Factors Affecting Voluntary HIV Testing Among General Adult Population: A Cross-Sectional Study in Sarawak, Malaysia
Objective: Voluntary HIV testing is one of the key strategies in the HIV/AIDS prevention and control program. New National Strategic Plan for 2016-2030 in Malaysia, adapt three zeros viz. ‘zero new infections of HIV/AIDS, zero discrimination and zero AIDS-related deaths’. This study aimed to determine the predictors of voluntary HIV testing in Sarawak.
Materials and methods: A cross-sectional study was conducted with a total of 900 respondents
(450 males and 450 females) from the state of Sarawak, aged 18 years and above, who were selected by gender-stratified multistage cluster sampling. Data were obtained by face-to-face interview using a pretested questionnaire. Binary logistic regression analysis was done to determine the potential predictors for voluntary HIV testing.
Results: The prevalence of HIV testing was higher among female respondents (26%) compared to male respondents (14.2%), and the difference was statistically significant (p < 0.001). Binary logistic regression analysis revealed that household income more than MYR 1501 (p = 0.009), not living with a partner (p < 0.001) and discussion on HIV/AIDS (p = 0.019) appeared to be predictors for the male respondents, while, ethnicity was statistically significant for female respondents (p < 0.001).
Conclusion: The utilisation of HIV testing was low in both males and females. Thus, the finding of this study could be considered when designing HIV education and screening program in Sarawak.
2. Malaysian AIDS Council. Snapshot of HIV & AIDS in Malaysia 2016. Kuala Lumpur; 2016:1-4.
3. Sarawak State Health Department. Sarawak Weekly Epid News 2016. Sarawak; 2016: 1–311.
4. Berkley-Patton J, Moore EW, Hawes SM, Thompson CB, Bohn A. Factors Related to HIV Testing Among an African American Church-Affiliated Population. AIDS Educ Prev 2012; 24: 148–62.
5. Gianella S, von Wyl V, Fischer M, Niederoest B, Battegay M, Bernasconi E, et al. Effect of Early Antiretroviral Therapy During Primary HIV-1 Infection on Cell-Associated HIV-1 DNA and Plasma HIV-1 Rna. Antivir Ther 2011; 16: 535–45.
6. Wong LP. Prevalence and factors associated with HIV/AIDS-related stigma and discriminatory attitudes: a cross-sectional nationwide study. Prev Med 2013; 57 Suppl: S60-3.
7. Ministry of Health, Malaysia. The national strategic plan for ending aids 2016-2030. Putra Jaya 2015.
8. Hall HI, Holtgrave DR, Maulsby C. HIV Transmission Rates from Persons Living with HIV Who Are Aware and Unaware of Their Infection. AIDS 2012; 26: 893–6.
9. Denison JA, O’Reilly KR, Schmid GP, Kennedy CE, Sweat MD. HIV Voluntary Counseling and Testing and Behavioral Risk Reduction in Developing Countries: A Meta-Analysis, 1990-2005. AIDS Behav 2008; 12: 363–73.
10. Mabuto T, Latka MH, Kuwane B, Churchyard GJ, Charalambous S, Hoffmann CJ. Four Models of HIV Counseling and Testing: Utilization and Test Results in South Africa. PloS One 2014; 9: e102267.
11. Gilks CF, Crowley S, Ekpini R, Gove S, Perriens J, Souteyrand Y, et al. The WHO Public-Health Approach
to antiretroviral treatment against HIV in resource-limited settings. Lancet 2006; 368: 505–10.
12. Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 Infection with Early Antiretroviral Therapy. N Engl J Med 2011; 365: 493–505.
13. Leta TH, Sandøy IF, Fylkesnes K. Factors Affecting Voluntary HIV Counselling and Testing Among Men in Ethiopia: A Cross-Sectional Survey. BMC Public Health 2012; 12:438.
