Background
Methods
Data source and study population
Outcome variable
Determinants of HIV testing
Data analysis
Results
Changes in HIV testing uptake
Source of HIV test
Determinants of HIV testing uptake in the 2018 DHS
Characteristics | Women | Men | ||||
---|---|---|---|---|---|---|
N | Percent (%) | 95% CI | N | Percent (%) | 95% CI | |
Age | ||||||
15–19 | 3112 | 52.3 | [50.8–53.9] | 2852 | 57.8 | [55.9–59.3] |
20–24 | 2687 | 47.7 | [46.1–49.2] | 1994 | 42.2 | [40.4–44.1] |
Education level | ||||||
No education | 237 | 3.6 | [2.9–4.4] | 133 | 3.0 | [2.3–4.0] |
Primary | 2313 | 39.0 | [37.0–41.0] | 1933 | 38.2 | [36.0–40.4] |
Secondary | 3118 | 54.8 | [52.8–56.8] | 2666 | 55.9 | [53.9–57.8] |
Higher | 131 | 2.6 | [1.9–3.5] | 114 | 2.9 | [2.1–3.9] |
Household wealth quintile | ||||||
Poorest | 1186 | 17.9 | [16.4–19.6] | 849 | 15.1 | [13.6–16.8] |
Poorer | 1132 | 17.5 | [16.0–19.2] | 961 | 17.3 | [15.6–19.0] |
Middle | 1153 | 18.2 | [16.5–20.1] | 1073 | 20.8 | [18.9–22.8] |
Richer | 1103 | 22.3 | [19.5–25.4] | 936 | 22.8 | [19.2–26.7] |
Richest | 1225 | 24.1 | [21.2–27.3] | 1027 | 24.0 | [20.8–27.7] |
Relationship status | ||||||
Never in union | 3681 | 63.1 | [60.8–65.3] | 4296 | 89.1 | [87.8–90.3] |
Currently in union | 1879 | 32.7 | [30.5–35.0] | 514 | 10.2 | [9.1–11.4] |
Formerly in union | 239 | 4.2 | [3.6–4.9] | 36 | 0.7 | [0.5–1.0] |
Residence | ||||||
Urban | 2335 | 46.0 | [43.1–48.9] | 1812 | 44.1 | [40.7–47.4] |
Rural | 3464 | 54.1 | [51.2–57.0] | 3034 | 56.0 | [52.6–59.3] |
Region | ||||||
Central | 612 | 8.9 | [7.9–9.9] | 533 | 8.9 | [7.9–10.1] |
Copperbelt | 683 | 16.2 | [13.8–19.0] | 558 | 15.3 | [13.3–17.5] |
Eastern | 661 | 12.0 | [10.6–13.5] | 574 | 13.1 | [11.7–14.7] |
Luapula | 599 | 7.8 | [6.8–9.0] | 530 | 8.1 | [7.1–9.4] |
Lusaka | 688 | 18.6 | [16.3–21.1] | 547 | 17.5 | [15.2–20.2] |
Muchinga | 501 | 5.6 | [4.8–6.7] | 435 | 5.6 | [4.9–6.3] |
Northern | 542 | 8.0 | [7.0–9.1] | 422 | 7.6 | [6.4–9.1] |
North western | 485 | 5.9 | [4.7–7.5] | 391 | 5.3 | [4.4–6.5] |
Southern | 572 | 11.1 | [9.0–13.7] | 489 | 12.8 | [9.5–17.2] |
Western | 456 | 5.9 | [5.1–6.8] | 367 | 5.6 | [4.7–6.6] |
Ever had sex | ||||||
No | 1741 | 30.2 | [28.4–32.0] | 1732 | 36.8 | [34.9–38.7] |
Yes | 4058 | 69.9 | [68.0–71.7] | 3114 | 63.2 | [61.3–65.1] |
Age at first sexual intercourseb | ||||||
Before 16 years | 1740 | 41.8 | [39.7–43.8] | 1425 | 44.1 | [41.7–46.4] |
At 16 years and above | 2318 | 58.3 | [56.2–60.3] | 1689 | 55.9 | [53.6–58.3] |
Number of sexual partners in the last 12 months | ||||||
None/never had sex | 2354 | 40.2 | [38.2–42.3] | 2384 | 50.3 | [48.3–52.3] |
