Use and awareness of and willingness to self-test for HIV: an analysis of cross-sectional population-based surveys in Malawi and Zimbabwe

Johnson, Cheryl; Neuman, Melissa; MacPherson, Peter; Choko, Augustine; Quinn, Caitlin; Wong, Vincent J.; Hatzold, Karin; Nyrienda, Rose; Ncube, Getrude; Baggaley, Rachel; Terris-Prestholt, Fern; Corbett, Elizabeth L.

doi:10.1186/s12889-020-08855-7

Table 1 Baseline characteristics in Malawi and Zimbabwe, 2015–16

From: Use and awareness of and willingness to self-test for HIV: an analysis of cross-sectional population-based surveys in Malawi and Zimbabwe

Variables^a	Ever tested (N = 31,385)^b			Ever self-test (N = 24,683)^b			Aware self-test (N = 24,683)^b
Variables^a	N	%	p-value^§	N	%	p-value^§	n	%	p-value^§
Total population	24,148	76.9		287	1.2		3118	12.6
Country			< 0.001			< 0.001			< 0.001
Malawi	11,726	75.4		141	1.0		1671	11.4
Zimbabwe	12,422	78.6		146	1.5		1447	14.5
Sex			< 0.001			0.008			< 0.001
Female	14,500	83.5		103	1.0		983	9.1
Male	9648	68.8		184	1.3		2135	15.3
Residence			< 0.001			< 0.001			< 0.001
Urban	7951	79.9		151	2.1		1516	21.2
Rural	16,197	75.9		136	0.8		1602	9.1
Age group (years)			< 0.001			< 0.001			< 0.001
15–19	3252	44.8		30	0.5		437	7.0
20–24	4703	80.7		42	0.9		562	12.1
25–29	4337	90.3		59	1.6		580	16.0
30–34	4070	91.1		55	1.7		497	15.2
35–39	3247	89.2		42	1.5		426	15.7
40–44	2446	87.4		35	1.7		303	15.0
45+	2093	80.8		24	1.1		313	14.7
Wealth			< 0.001			< 0.001			< 0.001
Poorest	3697	76.4		18	0.5		246	6.4
Poorer	4029	75.8		38	0.9		336	7.8
Middle	4252	75.3		26	0.6		279	8.3
Rich	5594	77.6		56	0.9		669	12.2
Richest	6576	78.5		149	2.3		1488	22.8
HIV status			< 0.001			0.108			0.029
HIV negative	20,646	75.0		249	1.1		2760	12.5
HIV positive	2570	90.6		38	1.5		358	10.4
Marital status			< 0.001			0.005			< 0.001
Single	7595	58.9		99	0.9		1175	11.2
Married or cohabiting	16,553	89.5		188	1.3		1943	13.7
Employment			< 0.001			0.033			< 0.001
Not actively working	8719	70.1		85	1.0		823	9.4
Actively working	15,429	81.4		202	1.3		2295	14.4
Education			< 0.001			< 0.001			< 0.001
≤ Primary	10,617	74.8		70	0.6		927	7.5
≥ Secondary	13,531	78.7		217	1.8		2191	17.8
Literacy			< 0.001			< 0.001			< 0.001
Illiterate	5211	73.5		44	0.7		488	8.0
Literate	18,937	77.9		243	1.3		2630	14.2
Sexually active			< 0.001			< 0.001			< 0.001
Sexually inactive	9064	64.0		107	1.5		1225	17.7
Active in past 4 weeks	15,053	87.6		180	1.5		1890	14.2
HIV-related risk^c			< 0.001			< 0.001			< 0.001
Low risk	8457	63.5		94	0.9		1102	10.3
Moderate risk	13,092	88.7		134	1.2		1497	13.6
High risk	2570	78.8		59	2.0		516	17.2

^aEver tested refers to people surveyed on HIV testing history who reported that they previously tested for HIV before the survey. Overall, 31,385 people were asked about their HIV testing history and 24,148 responded that they had tested previously. Ever self-tested refers to people surveyed on HIV self-testing who reported that they had previously self-tested. Overall, 24,683 people were asked whether they had self-tested and 287 reported that they had self-tested previously. Aware of self-testing refers to people surveyed who reported that they were aware of HIV self-testing. Overall, 24,683 people were asked whether they were aware of self-testing and 3118 reported that they were aware of self-testing
^bOut of 31,385 people surveyed, 31,348 were included as 37 people were missing information on sexual activity and HIV-related risk. Not all participants were systematically surveyed on self-testing questions. Out of 31,385 people surveyed, 24,683 were asked about self-testing, resulting in a smaller sample size. Among these were 15 people reporting on self-testing who did not provide information on sexual activity and HIV risk. Population size asked about ever testing for HIV: 31347 (HIV risk/sexual activity). Population size asked about awareness or ever self-testing for HIV: 24668 (HIV risk/sexual activity)
^cHIV risk as defined in this analysis includes reported sexual activity in the past four weeks, and the following high-risk exposures in the previous 12 months: multiple (i.e. ≥2) partners, any paid sex (asked to men), having received gifts, cash or other compensation in exchange for sex (asked to women), and having a sexually transmitted infection (STI). Individuals with any “high-risk” exposures were classified as “high-risk”, with the remaining respondents classified as “low risk” if reporting no sexually activity in the past four weeks, and as “moderate risk” otherwise
^§P-value based on cluster-adjusted chi-squared test

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ISSN: 1471-2458

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