14. Obermeyer CM, Neuman M, Hardon A, Desclaux A, Wanyenze R, Ky-Zerbo O, et al. Socio-economic determinants of HIV testing and counselling: a comparative study in four African countries. Trop Med Int Health 2013; 18: 1110–8.
15. Hutchinson PL, Mahlalela X. Utilization of voluntary counseling and testing services in the Eastern Cape, South Africa. AIDS Care 2006; 18: 446–55.
16. Godif M, Assefa H, Alemayehu M, Terefe W. Factors Associated with HIV Counseling and Testing among Males and Females in Ethiopia: Evidence from Ethiopian Demographic and Health Survey Data. J AIDS Clin Res 2015; 6: 1–11.
17. Matovu JK, Makumbi FE. Expanding access to voluntary HIV counselling and testing in Sub-saharan Africa: alternative approaches for improving uptake, 2001-2007. Trop Med Int Health 2007; 12: 1315–22.
18. Global Health Data Exchange ,Malaysia UNGASS Country Progress Report 2010 .
19. Ugarte WJ, Högberg U, Valladares EC, Essén B. Measuring HIV and AIDS-related stigma and discrimination in Nicaragua: results from a community-based study. AIDS Educ Prev 2013; 25: 164–78.
20. Banteyerga H, Aklilu K, Laura N, Kerry M, Rohini P. Exploring HIV and AIDS Stigma and Related Discrimination in Ethiopia: Causes, Manifestations, Consequences and Coping Mechanisms. 2003.
21. Ragimana MA. Factors related to the stigma associated with HIV/AIDS in Attridgeville and Mamelodi .Thesis and Disseration (University of Pretoria); 2006.
22. Li L, Rotheram-Borus MJ, Lu Y, Wu Z, Lin C, Guan J. Mass Media and HIV/AIDS in China. J Health Commun 2009; 14: 424–38.
23. Anita S, Zahir WM, Sa’iah A, Rahimah MA, Sha’ari BN. HIV/AIDS Knowledge, Attitudes and Risk Behaviours Among Orang Asli in Peninsular Malaysia. Med J Malaysia 2007; 62: 227–33.
24. Shiferaw Y, Alemu A, Girma A, Getahun A, Kassa A, Gashaw A, et al. Assessment of knowledge, attitude and risk behaviours towards HIV/AIDS and other sexual transmitted infection among preparatory students of Gondar town, North West Ethiopia. BMC Res Notes 2011;4:505.
25. IBM SPSS Statistics for Windows. Armonk, New York, IBM Corp; 2013.
26. Molla M, Emmelin M, Berhane Y, Lindtjørn B. Readiness of youth in rural Ethiopia to seek health services for sexually transmitted infections. Afr J AIDS Res 2009; 8: 135–46.
27. Weiser SD, Heisler M, Leiter K, Percy-de Korte F, Tlou S, DeMonner S, et al. Routine HIV testing in Botswana: a population-based study on attitudes, practices, and human rights concerns. PLoS Med 2006; 3: e261.
28. Peltzer K, Matseke G, Mzolo T, Majaja M. Determinants of knowledge of HIV status in South Africa: results from a population-based HIV survey. BMC Public Health 2009; 9: 174.
29. Byamugisha R, Tumwine JK, Semiyaga N, Tylleskär T. Determinants of Male Involvement in the Prevention of Mother-to-Child Transmission of HIV Programme in Eastern Uganda: A Cross-Sectional Survey. Reprod Health 2010; 7: 12.
30. Chandisarewa W, Stranix-Chibanda L, Chirapa E, Miller A, Simoyi M, Mahomva A, et al. Routine Offer of antenatal HIV testing (“opt-Out” approach) to Prevent mother-to-child transmission of HIV in Urban Zimbabwe. Bull World Health Organ 2007; 85: 843–50.
31. Babalola S. Readiness for HIV Testing Among Young People in Northern Nigeria: The Roles of Social Norm and Perceived Stigma. AIDS Behav 2007; 11: 759–69.
