Abstract
HIV infection remains a serious issue of community intervention. In this context, many actions are developed and implemented by both public authorities and non-governmental organizations. These are interventions to prevent HIV transmission, overall care, etc. There is a problem of differential propensity according to gender and belonging to social categories access to prevent HIV services. This study aims to identify the explanatory factors for unequal access to HIV prevention services in Benin. Thus, data from the survey on gender-based violence related to HIV collected in 2017 by Plan International Benin were used. The sample size is 929; composed of vulnerable and key populations. Access to prevention services is a composite indicator based on four variables (screening, condom promotion, management of STIs, information, education and communication (IEC) and Communication for Behavioral Change (CBC)). The analysis is done using SPSS.21 software. The bi-varied association was performed using Pearson’s Chi2 and Fisher’s F tests and prediction of explanatory factors by logistic regression. In both 929 populations, 64.5% (599) are key populations and 35.5% (330) are vulnerable. In total, 22.5% (209) population did not have access to prevention services including 66.5% (139) of vulnerable people. Adolescents under 20 years of age (50.8%), females (25.6%), singles (27.2%), farmers (61.1%) and people living in rural areas (43.4%) are more likely not to benefit from HIV prevention services. Five factors predict unequal access to prevent HIV interventions (p < 5%). These are social status, marital status, education level, occupation and department of residence. Indeed, the: 1) vulnerable people (OR = 4.54), 2) divorced/widowed (OR = 1.77), 3) uneducated (OR = 1.61), 4) farmers (OR = 2.18) and 5) people living in the departments of Mono-Couffo (OR = 2.57) have the highest odds ratio of poor access to HIV prevention services. From the above, it is necessary for the establishment of a mechanism to facilitate vulnerable people, especially women, access to HIV prevention services. In addition, there is a need to ensure global coverage of the availability and geographical accessibility of prevention services with particular attention in the department of Mono-Couffo.
Highlights
In West and Central Africa (WCA), 6.1 million people are living with HIV, 370,000 are newly infected and more than 280,000 are dying from the disease mainly due to lack of access to prevention services, treatment and care for HIV infection [1]
The results of this study show that key populations are more likely to benefit from HIV prevention services compared to vulnerable people
Contrary to the results observed by these authors, the present study shows that Atlantic-Littoral departments more urbanized and having more than 30% of HIV services despite that they account for a quarter (24.8%) of the population of the countries offer few HIV interventions to the vulnerable population
Summary
In West and Central Africa (WCA), 6.1 million people are living with HIV, 370,000 are newly infected and more than 280,000 are dying from the disease mainly due to lack of access to prevention services, treatment and care for HIV infection [1]. Recognizing the scale of this public health problem and the need to put in place urgent and adequate strategies, in September 2005, 191 United Nations member States adopted the goal of universal access: “to create an environment in which HIV prevention, treatment, care and support interventions are available, accessible and affordable for all who need them”. This action strategy takes into account a wide range of interventions for individuals, families, communities and countries. Their mobilization and involvement are essential to the success of a response to the virus, in that they are essential for both the dynamics of the epidemic and the response
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