Introduction HIV remains a severe global health problem. The Republic of Chad is moderately affected (1.3%), compared to Cameroon who suffers more of the burden of the HIV/AIDS (4.5%). We described the HIV risk factors in two neighboring Central African Republics, and compared the gaps in both countries. Methods This was a retrospective cross-sectional study; data was obtained from the Demographic and Health Survey. A stratified multi-stage cluster sample design was conducted. The sample size was 5248 in Chad and 7191 in Cameroon. We used SAS to fit a multilevel logistic model, and conducted a multivariate analysis. Results The median age of respondents was 30 (IQR, 20-40) years in Chad, and 28 (IQR, 20-40) in Cameroon. Only 12.45% reported had ever been tested for HIV in Chad, (41.77% in Cameroon). In Chad, 46.40% of participants did not know a place to get HIV test, (11.15% in Cameroon). The median number of lifetime sexual partners was 2 (IQR, 1-4) in Chad, and 6 (IQR, 3-15) in Cameroon. Among Chadian participants 31.63% had only one lifetime sexual partner, (10.76% in Cameroon). In Chad 86.95% of participants reported having no sex partner other than their spouse in the last 12 months; (57.3% in Cameroon). Conclusion Condom use and HIV testing rates were very low among Chadian men comparing to Cameroonian men; however, Cameroonian men were more likely to engage in multiple sexual partners and extra-marital relationship than Chadian men.

Using a logistic regression model, this dissertation employed a macro level Gateway Provider Model to explore eight factors that may influence community health center HIV testing approach. The logistic regression model indicated that three variables related to community health center HIV testing approach. First, all else equal, the odds of offering routine HIV testing for community health centers that perceived their patients and community to be at average risk for HIV were 3.676 times the odds for those centers that perceived their patients and community to be at low or no risk for HIV. Further, the odds of offering routine HIV testing for community health centers that perceived their patients and community to be at high risk for HIV were 4.693 times the odds for those centers that perceived the community to be at low or no HIV risk. Second, all else equal, the odds of offering routine HIV testing for community health centers in which an HIV testing policy exists were 2.202 times the odds for those centers in which an HIV testing policy does not exist. Third, all else equal, the odds of offering routine HIV testing for community health centers that received funding specifically for HIV testing were 2.938 times the odds for those centers that did not receive such funding. No other individual predictor variables in the model were related to community health center HIV testing approach.

In the past twenty years a global trend has emerged illustrating increasing rates of violence against women, with HIV rates among this population also steadily on the rise. Despite the burden of the problem, there is scant corpus of literature exploring the influence of domestic violence on HIV. Therefore, this study examined the association between domestic violence and women’s decision to consent to HIV testing, and their HIV status. Using the 2007 Zambia Demographic and Health Survey, it was found that Zambian women who have experienced domestic violence are 13% more likely to consent to an HIV test. After adjusting for residence as a confounder, women who had experienced domestic violence were 11% more likely to test positive for HIV. Studies similar to this one could provide the basis for future policy and program planning that would have significant implications on violence against women in HIV prevalent populations.

abstract: Access to testing for the human immunodeficiency virus (HIV), as well as other care services related to HIV/AIDS, have greatly improved in Tanzania over the last decade. Despite the country’s efforts to increase the number of individuals who get tested for HIV annually, it is estimated that only 52.2-70.0% of people living with HIV (PLWH) knew their HIV positive status at the end of 2017. In addition, research in Tanzania has shown that HIV-related stigma and discrimination are widespread and contribute to low uptake of HIV testing and non-adherence to antiretroviral treatment (ART). In order to achieve the goals set forth by the Government of Tanzania and the Joint United Nations Programme on HIV/AIDS (UNAIDS), as well as move towards an AIDS-free generation, a deeper understanding of the stigma-related barriers to seeking an HIV test is necessary. This research aims to better understand the relationship between HIV-related stigma and attitudes towards HIV testing among community members in Northern Tanzania. In addition, it looked at the specific barriers that contribute to low uptake of HIV testing, as well as the impact of social networks on an individual’s motivation and willingness to get tested for HIV. In this research, community members in Meru District (N = 108, male = 69.4%, female = 28.7%) were surveyed using various validated instruments that covered a range of topics, including knowledge of HIV/AIDS, testing attitudes, and perceived risk of HIV infection. The mean overall score for correct answers on the knowledge measure was 69.8% (SD = 16.4). There were no significant group differences between individuals who had ever tested and individuals who had not tested in relation to HIV/AIDS knowledge or HIV testing attitudes. The factors that were significantly associated with getting an HIV test were knowing someone who had previously tested (p = 0.003), as well as openly discussing HIV testing within one’s social group (p = 0.017). Participants also provided qualitative responses for barriers to receiving an HIV test, motivations for getting tested, and suggested interventions for improving HIV testing uptake. The goal of this research is to develop recommendations for interventions that are better informed by attitudes and motivations for testing. / Dissertation/Thesis / Masters Thesis Biology 2019

