Analysis of Factors Associated with Failure to Return for HIV Test Results in The Gambi

• Main Authors: Catherine Sesay, 施琳佳
• Other Authors: Li-Yin Chien
• Format: Others
• Language: en_US
• Published: 2011
• Online Access: http://ndltd.ncl.edu.tw/handle/69990255710005525408

碩士 === 國立陽明大學 === 公共衛生研究所 === 99 === Background: HIV testing and counseling has been singled out as one of the most effective methods for HIV/AIDS prevention worldwide. Knowing one’s HIV status is fundamental in that if one is HIV positive the individual can take the necessary steps to access treatment, prevent the spread of HIV to others and protect an unborn child. This prevention method is however defeated if individuals who opt to get tested fail to return for their HIV test results and further counseling. Various studies have been carried out on failure to return, however these studies have been done mainly in the US fueling a deficiency of such studies in Africa where the epidemic has hit the hardest and none done in the Gambia to date. Objective: The study aims to determine risk factors that are associated with failure to return for HIV test results in the Gambia Methods: The study is a cross-sectional study that used a total of 1755 patients that were tested at the GUM clinic in MRC, the Gambia from 2000 to 2009. Logistic regression was performed to evaluate the association between possible risk factors including demographics, sexual history, accessibility, and failure to return for HIV test results which is defined as no return after one month of having taking a HIV test at the GUM clinic. Results: Males were observed to have a higher FTR rate than females (OR; 1.366 (CI;0.577 – 0.929)), FTR was highest among younger participants, participants aged less than 18 years of age were more likely to FTR (OR; 2.542 (CI;1.288 – 5.017)) than participants aged 40 or older. Senegalese were more likely to fail to return when compared to Gambians (OR; 1.860 (CI;1.262 – 2.772)), individuals who were of other nationalities also had a higher failure to return than Gambians (OR; 1.619 (1.028 – 2.551)). Receiving some education was a significant predictor of FTR, with individuals having only primary education having a higher FTR (OR; 1.496 (CI;1.067 – 2.098)) than those who received no formal education, also those who also received secondary education were more likely to FTR (OR; 1.472 (CI;1.091 – 1.987)) than those who received no formal education. Persons who had ever used a condom were more likely in failing to return for HIV test results than persons who had never used a condom (OR; 1.748 (CI;1.310 – 2.331)) and those who permanently resided in urban areas where more likely to FTR for their HIV test results (OR; 1.596 (CI;1.213 – 2.100)) than individuals who lived in a rural area. Conclusion: The overall FTR rate of 30% shows a clear need to increase uptake of HIV results on different levels. It is important to implement feasible strategies that would curb failure to return for HIV test results such as introduction of rapid testing in health centers throughout the country among certain groups of people such as males, younger individuals and non-Gambians. Counselors should be trained to use different approaches based on the individuals profile, such as tackling risk perception and making individuals understand use of condom does not eliminate risk of contracting HIV completely. Strategies such as SMS could be introduced for individuals who live in urban areas to serve as reminders for test result pick-up. It is imperative that counselors educate people who come in to get tested and comprehensive campaigns are carried to increase knowledge, awareness and understanding of HIV/AIDS, to increase understanding prevention and control of HIV/AIDS, to stress the importance of knowing one’s status, getting tested, returning for test results and awareness of available medications whilst simultaneously discouraging stigma and discrimination. On a different scale, it is also important to understand FTR from a psychological, cultural and social aspect in order to better understand failure to return in the Gambian context and plan appropriate strategies to increase receipt uptake alongside these results.