Sex-specific determinants of HIV prevalence among mobile HIV counseling and testing clients

Background: The USAID-funded Private Health Sector Program (PHSP) is implementing mobile HIV counseling and testing (MHCT) services designed to reach most at-risk populations (MARPS) for HIV infection. A study was conducted to determine sex-specific seroprevalence and associated risk factors among MHCT clients. Methods: Quantitative data on HIV serology and socio-demographic and behavioral variables was collected between April and October 2010 from four regions in Ethiopia. A total of 38,375 MHCT clients (44.2% female) were included in the study. The outcome variable was HIV status while predictor variables were the risk factors. Univariate, bivariate, and multivariate analyses (logistic regression) were used to analyze the data in SPSS. Results: Overall HIV prevalence was 3.1%, with a significantly higher proportion of females (4.5%) than males (1.9%) testing positive. The difference in HIV infection rates between males and females was statically significant (p<0.0001). Irrespective of clients' sex, variables including educational status, ever had sex, number of lifetime sexual partners, and previously tested for HIV were significantly associated with HIV prevalence (p<0.0001). However, marital status, age at first sex, and condom use during last sexual encounter were significantly associated only with women (p<0.05). Among males, age was found as risk factor for HIV infection (p<0.0001). Conclusions: Although some risk factors for HIV infection are common for both males and females, some factors are sex-specific. Thus, prevention activities and program interventions should target these differences when addressing the risk of HIV transmission between men and women.