Recent advances in HIV antiretroviral therapy and the availability of prophylaxis for opportunistic infections, combined with the opportunity to prevent perinatal HIV infection, underscores the value of early diagnosis of HIV infection. HIV antibody home test kits offer individuals the opportunity to collect a blood sample, send it anonymously to a laboratory, and receive counseling and referral over the phone. Home HIV testing may reduce barriers to testing that have precluded individuals from learning their HIV serostatus, and if seropositive, from taking advantage of efficacious therapeutic and preventive regimens. This study employed a randomized-controlled prospective field trial design to determine if the availability of home testing increased HIV testing relative to traditional counseling and testing among injecting drug users in three HIV prevention/drug treatment contexts; methadone maintenance, hospital-based detoxification, and syringe exchange. Theoretical correlates to HIV testing were also evaluated. Multivariate analyses demonstrated that participants randomized to home testing were 2.2 times more likely than those randomized to traditional counseling and testing to test for HIV antibodies in this study after controlling for demographic, HIV risk, and theoretical variables. No differences were observed between testing methods with regard to obtaining HIV test results. The relationship between HIV testing and test type was moderated by drug treatment context and history of homeless, with home testing resulting in increased testing among methadone participants and persons without a history of homelessness. Analyses of theoretical variables suggested that prevention education stressing the benefits of HIV testing, personal risk of HIV infection, and efficacy of available treatments could increase HIV testing among injecting drug users. Participants randomized to home testing were more satisfied with testing and telephone-based counseling than were those receiving traditional testing and face-to-face counseling. Home testing was associated with increased testing perhaps due to reduced barriers to testing. To further reduce barriers to testing and to increase testing among injecting drug users, consideration should be given to incorporating oral fluid testing and rapid result capability in home test kits. Counseling could be made available as needed, delivered by telephone, and contingent upon the volitional control of the testing consumer.

This dissertation considers how Western health interventions are incorporated in non-Western societies. It focuses specifically on ‘HIV Testing,’ a key strategy that emerged to fight the spread of HIV in the West and was later institutionalized globally and exported to other, very different parts of the world. The empirical object of study is the “3Cs,” the cluster of Western norms and ideals upon which global testing policy rests: (1) that it includes counseling, (2) that it be conducted with informed consent, and (3) that the test results be confidential. Employing several methods of field research, this project investigates how the rationalities and motivations of various actors at national and local levels affect the implementation of a key global AIDS intervention in Malawi, a high HIV prevalence, rural African setting. Fundamental differences between the West and sub-Saharan Africa form the basis of this inquiry as to how imported models fare when implemented outside of their context of origin. Towards that end, this study considers how three strata of social and institutional actors who inform the HIV Testing encounter in Malawi interpret, and put into practice, the same ideas: the Counseling and Testing Establishment (CTE), HIV Counselors, and rural Malawians. For the CTE, its proponents, the “3Cs” are Western, human rights imports that are worth defending formally, but not necessarily worth prioritizing in practice. For HIV Counselors, its implementers, knowledge of the “3Cs” as Western biomedical jargon distinguishes them from villagers, but places them in situations where the ethics of testing conflict with moral concerns they have for those whom they were trained to help; thus they adapt them in practice. And for rural Malawians, its beneficiaries, the “3Cs” have little inherent value, and are perceived largely as doing harm rather than good in their communities. Thus, the net contribution of this study is that the “3Cs” have no single meaning as a normative testing regime, but rather acquire (differential) meaning (and import) during their implementation. Indeed, unless policy makers and analysts know something about this, interventions developed from afar are unlikely to have their intended effects on the ground. / text

