Factors associated with HIV testing among the general male population in Cambodia: A secondary data analysis of the Demographic Health Survey in 2005, 2010, and 2014.

Piseth Narin,Tetsuyoshi Kariya,Nobuyuki Hamajima,Eiko Yamamoto,Ny Net,Yu Mon Saw,Souphalak Inthaphatha,Siyan Yi

doi:10.1371/journal.pone.0219820

Abstract

In Cambodia, the human immunodeficiency virus (HIV) is predominantly transmitted between spouses and casual partners, with men having higher mortality and morbidity from HIV infection than women due to lesser access to healthcare services and antiretroviral therapy. This study aimed to identify the rate of HIV testing and barriers to HIV testing among the general male population in Cambodia. We analyzed secondary data of men who underwent HIV testing at Voluntary Confidential Counseling and Testing (VCCT) sites in 2006–2017 and of male participants in the Cambodia Demographic and Health Survey (CDHS) in 2005, 2010, and 2014. The number of men who underwent HIV testing at the VCCT sites increased during 2006–2010 and decreased during 2012–2015. CDHS data showed that the lifetime prevalence of HIV testing among men aged 15–49 years gradually increased from 14.7% in 2005 to 36.4% in 2014. Multivariate analysis revealed nine factors associated with a higher lifetime prevalence of HIV testing including: seven sociodemographic factors, namely CDHS year (2010 and 2014), age groups (20–35 and 36–49 years), urban residence, higher education, higher wealth index, having occupations other than agriculture, ever-married status (married and widowed/divorced); and two factors of HIV risk behavior, namely two or more lifetime sexual partners and condom use during the last sexual intercourse. To our knowledge, this is the first study that assessed factors associated with the lifetime prevalence of HIV testing among the general male population in Cambodia. The factors were mostly sociodemographic factors, and no factors were related to condom use, or the diagnosis or symptoms of sexually transmitted infections (STIs). These results suggest that reproductive health education at primary schools and strengthening of healthcare provider-initiated testing and counseling for patients with STIs are highly needed in Cambodia.

Highlights

In Cambodia, the estimated prevalence of human immunodeficiency virus (HIV) infection in the general population aged 15–49 years reached a peak of 1.7% in 1998 and decreased to 0.6% in 2016 [1, 2]
The results showed that men who were the age groups of 20–35 and 36–49 years old, who had high and very high wealth indices, who were ever married, who had a greater number of lifetime sexual partners, and who used condoms during the last sexual intercourse had a higher prevalence of having an HIV test
In terms of sexual behavior, the results of this study suggest that Cambodian men who used condoms in the last sexual intercourse might be highly cautious about HIV infection compared to men who were nonusers of condoms

Summary

Introduction

In Cambodia, the estimated prevalence of human immunodeficiency virus (HIV) infection in the general population aged 15–49 years reached a peak of 1.7% in 1998 and decreased to 0.6% in 2016 [1, 2]. Because HIV infection spread rapidly after the first reported case in 1991 [3], the Ministry of Health of Cambodia developed political strategies for preventing HIV infection and acquired immune deficiency syndrome (AIDS). The National Center for HIV/AIDS, Dermatology and STDs (NCHADS), which was established in 1998 following the merger of the National AIDS Programme and the National STD and Dermatology Clinic, developed HIV/ AIDS strategic plans under its role as the responsible unit within the Ministry of Health. The first strategic plan for 1993–1998 focused on the prevention of transmission by blood transfusion or condom use, including health education for the general and high-risk populations. Key populations (KPs) at risk for HIV infection in Cambodia were reported to be men who have sex with men (MSM), people who use drugs, FEWs, transgender people, and prisoners [4,5,6,7]. According to the reports by NCHADS, the numbers of new HIV infections and deaths in people who have HIV infection have been higher in men than in women, the total numbers of new infections and deaths have been decreasing [2]

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Conclusion