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Stigma, sexual risk and desire for HIV tests in Ghana
Authors: Emmanuel Koku
Source: Sexual Health, Papers In Press
Topic(s): HIV testing
Country: Africa
Published: APR 2010
Abstract: Abstract Background: Voluntary counseling and testing (VCT) has been recognized as the cornerstone of HIV surveillance, prevention and treatment programs. Although various HIV prevention and treatment programs have been implemented in Ghana since 2003, desire for and uptake of HIV testing is still low, owing largely to HIV-related stigma. As a result, this study examined the effect of AIDS stigma on desire for HIV testing, while controlling for socio-demographic and other confounding influences. Method: The study used data from the 2003 Ghana Demographic and Health Survey to regress desire for an HIV test on levels of stigma - the main explanatory variable - while controlling for selected socio-demographic, socio-cognitive and socio-behavioral covariates. Results: Consistent with findings from previous research, the study revealed significant associations between a number of socio-demographic and socio-cognitive variables and the desire for an HIV test. For example, both male (AOR=0.41; 95% CI=0.24-0.72) and female (AOR=0.62; 95% CI=0.41-0.93) respondents in wealthiest/richest households, as well as those who know someone infected with HIV (AOR=0.65; 95% CI=0.43-1.00) have lower odds of desiring an HIV test. Most importantly, the study showed that the interaction between risky sexual behaviors and community stigma is significant but negative (AOR=0.44; 95% CI=0.19-0.67), indicating that the positive effect of risky sex on HIV testing is attenuated among females (but not males) who live in communities with high levels of stigma. Conclusion: Since community level educational and risk reduction programs have demonstrable influences on reducing HIV stigma, it is imperative that the Ghana government's ongoing anti-stigma campaigns and other HIV prevention programs take cognizance of the role of community stigma in influencing HIV testing decisions especially in the context of risky sexual behaviors.