Examining sex differentials in the uptake and process of HIV testing

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Examining sex differentials in the uptake and process of HIV testing in three

high prevalence districts of India

Citation: AIDS Care (2010) 22 (3) 286-295 [DOI: 10.1080/09540120903193674]

S. ph; K. Kielmann; A. Kudale; K. Sheikh; S. Shinde; J. Porter; and S.

Rangan

Document: http://dx.doi.org/10.1080/09540120903193674

Summary:

Sex differentials in the uptake of HIV testing have been reported in a range of

settings, however, men's and women's testing patterns are not consistent across

these settings, suggesting the need to set sex differentials against gender

norms in patient testing behaviour and provider practices.

A community-based, cross-sectional survey among 347 people living with HIV in

three HIV high prevalence districts of India examined reasons for undergoing an

HIV test, location of testing and conditions under which individuals were

tested.

HIV testing was almost always provider-initiated for men. Men were more likely

to be advised to test by a private practitioner and to test in the private

sector. Women were more likely to be advised to test by a family member, and to

test in the public sector.

Men were more likely to receive pre-test information than women, when tested in

the private sector. Men were also more likely to receive direct disclosure of

their HIV positive status by a health provider, regardless of the sector in

which they tested.

More women than men were repeatedly tested for HIV, regardless of sector.

These sex differentials in the uptake and process of HIV testing are partially

explained through differences in public and private sector testing practices.

However, they also reflect women's lack of awareness and agency in HIV care

seeking and differential treatment by providers.

Examining gender dynamics that underpin sex differentials in HIV testing

patterns and practices is essential for a realistic assessment of the challenges

and implications of scaling-up HIV testing and mainstreaming gender in HIV/AIDS

programmes.

[A pdf copy of this article is avaialbe from AIDS INDIA eFORUM editor, for

review]