Provider-initiated HIV testing uptake and socio-economic status among women in a conflict zone in the Central African Republic: a mixed-methods cross-sectional study
Abstract Introduction In the Central African Republic (CAR), HIV/AIDS is the main cause of death in women aged 15–49 years. Increased testing coverage is essential in prevention of HIV/AIDS, especially in areas where conflict hinders access to health care. Socio-economic status (SES) has been shown...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | Conflict and Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13031-023-00505-0 |
| _version_ | 1827974510796603392 |
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| author | Mari Nythun Utheim Petros Isaakidis Rafael Van den Bergh Bantas Bata Ghislain Géraud Rodrigue Biguioh Mabvouna Tone Kristin Omsland Espen Heen Cecilie Dahl |
| author_facet | Mari Nythun Utheim Petros Isaakidis Rafael Van den Bergh Bantas Bata Ghislain Géraud Rodrigue Biguioh Mabvouna Tone Kristin Omsland Espen Heen Cecilie Dahl |
| author_sort | Mari Nythun Utheim |
| collection | DOAJ |
| description | Abstract Introduction In the Central African Republic (CAR), HIV/AIDS is the main cause of death in women aged 15–49 years. Increased testing coverage is essential in prevention of HIV/AIDS, especially in areas where conflict hinders access to health care. Socio-economic status (SES) has been shown to be associated with HIV testing uptake. We investigated whether “Provider-initiated HIV testing and counselling” (PITC) could be implemented in a family planning clinic in an active conflict zone in the Central African Republic to reach women of reproductive age and assessed whether socioeconomic status was associated with testing uptake. Methods Women aged 15–49 years were recruited from a free family planning clinic run by Médecins Sans Frontières in the capital Bangui. An asset-based measurement tool was created based on analysis of qualitative in-depth interviews. Measures of socioeconomic status were constructed from the tool, also by using factor analysis. Logistic regression was used to quantify the association between SES and HIV testing uptake (yes/no), while controlling for potential confounders: age, marital status, number of children, education level and head of household. Results A total of 1419 women were recruited during the study period, where 87.7% consented to HIV testing, and 95.5% consented to contraception use. A total of 11.9% had never been tested for HIV previously. Factors negatively associated with HIV testing uptake were: being married (OR = 0.4, 95% CI 0.3–0.5); living in a household headed by the husband as opposed to by another person (OR = 0.4, 95% CI 0.3–0.6), and lower age (OR = 0.96, 95% CI 0.93–0.99). Higher level of education (OR = 1.0, 95% CI 0.97–1.1) and having more children aged under 15 (OR = 0.92, 95% CI 0.81–1.1) was not associated with testing uptake. In multivariable regression, testing uptake was lower in the higher SES groups, but the differences were not significant (OR = 0.80, 95% CI 0.55–1.18). Conclusions The findings show that PITC can be successfully implemented in the patient flow in a family planning clinic, without compromising contraception uptake. Within the PITC framework in a conflict setting, socioeconomic status was not found to be associated with testing uptake in women of reproductive age. |
| first_indexed | 2024-04-09T19:55:31Z |
| format | Article |
| id | doaj.art-a699559e14964226a5dedb2dd6ea35c6 |
| institution | Directory Open Access Journal |
| issn | 1752-1505 |
| language | English |
| last_indexed | 2024-04-09T19:55:31Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Conflict and Health |
| spelling | doaj.art-a699559e14964226a5dedb2dd6ea35c62023-04-03T05:29:11ZengBMCConflict and Health1752-15052023-03-0117111810.1186/s13031-023-00505-0Provider-initiated HIV testing uptake and socio-economic status among women in a conflict zone in the Central African Republic: a mixed-methods cross-sectional studyMari Nythun Utheim0Petros Isaakidis1Rafael Van den Bergh2Bantas Bata Ghislain Géraud3Rodrigue Biguioh Mabvouna4Tone Kristin Omsland5Espen Heen6Cecilie Dahl7Institute of Health and Society, University of OsloMédecins Sans Frontières – Southern African Medical UnitMédecins Sans Frontières - Operational Centre Brussels, Operational Research Unit (LuxOR)Directeur de