Sex differences in HIV testing in Ghana, and policy implications

Abstract

HIV testing and counseling (HTC) is the primary gateway to all systems of AIDS-related care. This study describes sex differences in the use of HTC from data of the National AIDS/STI Control Program (NACP) over four years (2007–2010), across the 10 regions of Ghana. HTC data from NACP were from diagnostic centers (DCs), know your status campaigns (KYS) and prevention of mother-to-child transmission (PMTCT) sites across the country. Data highlight significantly greater use of HTC by females than males. From 2007 to 2010, females comprised 58.2% of all those using HIV testing at DCs and KYS, and this proportion rose to 75.9% when PMTCT data were included. The female: male testing ratio ranged from 6.2 in 2007 to 2.8 in 2010, suggesting a recent increase in male testing. The NACP data also indicate that females are more likely than males to test positive for HIV, suggesting either better catchment of HIV positive females, or potentially, a higher HIV epidemic among females than males. While the magnitude of the sex differences in testing varies by year and location, the data provide consistent evidence of lower male use of testing. Rigorous examination of HTC utilization rates, with closer attention to male use of testing, deserves closer policy attention.

Keywords:

• HIV testing
• HTC
• sex differentials in HIV
• Ghana
• Ghana National AIDS/STI Control Program

Acknowledgements

We are grateful to Dr Nii Akwei Addo (Program Manager of NACP) for leading the fight against HIV in Ghana. To Dr Bernard Dornoo and Dr Stephen Ayisi-Addo for providing explanations on aspects of the data and also Mr Ekow Wiah, the National Data Manager of the NACP. The views expressed in this paper are those of the authors. No official endorsement by GHS/NACP is intended or should be inferred.