Difference in HIV prevalence by testing venue: results from population level survey in Uganda

ABSTRACT

Growing demand for use of Health Facility (HF) HIV testing data, in addition to other testing data to obtain district level HIV prevalence requires understanding the comparability of these various sources. We analysed the 2011 Uganda AIDS indicator survey data to assess: the proportion of people tested for HIV across Uganda by venue of testing; HIV prevalence ratio for those tested in a HF compared to those tested in community setting; [Katz, D., Baptista, J., Azen, S. P., & Pike, M. C. (1978). Obtaining confidence intervals for the risk ratio in cohort studies. International Biometric Society, 34(3), 469–474. https://doi.org/10.2307/2530610] and factors associated with HIV positivity in each subgroup. Of the 11,685 individuals, 8978 (77.1%) had ever tested for HIV in a HF. Fifty nine per cent tested in a HF in the 12 months preceding the survey (female: 5507, 72.7% versus male: 1413, 34.9%). HIV prevalence ratio was 1.8 times among those tested in a HF compared to those tested at community setting (10.9% [95% CI: 10.0–11.7] versus 6.2% [95% CI: 5.4–7.0]). Among HF testers, older age group, previously married and having no sexual partner was associated with significantly higher HIV prevalence. Using facility testing data for planning and decisions should take into consideration the elevated and varying HIV prevalence among individuals accessing HIV testing services at HFs as well as differences in their social-demographic characteristics.

KEYWORDS:

• Population survey
• Health Information System
• HIV
• Prevalence
• Testing venue

Acknowledgements

We acknowledge Ministry of Health Uganda, ICF Macro International and their partners in conducting the 2011 Uganda AIDS Indicator Survey, and for the permission to use the dataset.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics

Ethical clearance was obtained from the University of Witwatersrand Human Research Ethics Committee (HREC) and Uganda National Council of Science and Technology (UNCST). Permission was also obtained from Ministry of Health, Uganda, and the Measure DHS (ORC MACRO).

Data availability statement

Data used for this study is publicly available from Measure DHS: https://dhsprogram.com.

Additional information

Funding

This study was supported through the Wellcome Trust, grant 107754/Z/15/Z-DELTAS Africa via Sub-Saharan Africa Consortium for Advanced Biostatistics (SSACAB). The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS) Alliance for Accelerating Excellence in Science in Africa (AESA). The views expressed in this publication are those of the authors and not necessarily those of the AAS, NEPAD Agency, Wellcome Trust or the UK government.