Social networks influence on HIV testing among young men in Tanzania

Background: Men in sub-Saharan Africa have low rates of HIV testing, with consequences including premature mortality and ongoing transmission. Social networks are an important source of influence on young men. We examine networks’ influence on HIV testing among young Tanzanian men.

 Methods: Data come from the baseline survey of a cluster randomized controlled HIV prevention trial with young men recruited through 48 networks called “camps” in Dar es Salaam. Each participant identified all camp members known to him, and, among those, who were friends. We used reconstruction to impute missing friendship ties. We examined whether a respondent was in the “core”, a network sub-group in which actors are maximally connected.  We also assessed whether one or more of a respondent’s closest friends encouraged testing. To measure normative behavior, we included whether the proportion of camp members who ever tested was higher than the all-camp median (52%).  We used random effects logistic regression to model factors associated with self-reported ever HIV testing among sexually active men.

 Results: Among 972 men (average age = 27), 51% reported ever having HIV tested. Men in the core were 1.35 times more likely (95% CI: 0.99 – 1.83) to have tested. If at least one friend encouraged testing, compared to none, men were 1.82 times more likely to have tested (1.37-2.43). Men were twice as likely to have tested if it was a normative camp behavior (1.56-2.76). 

Conclusions:  Interventions that leverage network position, relationships and norms may increase men’s uptake of HIV testing in Tanzania.