Factors associated with not testing for HIV and consistent condom use among men in Soweto, South Africa

Sakhile Mhlongo, Janan Dietrich, Kennedy N Otwombe, Gavin Robertson, Thomas J Coates, Glenda Gray, Sakhile Mhlongo, Janan Dietrich, Kennedy N Otwombe, Gavin Robertson, Thomas J Coates, Glenda Gray

Abstract

Background: Besides access to medical male circumcision, HIV testing, access to condoms and consistent condom use are additional strategies men can use to prevent HIV acquisition. We examine male behavior toward testing and condom use.

Objective: To determine factors associated with never testing for HIV and consistent condom use among men who never test in Soweto.

Methods: A cross-sectional survey in Soweto was conducted in 1539 men aged 18-32 years in 2007. Data were collected on socio-demographic and behavioral characteristics to determine factors associated with not testing and consistent condom use.

Results: Over two thirds (71%) of men had not had an HIV test and the majority (55%, n = 602) were young (18-23). Of those not testing, condom use was poor (44%, n = 304). Men who were 18-23 years (aOR: 2.261, CI: 1.534-3.331), with primary (aOR: 2.096, CI: 1.058-4.153) or high school (aOR: 1.622, CI: 1.078-2.439) education, had sex in the last 6 months (aOR: 1.703, CI: 1.055-2.751), and had ≥1 sexual partner (aOR: 1.749, CI: 1.196-2.557) were more likely not to test. Of those reporting condom use (n = 1036, 67%), consistent condom use was 43% (n = 451). HIV testing did not correlate with condom use.

Conclusion: Low rates of both condom use and HIV testing among men in a high HIV prevalence setting are worrisome and indicate an urgent need to develop innovative behavioral strategies to address this shortfall. Condom use is poor in this population whether tested or not tested for HIV, indicating no association between condom use and HIV testing.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Participant disposition flow diagram.
Figure 1. Participant disposition flow diagram.