Introduktion: HIV-infektion medför en kronisk och progressiv sjukdom som, i obehandlad form, leder till en successiv försämring av immunförsvaret och utvecklandet av AIDS. Syfte: Att vid två lärosäten undersöka sjuksköterskestudenters kunskaper om HIV och inställningen till behovet av HIV-testning. Metod: En empirisk tvärsnittsstudie med deskriptiv och komparativ design med kvantitativ ansats. Genomförd som enkätstudie bland studenter vid Högskolan i Gävle och Uppsala Universitet (N=95), som studerade på sjuksköterskeprogrammets tredje år. Resultat: Majoriteten (88,4 %) angav korrekt att samlag med fler än en partner ökar risken att smittas med HIV. Tre studenter (3,2 %) angav felaktigt att det finns ett vaccin mot HIV-infektion. Nästan hälften (42,1 %) saknade kunskap om att glidmedel, tillsammans med kondom, inte minskar risken för HIV-smitta. En majoritet (78,9 %) rekommenderade ett HIV-test till en kvinna som haft oskyddat sex med en man. I studenternas motiveringar till behovet av ett HIV-test, framkom fyra kategorier; ”risk”, ”sexualvanor”, ”patientens oro” och ”ovisshet”. Konklusion: Sjuksköterskestudenterna hade relativt goda kunskaper om HIV. Däremot fanns betydande brister i vissa frågor. Sjuksköterskestudenternas inställning till HIV-testning överensstämmer relativt väl med gällande riktlinjer. Däremot finns ett behov att förändra ett förlegat riskgruppstänkande för att kunna ge patienter rådgivning i enlighet med den senaste kunskapen. / Introduction: HIV-infection is a chronic and progressive disease that, left untreated, leads to a deterioration of the immune system and the development of AIDS.  Aim: To examine nursing students´, at two universities, knowledge about HIV and their attitude towards assessing the need for a HIV-test. Method: An empirical cross-sectional study using descriptive and comparative design with a quantitative approach. Data was collected by a questionnaire among third year nursing students at the University of Gavle and Uppsala University (N=95). Result: A majority (88,4 %) answered correctly that intercourse with more than one partner increases the risk for contracting HIV. Three students (3,2 %) answered incorrectly that there is a vaccine for HIV. Nearly half of the students did not know that lubricant, combined with a condom, does not reduce the risk for contracting HIV. A majority (78,9 %) recommended a HIV-test to a woman who have had unprotected sex with a man. In analyzing the students´ explanatory statements for the need for a HIV-test, four categories emerged; “risk”, “sexual behavior”, “patients´ concern” and “not knowing”.   Conclusion: The nursing students had relatively good knowledge about HIV. However, there was a significant lack of knowledge in some questions. The nursing students´ attitudes towards HIV-testing conforms relatively well with current guidelines. However, there is a need to change an outdated way of assessing the risk for HIV-infection to be able to provide counseling to patients based on current knowledge.

<p>Increased uptake of VCT services by pregnant women may be attributed to the development of counseling services and increased availability of rapid tests at the study clinics by the Namibian Health and Social Services. A high knowledge and understanding of HIV and VCT services by pregnant women also probably contributed.</p>

This research was conducted on the extent to which employers believe they are implementing the Code of Good Practice on Key Aspects of HIV/AIDS and Employment (hereafter referred to as the Code of Good Practice). The motivation for the study arose as a result of the seriousness and prevalence of HIV/ AIDS within the working population, as well as the lack of knowledge as to what employers are doing to address this issue within the world of work. An exploratory research design was used to evaluate the extent to which employers believe they are implementing to Code of Good Practice. A quantitative approach was used. A literature study examined the history of HIV/ AIDS, the definitions describing the pandemic and the social and legal aspects linked to the disease. For research purposes, a sample of twenty employers was purposefully chosen by the researcher. The questionnaire was completed by a representative of the aforementioned employers. The data was analysed and a comparison was drawn between the literature study and the empirical findings. Conclusions and recommendations for future research were formulated as a result of the study. The findings of the study included, among other, that all employers experience risks related to discrimination against people who are HIV positive. The study also found that the majority of the employers had no practical measures in place to prevent this kind of discrimination. The study was limited in focus to the Code of Good Practice and it is recommended that a bigger sample is needed to have a holistic view of the HIV/AIDS phenomena within the world of work in South Africa. / Dissertation (MSD (Social Work Management))--University of Pretoria, 2006. / Social Work and Criminology / unrestricted

Background: Human immunodeficiency virus (HIV) remains a global challenge with an estimate of 37.9 million confirm cases. Testing remains a critical indicator of HIV diagnosis and treatment, as it is the primary step towards taking accountability for the protection of oneself and the protection of others. Aim: This secondary analysis of Liberia Demographic and Health Survey data from 2013 aimed to statistically describe the association between Knowledge, Attitude, and Practices (KAP), demographics factors such as age, education, marital status, wealth, religion, place of residence, and testing uptake.  Methods: A cross-sectional study of Liberian women (n=7353, aged 15 - 49 ) was performed. Statistical analysis of the chi-square test and logistics regression was employed to identify the association between independent variables (KAP), selected demographics factors, and the dependent variable (HIV testing).   Results: The key findings of the study are that there is a statistically significant relationship between comprehensive knowledge and testing for HIV. The attitude in terms of stigmatizing behavior is also significantly associated with testing uptake. Demographic factors age, education, being ever married, being a Muslim, belonging to the middle class, and living in the rural area are positive determinants of HIV testing in Liberia. The study confirmed that there is no statistically significant association between high-risk behavior and testing uptake among women aged 15-49 in Liberia. Conclusion: Knowledge, stigmatizing attitude, and some demographic factors are determinants of testing uptake in Liberia.