HIV Testing and Tolerance to Gender Based Violence: A Cross-Sectional Study in Zambia |
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| Authors: | Sara Gari Jacob R. S. Malungo Adriane Martin-Hilber Maurice Musheke Christian Schindler Sonja Merten |
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| Affiliation: | 1. Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland.; 2. Department of Population Studies, University of Zambia, Lusaka, Zambia.; 3. Swiss Centre of International Health, Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland.; Vanderbilt University, United States of America, |
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| Abstract: | ![]()
This paper explores the effect of social relations and gender-based conflicts on the uptake of HIV testing in the South and Central provinces of Zambia. We conducted a community-based cross-sectional study of 1716 randomly selected individuals. Associations were examined using mixed-effect multivariable logistic regression. A total of 264 men (64%) and 268 women (56%) had never tested for HIV. The strongest determinants for not being tested were disruptive couple relationships (OR = 2.48 95% CI = 1.00–6.19); tolerance to gender-based violence (OR = 2.10 95% CI = 1.05–4.32) and fear of social rejection (OR = 1.48 95% CI = 1.23–1.80). In the Zambian context, unequal power relationships within the couple and the community seem to play a pivotal role in the decision to test which until now have been largely underestimated. Policies, programs and interventions to rapidly increase HIV testing need to urgently address gender-power inequity in relationships and prevent gender-based violence to reduce the negative impact on the lives of couples and families. |
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