32. Sambisa W, Curtis S, Mishra V. Aids stigma as an obstacle to uptake of HIV testing: evidence from a Zimbabwean national population-based survey. AIDS Care 2010; 22: 170–86.
33. Galdas PM, Cheater F, Marshall P. Men and Health Help-Seeking Behaviour: Literature Review. J Adv Nurs 2005; 49: 616–23.
34. Le Coeur S, Collins IJ, Pannetier J, Lelièvre E. Gender and Access to HIV Testing and Antiretroviral Treatments in Thailand: Why Do Women Have More and Earlier Access? Soc Sci Med 2009; 69: 846–53.
35. Caldeira KM, Singer BJ, O’Grady KE, Vincent KB, Arria AM. HIV Testing in Recent College Students: Prevalence and Correlates. AIDS Educ Prev 2012; 24: 363–76.
36. Chirawu P, Langhaug L, Mavhu W, Pascoe S, Dirawo J, Cowan F. Acceptability and Challenges of Implementing Voluntary Counselling and Testing (VCT) in Rural Zimbabwe: Evidence from the Regai Dzive Shiri Project. AIDS Care 2010; 22: 81–8.
37. Matovu JK, Gray RH, Makumbi F, Wawer MJ, Serwadda D, Kigozi G, et al. Voluntary HIV counseling and testing acceptance, sexual risk behavior and HIV incidence in Rakai, Uganda. AIDS 2005; 19: 503–11.
38. Yahaya LA, Jimoh A A, Balogun OR. Factors hindering acceptance of HIV/AIDS voluntary counselling and testing (VCT) among youth in Kwara state, Nigeria. Afr J Reprod Health 2010; 14: 159–64.
39. Ziraba AK, Madise NJ, Kimani JK, Oti S, Mgomella G, Matilu M, et al. Determinants for HIV testing and counselling in Nairobi urban informal settlements. BMC Public Health 2011; 11: 663.
40. Morin SF, Khumalo-Sakutukwa G, Charlebois ED, Routh J, Fritz K, Lane T, et al. Removing barriers to knowing HIV status: same-day mobile HIV testing in Zimbabwe. J Acquir Immune Defic Syndr 2006; 41: 218–24.
41. Homsy J, King R, Malamba SS, Opio C, Kalamya JN, Mermin J, et al. The Need for Partner Consent Is a Main Reason for Opting Out of Routine HIV Testing for Prevention of Mother-to-Child Transmission in a Rural Ugandan Hospital. J Acquir Immune Defic Syndr 2007; 44: 366-9.
42. Thior I, Gabaitiri L, Grimes J, Shapiro R, Lockman S, Kim S, et al. Voluntary counselling and testing among post-partum women in Botswana. Patient Educ Couns 2007; 65: 296–302.
43. Storey D, Seifert-Ahanda K, Andaluz A, Tsoi B, Matsuki JM, Cutler B. What is health communication and how does it affect the HIV/AIDS continuum of care? A brief primer and case study from New York city. J Acquir Immune Defic Syndr 2014; 66 Suppl: S241-9.
44. Hendriksen ES, Hbulinka D, Chariyalertsak S, Chingono A, Gray G, Mbwambo J, et al. Keep Talking About It: HIV/AIDS-Related Communication and Prior HIV Testing in Tanzania, Zimbabwe, South Africa, and Thailand. AIDS Behav 2009; 13: 1213–21.
45. MacPhail C, Pettifor A, Moyo W, Rees H. Factors associated with HIV testing among sexually active South African youth aged 15–24 years. AIDS Care 2009; 21: 456–67.
46. Mitchell S, Cockcroft A, Lamothe G, Andersson N. Equity in HIV testing: evidence from a cross-sectional study in ten Southern African countries. BMC Int Health Hum Rights 2010; 10: 23.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.