References

    1. UNAIDS (2010) Global Report: UNAIDS report on the global AIDS epidemic, 2010. : UNAIDS. Accessed 19 Mar 2012.
    1. Shisana O, Rehle T, Simbayi LC, Zuma K, Jooste S, et al... (2009) South African National HIV Prevalence, Incidence, Behaviour and Communication Survey 2008: A turning tide among teenagers?
    1. National Department of Health RoSA (2010) The 2010 National Antenatal Sentinel HIV & Syphilis Prevalence Survey in South Africa. In: National Department of Health RoSA, editor. : National Department of Health, South Africa. Accessed 19 Mar 2012.
    1. Saracco A, Musicco M, Nicolosi A, Angarano G, Arici C, et al. (1993) Man-to-Woman Sexual Transmission of HIV: Longitudinal Stady of 343 Steady Partners of Infected Men. Journal of Acquired Immune Deficiency Syndrome 6: 497–502.
    1. FoxNews (2012) HIV Transmission: 1 in 900 Sex Acts. : My Health News Daily. Acccesd 23 Mar 2012.
    1. UNAIDS (2001) 2001 Declaration on Committment on HIV/AIDS. : UNAIDS. Accessed 23 Mar 2012.
    1. WHO (2003) The Right to Know: New Approaches to HIV Testing and Counselling. : . Accessed 19 Mar 2012.
    1. National Department of Health RoSA (2007) HIV and AIDS and STI Strategic Plan for South Africa, 2007–2011. In: National Department of Health RoSA, editor. . Accessed 16 Feb 2012.
    1. Maharaj P, Cleland J (2005) Risk Perceptions and Condom Use Among Married Or Cohabitating Couples in KwaZulu-Natal, South Africa. International Family Planning Perspectives 31: 24–29.
    1. Fagbamigbe AF, Akinyemi JO, Adedokun BO, Bamgboye EA (2011) Gender Variation in Self-reported Likelihood of HIV Infection in Comparison with HIV Test Results in Rural and Urban Nigeria. AIDS Research Therapy 8.
    1. Hendrikssen ES, Pettifor A, Lee S, Coates TJ, Rees HV (2007) Predictors of Condom Use Among Young Adults in South Africa: The Reproductive Health and HIV Research Unit National Youth Survey. American Journal of Public Health 97: 1241–1248.
    1. BuaNews (2011) HCT Campaign Reaches Six Million. . Accessed 16 Feb 2012.
    1. Dalal S, Lee C, Farirai T, Schilsky A, Goldman T, et al. (2011) Provider-Initiated HIV Testing and Counseling: Increased Uptake in Two Public Community Health Centers in South Africa and Implications for Scale-Up. PLoS ONE 6: e27293.
    1. Khumalo-Sakutukwa G, Morin SF, Fritz K, Caharlebois ED, van Rooyen H, et al. (2008) Project Accept (HPTN 043): A Community-Based Intervention to Reduce HIV Incidence in Populations at Risk for HIV in Sub-Saharan Africa and Thailand. Journal of Acquired Immune Deficiency Syndrome 49: 422–431.
    1. Bogart LM, Skinner D, Weinhardt LS, Glasman L, Sitzler C, et al. (2011) HIV Misconceptions Associated with Condom Use Among Black South Africans: An Exploratory Study. African Journal of AIDS Research 10: 181–187.
    1. De Koker P, Lefevre P, Matthys F, van der Stuyft P, Delva W (2010) Barriers to VCT Despite 13 Years of Community-Based Awareness Campaigns in a Peri-Urban Township in Northern Limpopo. South African Medical Journal 100: 364–365.
    1. Galdas PM, Cheater F, Marshal P (2005) Men and Health Help-Seeking Behaviour: Literature Review. Journal of Advanced Nursing 49: 616–623.
    1. Weschberg WM, Luseno WK, Kline TL, Browne FA, Zule WA (2010) Preliminary Findings of an Adapted Evidence-Based Woman-Focused HIV Intervention on Condom Use and Negotiation Among At-Risk Women in Pretoria,. South Africa Journal of Prevention & Intervention in the Community 38: 132–146.
    1. Chimbindi NZ, McGarth N, Herbst H, Tint K, Newell M (2010) Socio-Demographic Determinants of Condom Use Among Sexually Active Young Adults in Rural KwaZulu-Natal, South Africa. The Open AIDS Journal 4: 88–95.
    1. Venkatesh KK, Modiba P, De Bruyn G, Lurie MN, Coates TJ, et al. (2011) Who Gets Tested for HIV in a South African Urban Township? Implications for Test and Treat and Gender-Based Prevention Interventions. Journal of Acquired Immune Deficiency Syndrome 56: 151–165.
    1. Venkatesh KK, Madiba P, De Bruyn G, Lurie MN, Coates TJ, et al. (2011) Who gets tested for HIV in a South African urban township? Implications for test and treat and gender-based prevention interventions. J Acquir Immune Defic Syndr 56: 151–165.
    1. Sweat M, Morin S, Celentano D, Mulawa M, Singh B, et al. (2011) Community-Based Intervention to Increase HIV Testing and Case Detection in People Aged 16–32 Years in Tanzania, Zimbabwe, and Thailand (NIMH Project Accept, HPTN 043): A Randomised Study. The Lancet Infectious Diseases 11: 525–532.
    1. GeoNames (2012) South Africa - Largest Cities. : Google Maps. Accessed 20 Mar 2012.
    1. ProjectAccept (2011) Project Accept (HPTN 043): A Phase III Randomized Controlled Trial of Community Mobilization, Mobile Testing, Same-Day Results, and Post-Test Support for HIV in Sub-Saharan Africa and Thailand. . Accessed 20 Mar 2012.
    1. Kish L (1949) A Procedure for Objective Respondent Selection Within the Household. Journal of the American Statistical Association 44: 380–387.
    1. Genberg BL, Kulich M, Kawichai S, Modiba P, Chingono A, et al. (2008) HIV Risk Behaviors in Sub-Saharan Africa an Northern Thailand: Baseline Behavioral Data From Project Accept. Journal of Acquired Immune Deficiency Syndrome 49: 309–319.
    1. Rehle T, Shisana O, Pillay V, Zuma K, Puren A, et al. (2007) National HIV Incidence Measures - New Insights into the South African Epidemic. South African Medical Journal 97: 194–199.
    1. National Department of Health RoSA (2010) Country Progress report on the Declaration of Commitment on HIV/AIDS. In: National Department of Health RoSA, editor. : UNIADS. Accessed 19 Apr 2012.
    1. Walensky R, Kuritzkes DR (2010) The Impact of The President's Emergency Plan for AIDS Relief (PEPFAR) Beyond HIV and Why It Remains Essential. Clinical Infectious Diseases 50: 272–275.
    1. National Department of Health RoSA (2010) National Department of Health Strategic Plan 2010/11–2012/13. In: National Department of Health RoSA, editor. : National Department of Health, Republic of South Africa. Accessed 19 Apr 2012.
    1. Peltzer K, Matseke G, Mzolo T, Majaja M (2009) Determinants of Knowledge of HIV Status in South Africa: Resullts from a Population-Based HIV Survey BMC Public Health. 9: 1–11.
    1. Mackellar DA, Hou SI, Whalen CC, Samuelsen K, Sanchez T, et al. (2011) Reasons for not HIV Testing, Testing Intentions, and Potential Use of an Over-the-Counter Rapid HIV Test in an Internet Sample of Men Who Have Sex with Men Who Have Never Tested for HIV Sexually Transmitted Diseases. 38: 419–428.
    1. Cleary PD, Van Devanter N, Rogers TF, Singer E, Shipton-Levy R, et al. (1991) Behaviour Changes after Notification of HIV Infection. American Journal of Public Health 81: 1586–1590.
    1. Arthur G, Nduba V, Forsythe S, Mutemi R, Odhiambo J, et al. (2007) Behaviour Change in Clients of Health Cenre-Based Voluntary HIV Counselling and Testing Services in Kenya. Sexually Transmitted Infections 83: 541–546.
    1. Bryan A, Kagee A, Broaddus MR (2006) Condom Use Among South African Adolescents: Developing and Testing Theoretical Models of Intentions and Behaviour. AIDS Behavior 10: 387–397.
    1. Bunnell R, Opio A, Musinguzi J (2008) HIV Transmission Risk Behaviour Among HIV-Infected Adults in Uganda: Results from a Nationally Representative Survey AIDS. 22: 617–624.

Source: PubMed

Sponsoren und Mitarbeiter

Krankheiten

Drogeninterventionen

3
Abonnieren