HIV testing and tolerance to gender based violence: a cross-sectional study in Zambia

This paper explores the effect of social relations and gender-based conflicts on the uptake of HIV testing in the South and Central provinces of Zambia. We conducted a community-based cross-sectional study of 1716 randomly selected individuals. Associations were examined using mixed-effect multivari...

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Bibliographic Details
Published in:PloS one 2013-08, Vol.8 (8), p.e71922-e71922
Main Authors: Gari, Sara, Malungo, Jacob R S, Martin-Hilber, Adriane, Musheke, Maurice, Schindler, Christian, Merten, Sonja
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
Adolescent
Adult
Aggression
AIDS
Cross-Sectional Studies
Decision Making
Family Characteristics
Female
Gender-based violence
HIV
HIV Infections - diagnosis
HIV Infections - epidemiology
HIV Infections - psychology
Households
Human immunodeficiency virus
Humans
Interpersonal Relations
Logistic Models
Male
Mass Screening - methods
Mass Screening - psychology
Medicine
Middle Aged
Multivariate Analysis
Odds Ratio
Sex Factors
Social and Behavioral Sciences
Social aspects
Social interactions
Socioeconomic Factors
Studies
Surveys and Questionnaires
Violence
Violence - prevention & control
Violence - psychology
Violence - statistics & numerical data
Young Adult
Zambia - epidemiology
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Summary:This paper explores the effect of social relations and gender-based conflicts on the uptake of HIV testing in the South and Central provinces of Zambia. We conducted a community-based cross-sectional study of 1716 randomly selected individuals. Associations were examined using mixed-effect multivariable logistic regression. A total of 264 men (64%) and 268 women (56%) had never tested for HIV. The strongest determinants for not being tested were disruptive couple relationships (OR = 2.48 95% CI = 1.00-6.19); tolerance to gender-based violence (OR = 2.10 95% CI = 1.05-4.32) and fear of social rejection (OR = 1.48 95% CI = 1.23-1.80). In the Zambian context, unequal power relationships within the couple and the community seem to play a pivotal role in the decision to test which until now have been largely underestimated. Policies, programs and interventions to rapidly increase HIV testing need to urgently address gender-power inequity in relationships and prevent gender-based violence to reduce the negative impact on the lives of couples and families.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0071922