One | 3350 | 58.1 | [56.1–60.1] | 1934 | 39.1 | [37.2–41.1] |
Two or more | 95 | 1.7 | [1.3–2.1] | 528 | 10.6 | [9.4–11.8] |
Condom used during last sexual intercourseb | ||||||
No | 3429 | 84.1 | [82.5–85.6] | 2119 | 67.4 | [65.2–69.5] |
Yes | 629 | 15.9 | [14.4–17.5] | 995 | 32.6 | [30.5–34.8] |
Heard about STI | ||||||
No | 115 | 1.8 | [1.5–2.3] | 43 | 0.8 | [0.6–1.2] |
Yes | 5684 | 98.2 | [97.7–98.5] | 4803 | 99.2 | [98.8–99.4] |
History of STI | ||||||
No | 5735 | 99.0 | [98.6–99.3] | 4692 | 97.0 | [96.3–97.6] |
Yes | 64 | 1.0 | [0.7–1.4] | 154 | 3.0 | [2.4–3.7] |
Heard about AIDS | ||||||
No | 189 | 3.0 | [2.5–3.7] | 76 | 1.5 | [1.2–2.0] |
Yes | 5610 | 97.0 | [96.3–97.5] | 4770 | 98.5 | [98.0–98.9] |
Reported stigma | ||||||
No | 888 | 15.5 | [14.1–17.0] | 517 | 9.3 | [8.3–10.5] |
Yes | 4048 | 69.6 | [67.7–71.3] | 3765 | 79.4 | [77.7–80.9] |
Don’t know | 863 | 14.9 | [13.7–16.3] | 564 | 11.3 | [10.1–12.7] |
Discriminatory attitudes | ||||||
No | 3966 | 69.5 | [67.9–71.1] | 3401 | 70.1 | [65.3–71.9] |
Yes | 1833 | 30.5 | [28.9–32.1] | 1445 | 29.9 | [28.1–31.8] |
Comprehensive knowledge of HIV | ||||||
No | 3269 | 55.2 | [53.1–57.3] | 2802 | 57.7 | [55.8–59.6] |
Yes | 2530 | 44.8 | [42.7–47.0] | 2044 | 42.3 | [40.4–44.2] |
Knowledge of a place to get HIV testa | ||||||
No | 417 | 6.8 | [6.0–7.7] | 389 | 7.9 | [6.9–8.9] |
Yes | 5382 | 93.2 | [92.3–94.0] | 4457 | 92.1 | [91.1–93.1] |
HIV Self testing | ||||||
Never heard of HIV self-test Kit | 4908 | 85.4 | [83.7–87.0] | 3926 | 80.3 | [78.4–82.1] |
Has tested with HIV self-test Kit | 105 | 2.6 | [2.0–3.5] | 89 | 2.5 | [1.8–3.4] |
Knows self-test kits but never tested with | 597 | 12.0 | [10.8–13.2] | 755 | 17.2 | [15.7–18.9] |
Circumcised | ||||||
No | 2952 | 62.6 | [60.4–64.7] | |||
Yes | 1894 | 37.4 | [35.3–39.6] | |||
Exposure to television | ||||||
Not at all | 3582 | 56.7 | [53.8–59.6] | 2424 | 45.6 | [42.9–48.3] |
Less than once a week | 341 | 6.0 | [5.2–6.9] | 565 | 11.9 | [9.9–14.3] |
At least once a week | 1876 | 37.3 | [34.6–40.1] | 1857 | 42.5 | [39.8–45.3] |
Exposure to radio | ||||||
Not at all | 3307 | 55.2 | [53.1–57.3] | 1766 | 34.6 | [32.5–36.8] |
Less than once a week | 721 | 13.6 | [12.4–14.8] | 697 | 15.0 | [13.6–16.6] |
At least once a week | 1771 | 31.2 | [29.3–33.1] | 2383 | 50.4 | [48.0–52.7] |
Use of internet | ||||||
Not at all | 5123 | 87.3 | [85.6–88.7] | 3709 | 73.8 | [71.5–76.1] |
Less than once a week | 118 | 2.1 | [1.7–2.6] | 234 | 5.3 | [4.5–6.3] |
At least once a week | 218 | 4.1 | [3.4–4.9] | 457 | 9.6 | [8.4–11.0] |
Almost everyday | 340 | 6.5 | [5.5–7.7] | 446 | 11.2 | [9.5–13.2] |
