Associations with HIV testing in Uganda: an analysis of the Lot Quality Assurance Sampling database 2003–2012

ABSTRACT

Beginning in 2003, Uganda used Lot Quality Assurance Sampling (LQAS) to assist district managers collect and use data to improve their human immunodeficiency virus (HIV)/AIDS program. Uganda's LQAS-database (2003–2012) covers up to 73 of 112 districts. Our multidistrict analysis of the LQAS data-set at 2003–2004 and 2012 examined gender variation among adults who ever tested for HIV over time, and attributes associated with testing. Conditional logistic regression matched men and women by community with seven model effect variables. HIV testing prevalence rose from 14% (men) and 12% (women) in 2003–2004 to 62% (men) and 80% (women) in 2012. In 2003–2004, knowing the benefits of testing (Odds Ratio [OR] = 6.09, 95% CI = 3.01–12.35), knowing where to get tested (OR = 2.83, 95% CI = 1.44–5.56), and secondary education (OR = 3.04, 95% CI = 1.19–7.77) were significantly associated with HIV testing. By 2012, knowing the benefits of testing (OR = 3.63, 95% CI = 2.25–5.83), where to get tested (OR = 5.15, 95% CI = 3.26–8.14), primary education (OR = 2.01, 95% CI = 1.39–2.91), being female (OR = 3.03, 95% CI = 2.53–3.62), and being married (OR = 1.81, 95% CI = 1.17–2.8) were significantly associated with HIV testing. HIV testing prevalence in Uganda has increased dramatically, more for women than men. Our results concurred with other authors that education, knowledge of HIV, and marriage (women only) are associated with testing for HIV and suggest that couples testing is more prevalent than other authors.

KEYWORDS:

• LQAS, Lot Quality Assurance Sampling
• HIV testing
• Uganda
• logistic regression
• VCT, voluntary counseling and testing

Acknowledgments

The authors gratefully acknowledge Nick Atkins, Charles Nkolo, and Ronald Egonda for their support in developing the database, Magreen Mugoola for her consultancy work, and William Vargas for his support over the years as an exceptional LQAS trainer. We also are grateful for the entire STAR-E LQAS staff who worked in support of the LQAS data collection including Esther Sempiira and Edward Were. The authors wish to thank all of the districts staff for the collection of these data, and all those who participated in these surveys for their time and trust.

Disclosure statement

The contents are the responsibility of the Liverpool School of Tropical Medicine and Management Science for Health and do not necessarily reflect the views of USAID or the United States Government. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

ORCID

Caroline Jeffery http://orcid.org/0000-0002-8023-0708

Additional information

Funding

This work was supported by the American people through USAID under terms of the Cooperative agreement [grant number 617-A-00-09-00006-00] with Management Sciences for Health.