Abstract
BackgroundDespite the adoption of the provider-initiated HIV testing strategy, the rate of HIV testing is still very low in sub-Saharan Africa. The aim of this study was to assess the factors associated with HIV testing among sexually active women and men in Senegal. Knowledge of HIV status is the gateway to antiretroviral treatment.MethodsA secondary analysis of the 2017 Senegal Demographic and Health Survey (DHS) was performed, using data on sexually active women aged 15–49 and men aged 15–59. The outcome variable was the proportion of women and men who reported ever being tested for HIV in the last 12 months before the survey. Descriptive, bivariate, and multivariable logistic regression analyses were performed to identify the socio-demographic, HIV-knowledge, media exposure, and behavioral factors associated with HIV testing in Senegal.ResultsThe study found that 61.1% (95%CI: 59.2–62.9) of women and 26.2% (95%CI: 24.2–28.3) of men were tested for HIV at the last 12 months. In multivariate analysis, among men the factors independently associated with being tested for HIV were: age groups 20–24 to 40–44 and age group 50–54; a higher level of education; being in the richest household wealth quintile; being married; knowing about the efficacy of HAART during pregnancy; having 2 or more lifetime sex partners and owning a mobile phone. Among women factors independently associated with HIV testing were: being in any age groups versus 15–19; a higher level of education; being in the richest household wealth quintile; being married; knowing about the efficacy of HAART during pregnancy; having any STI in last 12 months; fearing stigma; owning a mobile phone; and having any number of ANC visits, versus none.ConclusionAlthough HIV remains a public health threat, HIV testing’s prevalence is still low in Senegal, making it difficult to interrupt the transmission chain within the community and to reach the UNAIDS goal for 2020 of “90–90-90”. Innovative community-based strategies are needed to address barriers and improve access to HIV testing in Senegal, particularly for men and for the youngest and poorest populations.
Highlights
Despite the adoption of the provider-initiated HIV testing strategy, the rate of HIV testing is still very low in sub-Saharan Africa
The significant advances related to the adoption of early antiretroviral treatment from diagnosis [4] justify the ambitious goal set by the United Nations Programme on HIV and AIDS (UNAIDS) to reach the target of three 90s for 2020—meaning 90% of people with HIV are aware of their HIV status, 90% of those are on antiretroviral therapy, and 90% of those are virally suppressed [5]
Our study shows that men are slightly more knowledgeable about HIV compared with women, including awareness of mother-to-child transmission (MTCT)
Summary
Despite the adoption of the provider-initiated HIV testing strategy, the rate of HIV testing is still very low in sub-Saharan Africa. In Senegal, the AIDS response has achieved notable success since the first case was diagnosed in 1986, with a low and stable prevalence of 0.4% in adults age 15–49 [1], a steady decline in new infections as well as in HIV-related deaths, and a significant increase of 57% in antiretroviral therapy coverage in 2017 [2]. The significant advances related to the adoption of early antiretroviral treatment from diagnosis [4] justify the ambitious goal set by the UNAIDS to reach the target of three 90s for 2020—meaning 90% of people with HIV are aware of their HIV status, 90% of those are on antiretroviral therapy, and 90% of those are virally suppressed [5]. In Senegal, the “Test All, Treat All and Retain in Senegal” strategy, called TATARSEN, was implemented in 2016 and was scaled up at the national level in 2017
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