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      Factors associated with HIV testing and intention to test for HIV among the general population of Nonthaburi Province, Thailand

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          Abstract

          Background

          Research on HIV testing in Thailand has largely focused on at-risk population groups, with limited information about the prevalence of correlates of HIV testing among the Thai general population. This study addresses this gap in research by using a population-based probability sample to examine correlates of HIV testing experience and intention to test.

          Methods

          We conducted a cross-sectional survey in Nonthaburi, Thailand during October-December 2012 using tablet computers to collect self-administered questionnaires from 2138 men and women (aged 15–59 years) identified through three-stage stratified cluster sampling.

          Findings

          Almost half of the respondents, 962 (45%), reported having been tested for HIV while an almost equal proportion, 1032 (48.3%), indicated their intention to test for HIV. Being sexually experienced, having a history of sexually transmitted infection, personally knowing someone infected with HIV, and youth were associated with both history of HIV testing and intention to test for HIV. High perceived risk of HIV, knowledge of an HIV testing location, and having been married were associated with having been tested for HIV. Having been tested for HIV and HIV/AIDS education were associated with intention to test for HIV. The most common reasons for testing were routine medical checkup and antenatal care. The major reasons for not testing were perception of having no or low risk.

          Conclusion

          A substantially low proportion of the respondents reported a history of HIV testing and intention to test for HIV. Culturally appropriate programs that address HIV risk perception and provide accurate information related to HIV infection and HIV testing may be beneficial in increasing uptake of HIV testing among the general population in Thailand.

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          Most cited references18

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          Methodological challenges in research on sexual risk behavior: II. Accuracy of self-reports.

          Assessing sexual behavior with self-report is essential to research on a variety of health topics, including pregnancy and infertility, sexually transmitted infections, and sexual health and functioning. Recent methodological research has provided new insights regarding the accuracy of self-reports of sexual behavior. We review these studies, paying particular attention to a promising new development: the use of computer-assisted assessments. The collection of sexual risk behavior data with computers has increased dramatically in recent years, but little is known about the accuracy of such assessments. We summarize the evidence, discuss methodological issues that arise in studies evaluating the accuracy of self-reports, and offer recommendations for future research.
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            Factors associated with HIV testing and condom use in Mozambique: implications for programs

            Background To identify predictors of HIV testing and condom use in Mozambique. Methods Nationally representative survey data collected in Mozambique in 2009 was analyzed. Logistic regression analysis was used for two outcomes: HIV testing and condom use. Results Women at a higher risk of HIV were less likely to be tested for HIV than women at a lower risk: compared to married women, HIV testing was lower among never married women (OR = 0.37, CI: 0.25-0.54); compared to women with one lifetime partner, HIV testing was lower among women with four or more lifetime partners (OR = 0.62, CI: 0.47-0.83). Large wealth differentials were observed: compared to the poorest women, HIV testing was higher among the wealthiest women (OR = 3.03, CI: 1.96-4.68). Perceived quality of health services was an important predictor of HIV testing: HIV testing was higher among women who rated health services as being of very good quality (OR = 2.12, CI: 1.49-3.00). Type of sexual partner was the strongest predictor of condom use: condom use was higher among men who reported last sex with a girlfriend (OR = 9.75, CI: 6.81-13.97) or a casual partner (OR = 11.05, CI: 7.21-16.94). Being tested for HIV during the last two years was the only programmatic variable that predicted condom use. Interestingly, being tested for HIV more than two years ago was not associated with condom use. Frequent mass media exposure was neither associated with HIV testing nor with condom use. Conclusions The focus of HIV testing should shift from married women (routinely tested during antenatal care visits) to unmarried women and women with multiple sexual partners. Financial barriers to HIV testing appear to be substantial. Since HIV testing is done without a fee being charged, these barriers are presumably related to the cost of transportation to static health facilities. Mechanisms should be developed to cover the cost of transportation to health facilities. Substantially increasing community-based counseling is one way of reducing the cost of transportation. Men should be encouraged to test for HIV periodically.
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              HIV testing is associated with increased knowledge and reductions in sexual risk behaviours among men in Cape Town, South Africa.

              HIV testing benefits those who test positive, allowing them to receive treatment, but the benefits for those who test negative remain controversial. We evaluated the impact of testing on HIV knowledge and sexual risk among men in South Africa. Men were recruited from townships outside Cape Town and completed a survey that assessed testing history, knowledge, and sexual behaviours. Among the 820 participants, 516 (63%) reported being tested (82% tested negative, 6% tested positive, and 12% unknown). Compared to those who had never been tested for HIV, men who tested for HIV were more knowledgeable about HIV transmission, but did not differ on sexual risk behaviour. Knowledge moderated the effect of testing on sexual risk such that men reported fewer sexual partners (incidence rate ratio (IRR) = 0.91, 95% CI = 0.84, 0.98) and fewer unprotected anal sex events (IRR = 0.81, 95% CI = 0.66, 1.00) if they had been tested for HIV and were knowledgeable about HIV transmission. For men testing HIV-negative, knowledge predicted fewer sexual risk behaviours. Previous HIV testing is associated with enhanced knowledge, which moderates sexual risk behaviour among South African men living in Cape Town. Results suggest that HIV testing may increase knowledge and lead to reductions in sexual risk even when results are negative.
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                Author and article information

                Contributors
                Role: Formal analysisRole: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: Funding acquisitionRole: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: Formal analysisRole: SupervisionRole: Writing – review & editing
                Role: Formal analysisRole: SupervisionRole: Writing – review & editing
                Role: SupervisionRole: Writing – review & editing
                Role: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                14 August 2020
                2020
                : 15
                : 8
                : e0237393
                Affiliations
                [1 ] Global Health Interdisciplinary Unit, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Yoshida-honmachi, Sakyo-ku, Kyoto, Japan
                [2 ] Research Institute for Health Sciences, Chiang Mai University, Sriphum, Muang Chiang Mai, Thailand
                [3 ] Department of Health Informatics, Kyoto University School of Public Health, Yoshida Konoe-Cho, Sakyo-ku, Kyoto, Japan
                [4 ] Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
                National University of Singapore, SINGAPORE
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0002-1683-4259
                Article
                PONE-D-20-02671
                10.1371/journal.pone.0237393
                7428091
                32797048
                a0aec44b-2d41-423d-b46d-c28fe4eab58f
                © 2020 Musumari et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 29 January 2020
                : 26 July 2020
                Page count
                Figures: 1, Tables: 4, Pages: 16
                Funding
                The study was supported by the Department of Global Health and Socio-epidemiology and a partial research grant from Fujiwara Foundation for the academic year 2012. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Biology and Life Sciences
                Microbiology
                Medical Microbiology
                Microbial Pathogens
                Viral Pathogens
                Immunodeficiency Viruses
                HIV
                Medicine and Health Sciences
                Pathology and Laboratory Medicine
                Pathogens
                Microbial Pathogens
                Viral Pathogens
                Immunodeficiency Viruses
                HIV
                Biology and Life Sciences
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                Immunodeficiency Viruses
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