AIDS Stigma and Uptake of HIV Testing in Zimbabwe (English)

Document Type

Working Papers

Publication Topic(s)

HIV, HIV/AIDS Knowledge, Attitudes, and Behavior

Country(s)

Zimbabwe

Language

English

Author(s)

William Sambisa and Macro International Inc. Calverton, Maryland, USA

Publication Date

August 2008

Publication ID

WP49

Abstract:

The objective of this report is to examine the effects of AIDS stigma on uptake of HIV testing in Zimbabwe, with particular emphasis on pathways to HIV testing and reasons for not being tested. Understanding the role of AIDS stigma on uptake of HIV testing can be useful in providing input on the development of HIV testing services. Data are derived from the nationally representative 2005-06 Zimbabwe Demographic and Health Survey. Analyses are restricted to women (6,997) and men (5,359) who have ever had sex. Multinomial logistic regression models are used to determine the independent effects of AIDS stigma on HIV testing uptake through different pathways (volunteering, being offered and accepting the test, and being required to be tested) and on competing reasons for not being tested. Testing for HIV is higher among women (30 percent) than men (22 percent). For women, the main reason for being tested for HIV is accepting testing when it is offered (particularly in the context of antenatal care), whereas for men it is volunteering to be tested. For both women and men, the most common reasons for not being tested are lack of access to testing services and fear of test results. The odds of having ever been tested for HIV across all pathways to testing are lower for women but not men who have social rejection stigma. Testing uptake is significantly increased among those women and men who have observed enacted stigma. Education, religion, exposure to mass media, perceived risk of HIV infection, and ever use of condoms are strongly predictive of having ever been tested for HIV. Social rejection stigma is predictive of not being tested because of fear of test results. Rural residence and having had three or more lifetime sexual partners increases the odds of not having been tested because of lack of access to testing services. In conclusion, AIDS-related stigma appears to be a deterrent to HIV testing uptake. Hence, more work needs to be done to reduce the impact of AIDS-related stigma on the adoption of preventive behaviors.