Citation

Gari S, Malungo JR, Martin-Hilber A, Musheke M, Schindler C, Merten S. PLoS One 2013; 8(8): e71922.

Affiliation

Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland.

Copyright

(Copyright © 2013, Public Library of Science)

DOI

10.1371/journal.pone.0071922

PMID

23991005

PMCID

PMC3749220

Abstract

This paper explores the effect of social relations and gender-based conflicts on the uptake of HIV testing in the South and Central provinces of Zambia. We conducted a community-based cross-sectional study of 1716 randomly selected individuals. Associations were examined using mixed-effect multivariable logistic regression. A total of 264 men (64%) and 268 women (56%) had never tested for HIV. The strongest determinants for not being tested were disruptive couple relationships (OR = 2.48 95% CI = 1.00-6.19); tolerance to gender-based violence (OR = 2.10 95% CI = 1.05-4.32) and fear of social rejection (OR = 1.48 95% CI = 1.23-1.80). In the Zambian context, unequal power relationships within the couple and the community seem to play a pivotal role in the decision to test which until now have been largely underestimated. Policies, programs and interventions to rapidly increase HIV testing need to urgently address gender-power inequity in relationships and prevent gender-based violence to reduce the negative impact on the lives of couples and families.

Language: en