Online Program

Do demographics alone predict HIV testing behavior among rural malawians?

Monday, November 4, 2013 : 1:45 p.m. - 2:00 p.m.

Jennifer Kibicho, PhD, Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, WI
Lance S. Weinhardt, PhD, Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI
Loren W. Galvao, MD, MPH, Center for Global Health Equity, College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI
Thokozani Mwenyekonde, CARE, CARE International in Malawi, Lilongwe, Malawi
Katarina Grande, MPH, Department of Population Health Sciences, University of Wisconsin-Madison Population Health Institute, Madison, WI
Patricia E. Stevens, RN, PhD, FAAN, College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI
Lucy Mkandawire-Valmu, PhD, RN, College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI
Background: Many individuals in developing countries, including Malawi, are not aware of their HIV status. HIV testing is a pre-requisite to knowledge of HIV status, accessing HIV treatment services, and preventing HIV transmission. We evaluated CARE Malawi's SAFE food security program to examine self-reported HIV testing rates at baseline and 18 month follow-up for 870 randomly selected individuals (582 SAFE, 288 controls) living in 6 traditional authorities in rural Malawi. Methods: Mixed methods logistic regression with random effects was used to identify predictors of HIV testing. Results: HIV testing rates increased in both SAFE group and controls. HIV testing rates increased from 52% at baseline to 70% at follow-up in the SAFE group, and from 66% to 70% in controls. Testers were three times (p =.01) more likely to be women compared to men, 28% (p <.001) more likely to live in large households, and three times (p <.001) more likely to have a secondary education. Perceptions of current HIV risk and confidentiality in testing were each associated with 1% (p <.001) likelihood of testing, while future HIV risk with 2% (p =.01) less likelihood of testing. Surprisingly, Village Health Committee (VHC) was associated with 50% (p =.02) less likelihood of testing. Conclusions: HIV testing in rural Malawi has increased. HIV risk perceptions and confidentiality are important predictors of HIV testing behavior. Because of the significant relationship between confidentiality and HIV testing, qualitative research may shed light on how to increase HIV testing rates in rural communities in Malawi.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Public health or related public policy

Learning Objectives:
Evaluate the effectiveness of CARE Malawi's SAFE economic and food security intervention in increasing HIV testing rates, by comparing SAFE and control groups at baseline and 18-months follow-up. Identify predictors of HIV testing behavior in rural Malawi.

Keyword(s): HIV Risk Behavior, Public Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted the data analysis and have been involved in the project. I have a PhD in Economics.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.