Factors associated with uptake of HIV testing among clients diagnosed with sexually transmitted infections in Chegutu District, Zimbabwe, 2021.

Abstract

HIV testing services (HTS) enable early linkage to HIV prevention, treatment and care. A review of Chegutu District Health Information System 2 sexually transmitted infection (STI)/HIV data revealed HIV testing rates among those infected with STIs were 41%, 48%, 50%, 51% and 68%, respectively, for the period 2016-2020 against a target of 100%. We investigated factors associated with the uptake of HTS among STI clients.

Methods: We conducted a 1:1 unmatched case-control study. We randomly selected cases from STI registers and controls from HTS registers. We defined a case as an individual 18-49 years old diagnosed with STI, unknown HIV status and no documented HIV test result from 01 August 2020 through 31 August 2021. We recruited 115 cases and 115 controls. We used questionnaires to collect data from cases and controls after obtaining written consent. Epi Info7 generated frequencies, proportions, odds ratios and confidence intervals (CIs) at a 0.05 significance level. We applied forward stepwise logistic regression to determine independent factors for HIV testing uptake.

Results: Independent factors for uptake of HIV testing among STI clients were: being employed [aOR 0.23; 95% CI(0.09-0.50)], having no stigma towards people living with HIV [aOR 0.19;95% CI(0.06-0.61)], preferring health facility for HIV testing [aOR 0.30;95% CI(0.13-0.65)], male head of family [aOR 2.95. 95% CI(1.25-6.95)], and confidence in clinic staff's commitment to confidentiality [aOR 0.19; 95% CI(0.06-0.63)].

Conclusion: Male decision-makers may deter partner involvement in HTS. We recommended strengthening male involvement in HIV programming through community dialogues that address gender inequalities.