zimbabwe: An Extended Analysis of the Zimbabwe Demographic and Health Survey (2010-2011).
abstract: BACKGROUND
  Zimbabwe has a high human immunodeficiency virus (HIV) burden. It is therefore important to scale up HIV-testing and counseling (HTC) as a gateway to HIV prevention, treatment and care.
  
  
  OBJECTIVE
  To determine factors associated with being HIV-tested among adult men and women in Zimbabwe.
  
  
  METHODS
  Secondary analysis was done using data from 7,313 women and 6,584 men who completed interviewer-administered questionnaires and provided blood specimens for HIV testing during the Zimbabwe Demographic and Health Survey (ZDHS) 2010-11. Factors associated with ever being HIV-tested were determined using multivariate logistic regression.
  
  
  RESULTS
  HIV-testing was higher among women compared to men (61% versus 39%). HIV-infected respondents were more likely to be tested compared to those who were HIV-negative for both men [adjusted odds ratio (AOR) = 1.53; 95% confidence interval (CI) (1.27-1.84)] and women [AOR = 1.42; 95% CI (1.20-1.69)]. However, only 55% and 74% of these HIV-infected men and women respectively had ever been tested. Among women, visiting antenatal care (ANC) [AOR = 5.48, 95% CI (4.08-7.36)] was the most significant predictor of being tested whilst a novel finding for men was higher odds of testing among those reporting a sexually transmitted infection (STI) in the past 12 months [AOR = 1.86, 95%CI (1.26-2.74)]. Among men, the odds of ever being tested increased with age ≥ 20 years, particularly those 45-49 years [AOR = 4.21; 95% CI (2.74-6.48)] whilst for women testing was highest among those aged 25-29 years [AOR = 2.01; 95% CI (1.63-2.48)]. Other significant factors for both sexes were increasing education level, higher wealth status and currently/formerly being in union.
  
  
  CONCLUSIONS
  There remains a high proportion of undiagnosed HIV-infected persons and hence there is a need for innovative strategies aimed at increasing HIV-testing, particularly for men and in lower-income and lower-educated populations. Promotion of STI services can be an important gateway for testing more men whilst ANC still remains an important option for HIV-testing among pregnant women.
authors.affiliation: AIDS and TB Department, Ministry of Health and Child Care, Harare, Zimbabwe.|International Union Against Tuberculosis and Lung Disease, Paris, France.
authors.forename: Kudakwashe Collin
authors.initials: KC
authors.lastname: Takarinda
authors.affiliation: AIDS and TB Department, Ministry of Health and Child Care, Harare, Zimbabwe.
authors.forename: Lydia Kudakwashe
authors.initials: LK
authors.lastname: Madyira
authors.affiliation: AIDS and TB Department, Ministry of Health and Child Care, Harare, Zimbabwe.
authors.forename: Mutsa
authors.initials: M
authors.lastname: Mhangara
authors.affiliation: National AIDS Council, Harare, Zimbabwe.
authors.forename: Victor
authors.initials: V
authors.lastname: Makaza
authors.affiliation: National AIDS Council, Harare, Zimbabwe.
authors.forename: Memory
authors.initials: M
authors.lastname: Maphosa-Mutsaka
authors.affiliation: Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.|Centre for Research and Training in Clinical Epidemiology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
authors.forename: Simbarashe
authors.initials: S
authors.lastname: Rusakaniko
authors.affiliation: Division of Global HIV/AIDS, Centers for Disease Control and Prevention (CDC), Harare, Zimbabwe.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Kilmarx
authors.affiliation: AIDS and TB Department, Ministry of Health and Child Care, Harare, Zimbabwe.
authors.forename: Tsitsi
authors.initials: T
authors.lastname: Mutasa-Apollo
authors.affiliation: AIDS and TB Department, Ministry of Health and Child Care, Harare, Zimbabwe.
authors.forename: Getrude
authors.initials: G
authors.lastname: Ncube
authors.affiliation: International Union Against Tuberculosis and Lung Disease, Paris, France.|Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors.forename: Anthony David
authors.initials: AD
authors.lastname: Harries
mesh_terms: D015492:AIDS Serodiagnosis / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult; D015030:Zimbabwe