Socio-demographic inequalities in HIV testing behaviour and HIV prevalence among older adults in rural Tanzania, 2013

ABSTRACT

Most HIV research in Sub-Saharan Africa (SSA) ignores persons aged 50 years and above, though a few studies have reported a high HIV prevalence among older people. This study aimed to estimate socio-demographic inequalities in HIV testing behaviour and HIV prevalence among adults aged 50+ years, living in Ifakara town, Tanzania. This cross-sectional study used data from the baseline measurement of the Ifakara MZIMA cohort study in 2012/13. Consenting participants were interviewed and tested for HIV. Associations between HIV testing behaviour and HIV prevalence with socio-demographic indicators were explored with multivariable logistic regression. Among the 1643 adults 50+ years included in the study, HIV prevalence and the HIV testing rate (ever tested) were 6% and 11.4% respectively. The HIV testing rate was lower for older people (aOR = 0.19 (95% CI 0.09–0.41 for 75+ versus 50–54 years); higher for those separated/divorced/widowed than those married (aOR = 1.46; 1.02–2.10); higher for “other Christians” than Muslims (aOR = 1.95; 1.06–3.58); and higher for primary (aOR = 1.54; 1.01–2.33) and secondary (aOR = 3.47; 2.11–5.70) school graduates than those without education. HIV prevalence was lower for older people (aOR = 0.27; 0.11–0.66 for 75+ versus 50–54); and for Catholics compared to Muslims (aOR = 0.54; 0.34–0.85). The high HIV prevalence among older adults and the low HIV testing behaviour call for more efforts on HIV prevention, treatment and care.

KEYWORDS:

• HIV
• older adults
• testing
• prevalence
• socio-economic inequalities

Acknowledgements

We acknowledge the support from the Ministry of Health and Social Welfare (MoHSW), Kilombero district, IHI staff, and the local community of Ifakara.This work was supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria, the INDEPTH Network, Kanda, Accra, Ghana and ALPHA Network, London School of Hygiene and Tropical Medicine, London, UK.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Angelina Mtowa http://orcid.org/0000-0002-2986-7295