Owns a mobile phone | ||||||
No | 3471 | 56.8 | [54.6–58.9] | 2313 | 46.1 | [43.8–48.5] |
Yes | 2328 | 43.2 | [41.1–45.4] | 2533 | 53.9 | [51.6–56.2] |
HIV test in the last 12 months and received the result | ||||||
No | 2096 | 34.8 | [33.1–36.6] | 2591 | 51.2 | [48.4–54.0] |
Yes | 3703 | 65.2 | [63.4–67.0] | 2255 | 48.8 | [46.0–51.6] |
Respondent characteristics | N | HTC coverage (%) | Crude OR(95% CI) | P-value | Adjusted OR(95% CI) | P-value |
---|---|---|---|---|---|---|
Age | < 0.001 | < 0.001 | ||||
15–19 | 2484 | 45.8 | 1 | 1 | ||
20–24 | 1714 | 74.4 | 3.44 [2.98–3.98] | 1.74 [1.40–2.15] | ||
Education level | < 0.001 | < 0.001 | ||||
No education | 145 | 22.9 | 1 | 1 | ||
Primary | 1521 | 47.0 | 3.00 [1.89–4.75] | 3.14 [1.94–5.08] | ||
Secondary | 2418 | 65.5 | 6.41 [3.98–10.32] | 5.52 [3.30–9.25] | ||
Higher | 114 | 77.3 | 11.49 [5.14–25.68] | 6.97 [2.82–17.19] | ||
Household wealth quintile | < 0.001 | 0.04 | ||||
Poorest | 719 | 48.5 | 1 | 1 | ||
Poorer | 730 | 50.9 | 1.10 [0.88–1.38] | 0.99 [0.76–1.29] | ||
Middle | 790 | 56.3 | 1.37 [1.08–1.74] | 1.02 [0.76–1.37] | ||
Richer | 858 | 68.4 | 2.30 [1.74–3.04] | 1.41 [0.96–2.09] | ||
Richest | 1101 | 59.3 | 1.55 [1.23–1.96] | 0.90 [0.59–1.38] | ||
Relationship status | < 0.001 | 0.04 | ||||
Never in union | 3185 | 53.0 | 1 | 1 | ||
Currently in union | 850 | 73.5 | 2.46 [2.03–2.99] | 1.33 [0.99–1.79] | ||
Formerly in union | 163 | 73.1 | 2.42 [1.58–3.68] | 1.70 [1.04–2.78] | ||
Residence | < 0.001 | 0.23 | ||||
Urban | 1915 | 63.3 | 1 | 1 | ||
Rural | 2283 | 52.5 | 0.64 [0.54–0.76] | 0.85 [0.65–1.11] | ||
Region | < 0.001 | < 0.001 | ||||
Central | 445 | 57.3 | 0.85 [0.62–1.16] | 1.10 [0.78–1.54] | ||
Copperbelt | 549 | 61.3 | 1 | 1 | ||
Eastern | 419 | 53.4 | 0.72 [0.52–1.01] | 1.11 [0.76–1.62] | ||
Luapula | 414 | 41.5 | 0.45 [0.34–0.60] | 0.66 [0.48–0.90] | ||
Lusaka | 560 | 63.8 | 1.11 [0.82–1.51] | 1.00 [0.71–1.40] | ||
Muchinga | 363 | 41.7 | 0.45 [0.31–0.67] | 0.68 [0.47–0.99] | ||
Northern | 371 | 46.1 | 0.54 [0.37–0.79] | 0.90 [0.58–1.41] | ||
North western | 362 | 58.8 | 0.90 [0.62–1.32] | 1.07 [0.73–1.58] | ||
Southern | 406 | 67.1 | 1.29 [0.91–1.82] | 1.44 [0.98–2.11] | ||
Western | 309 | 73.0 | 1.71 [1.18–2.47] | 2.48 [1.63–3.77] | ||
Number of sexual partners | < 0.001 | < 0.001 | ||||
None | 2255 | 45.5 | 1 | 1 | ||
One | 1861 | 72.6 | 3.17 [2.72–3.70] | 2.13 [1.74–2.61] | ||
Two or more | 82 | 67.2 | 2.45 [1.37–4.40] | 1.61 [0.79–3.31] | ||
History of STI | 0.006 | 0.16 | ||||
No | 4161 | 57.9 | 1 | 1 | ||
Yes | 37 | 87.1 | 4.90 [1.60–15.03] | 2.63 [0.68–10.16] | ||
Reported stigma | < 0.001 | < 0.001 | ||||