Ressources, Ministère de La SantéDepartment of Biology, University of Roma Tor VergataInstitute of Health and Society, University of OsloInstitute of Health and Society, University of OsloInstitute of Health and Society, University of OsloAbstract Introduction In the Central African Republic (CAR), HIV/AIDS is the main cause of death in women aged 15–49 years. Increased testing coverage is essential in prevention of HIV/AIDS, especially in areas where conflict hinders access to health care. Socio-economic status (SES) has been shown to be associated with HIV testing uptake. We investigated whether “Provider-initiated HIV testing and counselling” (PITC) could be implemented in a family planning clinic in an active conflict zone in the Central African Republic to reach women of reproductive age and assessed whether socioeconomic status was associated with testing uptake. Methods Women aged 15–49 years were recruited from a free family planning clinic run by Médecins Sans Frontières in the capital Bangui. An asset-based measurement tool was created based on analysis of qualitative in-depth interviews. Measures of socioeconomic status were constructed from the tool, also by using factor analysis. Logistic regression was used to quantify the association between SES and HIV testing uptake (yes/no), while controlling for potential confounders: age, marital status, number of children, education level and head of household. Results A total of 1419 women were recruited during the study period, where 87.7% consented to HIV testing, and 95.5% consented to contraception use. A total of 11.9% had never been tested for HIV previously. Factors negatively associated with HIV testing uptake were: being married (OR = 0.4, 95% CI 0.3–0.5); living in a household headed by the husband as opposed to by another person (OR = 0.4, 95% CI 0.3–0.6), and lower age (OR = 0.96, 95% CI 0.93–0.99). Higher level of education (OR = 1.0, 95% CI 0.97–1.1) and having more children aged under 15 (OR = 0.92, 95% CI 0.81–1.1) was not associated with testing uptake. In multivariable regression, testing uptake was lower in the higher SES groups, but the differences were not significant (OR = 0.80, 95% CI 0.55–1.18). Conclusions The findings show that PITC can be successfully implemented in the patient flow in a family planning clinic, without compromising contraception uptake. Within the PITC framework in a conflict setting, socioeconomic status was not found to be associated with testing uptake in women of reproductive age.https://doi.org/10.1186/s13031-023-00505-0HIV/AIDSPITCHIV testing uptakeFamily planningConflictCentral African Republic |
| spellingShingle | Mari Nythun Utheim Petros Isaakidis Rafael Van den Bergh Bantas Bata Ghislain Géraud Rodrigue Biguioh Mabvouna Tone Kristin Omsland Espen Heen Cecilie Dahl Provider-initiated HIV testing uptake and socio-economic status among women in a conflict zone in the Central African Republic: a mixed-methods cross-sectional study Conflict and Health HIV/AIDS PITC HIV testing uptake Family planning Conflict Central African Republic |
| title | Provider-initiated HIV testing uptake and socio-economic status among women in a conflict zone in the Central African Republic: a mixed-methods cross-sectional study |
| title_full | Provider-initiated HIV testing uptake and socio-economic status among women in a conflict zone in the Central African Republic: a mixed-methods cross-sectional study |
| title_fullStr | Provider-initiated HIV testing uptake and socio-economic status among women in a conflict zone in the Central African Republic: a mixed-methods cross-sectional study |
| title_full_unstemmed | Provider-initiated HIV testing uptake and socio-economic status among women in a conflict zone in the Central African Republic: a mixed-methods cross-sectional study |
| title_short | Provider-initiated HIV testing uptake and socio-economic status among women in a conflict zone in the Central African Republic: a mixed-methods cross-sectional study |
| title_sort | provider initiated hiv testing uptake and socio economic status among women in a conflict zone in the central african republic a mixed methods cross sectional study |
| topic | HIV/AIDS PITC HIV testing uptake Family planning Conflict Central African Republic |
| url | https://doi.org/10.1186/s13031-023-00505-0 |
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