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Trends in HIV counseling and testing uptake among married individuals in Rakai, Uganda

Trends in HIV counseling and testing uptake among married individuals in Rakai, Uganda
Trends in HIV counseling and testing uptake among married individuals in Rakai, Uganda
Background: despite efforts to promote HIV counseling and testing (HCT) - among couples, few couples know their own or their partners' HIV status. We assessed trends in HCT uptake among married individuals in Rakai district, southwestern Uganda.

Methods: we analysed data for 21,798 married individuals aged 15-49 years who were enrolled into the Rakai Community Cohort Study (RCCS) between 2003 and 2009. Married individuals were interviewed separately but were retrospectively linked to their partners at analysis. All participants had serologic samples obtained for HIV testing, and had the option of receiving HCT together (couples' HCT) or separately (individual HCT). Individuals were categorized as concordant HIV-positive if both partners had HIV; concordant HIV-negative if both did not have HIV; or HIV-discordant if only one of the partners had HIV. We used chi2 tests to assess linear trends in individual and couples' HCT uptake in the entire sample and conducted multinomial logistic regression on a sub-sample of 10,712 individuals to assess relative risk ratios (RRR) and 95% Confidence Intervals (95%CI) associated with individual and couples' HCT uptake. Analysis was done using STATA version 11.0.

Results: uptake of couples' HCT was 27.2% in 2003/04, 25.1% in 2005/06, 28.5% in 2006/08 and 27.8% in 2008/09 (chi2 for trend = 2.38; P = 0.12). Uptake of individual HCT was 57.9% in 2003/04, 60.2% in 2005/06, 54.0% in 2006/08 and 54.4% in 2008/09 (chi2 for trend = 8.72; P = 0.003). The proportion of couples who had never tested increased from 14.9% in 2003/04 to 17.8% in 2008/09 (chi2 for trend = 18.16; P < 0.0001). Uptake of couples' HCT was significantly associated with prior HCT (Adjusted [Adj.] RRR = 6.80; 95%CI: 5.44, 8.51) and being 25-34 years of age (Adj. RRR = 1.81; 95% CI: 1.32, 2.50). Uptake of individual HCT was significantly associated with prior HCT (Adj. RRR = 6.26; 95%CI: 4.24, 9.24) and the female partner being HIV-positive (Adj. RRR = 2.46; 95%CI: 1.26, 4.80).

Conclusion: uptake of couples' HCT remained consistently low (below 30%) over the years, while uptake of individual HCT declined over time. These findings call for innovative strategies to increase demand for couples' HCT, particularly among younger couples and those with no prior HCT
1471-2458
618
Matovu, Joseph
8c22eb1c-bcad-4f7f-8bca-8daed72be410
Denison, Julie
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Wanyenze, Rhoda W.
77c5b5f5-6cdc-4576-8e8e-85b9e158af38
Ssekasanvu, Joseph
1cc3bd3b-32cb-4e62-9078-034cd15afdc7
Makumbi, Fredrick
406f42c2-d147-4e95-b08e-e61e2ac16d9d
Ovuga, Emilio
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McGrath, Nuala
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Serwadda, David
aae0305e-5bc0-4e96-8b3a-7e2169b3c951
Matovu, Joseph
8c22eb1c-bcad-4f7f-8bca-8daed72be410
Denison, Julie
c292882b-9886-43e8-8c11-4a5332bd3b82
Wanyenze, Rhoda W.
77c5b5f5-6cdc-4576-8e8e-85b9e158af38
Ssekasanvu, Joseph
1cc3bd3b-32cb-4e62-9078-034cd15afdc7
Makumbi, Fredrick
406f42c2-d147-4e95-b08e-e61e2ac16d9d
Ovuga, Emilio
fd826b1b-a484-47c5-954f-f44864f543b7
McGrath, Nuala
b75c0232-24ec-443f-93a9-69e9e12dc961
Serwadda, David
aae0305e-5bc0-4e96-8b3a-7e2169b3c951

Matovu, Joseph, Denison, Julie, Wanyenze, Rhoda W., Ssekasanvu, Joseph, Makumbi, Fredrick, Ovuga, Emilio, McGrath, Nuala and Serwadda, David (2013) Trends in HIV counseling and testing uptake among married individuals in Rakai, Uganda. BMC Public Health, 13, 618. (doi:10.1186/1471-2458-13-618).

Record type: Article

Abstract

Background: despite efforts to promote HIV counseling and testing (HCT) - among couples, few couples know their own or their partners' HIV status. We assessed trends in HCT uptake among married individuals in Rakai district, southwestern Uganda.

Methods: we analysed data for 21,798 married individuals aged 15-49 years who were enrolled into the Rakai Community Cohort Study (RCCS) between 2003 and 2009. Married individuals were interviewed separately but were retrospectively linked to their partners at analysis. All participants had serologic samples obtained for HIV testing, and had the option of receiving HCT together (couples' HCT) or separately (individual HCT). Individuals were categorized as concordant HIV-positive if both partners had HIV; concordant HIV-negative if both did not have HIV; or HIV-discordant if only one of the partners had HIV. We used chi2 tests to assess linear trends in individual and couples' HCT uptake in the entire sample and conducted multinomial logistic regression on a sub-sample of 10,712 individuals to assess relative risk ratios (RRR) and 95% Confidence Intervals (95%CI) associated with individual and couples' HCT uptake. Analysis was done using STATA version 11.0.

Results: uptake of couples' HCT was 27.2% in 2003/04, 25.1% in 2005/06, 28.5% in 2006/08 and 27.8% in 2008/09 (chi2 for trend = 2.38; P = 0.12). Uptake of individual HCT was 57.9% in 2003/04, 60.2% in 2005/06, 54.0% in 2006/08 and 54.4% in 2008/09 (chi2 for trend = 8.72; P = 0.003). The proportion of couples who had never tested increased from 14.9% in 2003/04 to 17.8% in 2008/09 (chi2 for trend = 18.16; P < 0.0001). Uptake of couples' HCT was significantly associated with prior HCT (Adjusted [Adj.] RRR = 6.80; 95%CI: 5.44, 8.51) and being 25-34 years of age (Adj. RRR = 1.81; 95% CI: 1.32, 2.50). Uptake of individual HCT was significantly associated with prior HCT (Adj. RRR = 6.26; 95%CI: 4.24, 9.24) and the female partner being HIV-positive (Adj. RRR = 2.46; 95%CI: 1.26, 4.80).

Conclusion: uptake of couples' HCT remained consistently low (below 30%) over the years, while uptake of individual HCT declined over time. These findings call for innovative strategies to increase demand for couples' HCT, particularly among younger couples and those with no prior HCT

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e-pub ahead of print date: 1 July 2013
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 354285
URI: https://eprints.soton.ac.uk/id/eprint/354285
ISSN: 1471-2458
PURE UUID: 4fda1fda-e6e1-4d36-8df8-f3e5ce38ebea
ORCID for Nuala McGrath: ORCID iD orcid.org/0000-0002-1039-0159

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Date deposited: 05 Jul 2013 10:40
Last modified: 20 Jul 2019 00:39

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