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Why Zambians don't test and treat
Gus Cairns, 2012-07-26 03:10:00
A study amongst 2443 people in Zambia, recruited from HIV clinics and community organisations, found that social ostracism, rejection by sexual partners and fear of not being able to handle antiretroviral therapy (ART) were the reasons people most often gave for not testing for HIV. A session at the 19th International AIDS Conference (AIDS 2012) in Washington heard that, perhaps surprisingly, in terms of demographic characteristics, people living in cities were far less likely to test than people in rural areas. Unmarried people and men were also less likely to test, as were people who did not belong to community associations or attend church.
Religious beliefs, on the other hand, were the second most common reason people gave for not taking ART if they did test, the most common being that they felt healthy. In demographic terms, the characteristic most strongly associated with failing to take ART when it was indicated was a belief in traditional medicine.
The study was a mixed qualitative/quantitative survey and consisted of two groups of people: 1764 people sampled at random from local communities and another 551 people known to have HIV who attended HIV clinics. Sixty per cent of those questioned were women and 59% married; 50% lived in urban areas and 80% were employed. While the majority were in the 25 to 40 age group, 13% were under 25 and 16% were over 55.
In the random community sample, 1231 (70%) had ever taken an HIV test and 238 (13.5%) were HIV positive, of whom 164 (9.3%, or 69% of those with HIV) were on ART. HIV prevalence in this survey reflects previous estimates of national prevalence, but a far higher proportion of people had tested than UNAIDS estimates, which cite testing rates of 35% in women and 20% in men. Another impetus behind the survey was that loss to follow-up in Zambian ART programmes is as high as 33% and researchers wanted to find out why people dropped out of treatment.
In the qualitative part of the survey, people both tested and untested were asked to agree or disagree with a number of reasons to test or not to test, and the HIV-positive ones, whether they were on ART or not, with a number of reasons to take or not take treatment.
Source:1