No | 607 | 63.2 | 1.08 [0.87–1.34] | 1.26 [0.98–1.61] | ||
Yes | 2937 | 61.3 | 1 | 1 | ||
Don’t know | 654 | 39.0 | 0.40 [0.32–0.52] | 0.55 [0.42–0.72] | ||
Discriminatory attitudes | 0.01 | 0.12 | ||||
No | 2957 | 59.7 | 1 | 1 | ||
Yes | 1241 | 54.1 | 0.80 [0.67–0.95] | 1.16 [0.96–1.39] | ||
Comprehensive knowledge of HIV | < 0.001 | 0.18 | ||||
No | 2311 | 53.1 | 1 | 1 | ||
Yes | 1887 | 63.8 | 1.56 [1.32–1.83] | 1.13 [0.95–1.35] | ||
Exposure to television | 0.007 | 0.17 | ||||
Not at all | 2368 | 55.8 | 1 | 1 | ||
Less than once a week | 257 | 53.6 | 0.91 [0.69–1.22] | 0.72 [0.51–1.01] | ||
At least once a week | 1573 | 61.5 | 1.27 [1.07–1.50] | 0.88 [0.67–1.16] | ||
Exposure to radio | 0.003 | 0.21 | ||||
Not at all | 2311 | 56.1 | 1 | 1 | ||
Less than once a week | 537 | 55.6 | 0.98 [0.76–1.25] | 0.91 [0.69–1.18] | ||
At least once a week | 1350 | 62.3 | 1.29 [1.09–1.53] | 1.13 [0.92–1.40] | ||
Owns a mobile phone | < 0.001 | < 0.001 | ||||
No | 2400 | 45.5 | 1 | 1 | ||
Yes | 1798 | 72.6 | 3.17 [2.71–3.70] | 1.88 [1.52–2.33] | ||
Use of internet | < 0.001 | 0.24 | ||||
Not at all | 3609 | 56.0 | 1 | 1 | ||
Less than once a week | 100 | 55.0 | 0.96 [0.60–1.54] | 0.60 [0.34–1.05] | ||
At least once a week | 186 | 73.1 | 2.14 [1.42–3.21] | 1.26 [0.80–1.98] | ||
Almost everyday | 303 | 72.2 | 2.04 [1.55–2.69] | 0.98 [0.69–1.40] |
Respondent characteristics | N | HTC coverage (%) | Crude OR(95% CI) | P value | Adjusted OR(95% CI) | P value |
---|---|---|---|---|---|---|
Age | < 0.001 | < 0.001 | ||||
15–19 | 2852 | 37.5 | 1 | 1 | ||
20–24 | 1994 | 64.2 | 2.98 [2.58–3.45] | 1.55 [1.30–1.84] | ||
Education level | < 0.001 | < 0.001 | ||||
No education | 133 | 37.8 | 1 | 1 | ||
Primary | 1933 | 37.1 | 0.97 [0.59–1.61] | 1.02 [0.68–1.51] | ||
Secondary | 2666 | 56.4 | 2.13 [1.33–3.40] | 1.51 [1.01–2.26] | ||
Higher | 114 | 68.8 | 3.63 [1.98–6.65] | 1.41 [0.74–2.71] | ||
Household wealth quintile | 0.001 | < 0.001 | ||||
Poorest | 849 | 39.8 | 1 | 1 | ||
Poorer | 961 | 43.4 | 1.16 [0.93–1.44] | 1.23 [0.95–1.59] | ||
Middle | 1073 | 49.7 | 1.49 [1.20–1.86] | 1.36 [1.03–1.79] | ||
Richer | 936 | 56.8 | 1.99 [1.38–2.87] | 1.37 [0.99–1.90] | ||
Richest | 1027 | 50.0 | 1.52 [1.21–1.90] | 0.78 [0.53–1.15] | ||
Relationship status | < 0.001 | < 0.001 | ||||
Never in union | 4296 | 45.8 | 1 | 1 | ||
Currently in union | 514 | 74.0 | 3.37 [2.60–4.37] | 2.46 [1.85–3.28] | ||
Formerly in union | 36 | 65.1 | 2.21 [0.97–5.04] | 1.78 [0.74–4.27] | ||
Residence | < 0.001 | 0.06 | ||||
urban | 1812 | 54.6 | 1 | 1 | ||
rural | 3034 | 44.2 | 0.66 [0.52–0.83] | 0.72 [0.52–1.01] | ||
Region | < 0.001 | 0.002 | ||||
Central | 533 | 52.1 | 1.13 [0.84–1.51] | 1.44 [1.00–2.06] | ||
Copperbelt | 558 | 49.2 | 1 | 1 | ||
Eastern | 574 | 49.1 | 1.00 [0.74–1.34] | 1.41 [0.97–2.05] | ||
Luapula | 530 | 39.8 | 0.68 [0.50–0.92] | 0.96 [0.67–1.38] | ||
Lusaka | 547 | 52.4 | 1.12 [0.84–1.54] | 1.10 [0.79–1.53] | ||
Muchinga | 435 | 33.3 | 0.51 [0.35–0.76] | 0.76 [0.49–1.20] | ||
Northern | 422 | 41.6 | 0.73 [0.53–1.03] | 1.12 [0.77–1.64] | ||
North western | 391 | 44.8 | 0.84 [0.60–1.17] | 0.75 [0.51–1.10] | ||
Southern | 489 | 56.4 | 1.34 [0.70–2.54] | 1.39 [0.75–2.58] | ||
Western | 367 | 55.1 | 1.27 [0.93–1.73] | 1.45 [0.98–2.13] | ||
Ever had sex | < 0.001 | 0.14 | ||||
No | 1732 | 34.0 | 1 | 1 | ||
Yes | 3114 | 57.4 | 2.62 [2.27–3.01] | 1.19 [0.95–1.50] | ||
Number of sexual partners | < 0.001 | < 0.001 | ||||
None | 2384 | 37.1 | 1 | 1 | ||
One | 1934 | 61.2 | 2.67 [2.30–3.09] | 1.79 [1.41–2.27] | ||
Two or more | 528 | 58.4 | 2.37 [1.84–3.06] | 1.38 [0.99–1.91] | ||
History of STI | 0.26 | |||||
No | 4692 | 48.6 | 1 | – | ||
Yes | 154 | 54.1 | 1.25 [0.85–1.82] | – | ||
Circumcised | < 0.001 | < 0.001 | ||||
No | 2952 | 43.8 | 1 | 1 | ||
Yes | 1894 | 57.2 | 1.72 [1.46–2.02] | 1.58 [1.32–1.89] | ||
Reported stigma | < 0.001 | < 0.001 | ||||
No | 517 | 40.6 | 0.64 [0.50–0.81] | 0.65 [0.50–0.84] | ||
Yes | 3765 | 51.8 | 1 | 1 | ||
Don’t know | 564 | 34.3 | 0.49 [0.40–0.59] | 0.61 [0.49–74] | ||
Discriminatory attitudes | < 0.001 | 0.02 | ||||
No | 3401 | 52.3 | 1 | 1 | ||
Yes | 1445 | 29.8 | 0.63 [0.53–0.73] | 0.80 [0.67–0.97] | ||
Comprehensive knowledge of HIV | < 0.001 | 0.14 | ||||
No | 2802 | 44.8 | 1 | 1 | ||
Yes | 2044 | 54.2 | 1.46 [1.28–1.66] | 1.13 [0.96–1.33] | ||
Owns a mobile phone | < 0.001 | 0.002 | ||||
no | 2313 | 36.8 | 1 | |||
yes | 2533 | 59.0 | 2.47 [2.10–2.89] | 1.32 [1.11–1.57] | ||
Use of internet | < 0.001 | < 0.001 | ||||
Not at all | 3709 | 43.5 | 1 | 1 | ||
Less than once a week | 234 | 57.8 | 1.78 [1.32–2.39] | 1.41 [1.02–1.94] | ||
At least once a week | 457 | 63.0 | 2.21 [1.69–2.87] | 1.53 [1.13–2.08] | ||
Almost everyday | 446 | 66.9 | 2.62 [2.04–3.37] | 1.76 [1.32–2.35] | ||
Exposure to television | < 0.001 | 0.07 | ||||
Not at all | 2424 | 42.7 | 1 | 1 | ||
Less than once a week | 565 | 57.9 | 1.85 [1.30–2.61] | 1.38 [1.05–1.82] | ||
At least once a week | 1857 | 52.7 | 1.50 [1.29–1.73] | 1.08 [0.85–1.38] | ||
Exposure to radio | < 0.001 | 0.04 | ||||
Not at all | 1766 | 43.9 | 1 | 1 | ||
Less than once a week | 697 | 48.6 | 1.21 [1.00–1.47] | 0.86 [0.69–1.07] | ||
At least once a week | 2383 | 52.2 | 1.40 [1.22–1.59] | 1.12 [0.94–1.34] |