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Actual Versus Perceived HIV Testing Norms, and Personal HIV Testing Uptake: A Cross-Sectional, Population-Based Study in Rural Uganda

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Abstract

HIV testing is an essential part of treatment and prevention. Using population-based data from 1664 adults across eight villages in rural Uganda, we assessed individuals’ perception of the norm for HIV testing uptake in their village and compared it to the actual uptake norm. In addition, we examined how perception of the norm was associated with personal testing while adjusting for other factors. Although the majority of people had been tested for HIV across all villages, slightly more than half of men and women erroneously thought that the majority in their village had never been tested. They underestimated the prevalence of HIV testing uptake by 42 percentage points (s.d. = 17 percentage points), on average. Among men, perceiving that HIV testing was not normative was associated with never testing for HIV (AOR = 2.6; 95% CI 1.7–4.0, p < 0.001). Results suggest an opportunity for interventions to emphasize the commonness of HIV testing uptake.

Resumen

La prueba de VIH es una parte esencial en el tratamiento y prevención de la enfermedad. Utilizando una base de datos de 1664 adultos, representando la población de ocho aldeas de una zona rural de Uganda, examinamos cómo individuos percibían la norma de la realización de la prueba de VIH en su aldea y la comparamos con la norma actual. Además, examinamos cómo la percepción de la norma se asoció con la realización personal de la prueba, mientras ajustamos por otros factores. Aunque la mayoría de la gente en cada aldea se había realizado la prueba de VIH, más de la mitad de los hombres y de las mujeres pensaron erróneamente que la mayoría de la gente en su aldea nunca se realizó la prueba de VIH. Ellos subestimaron la prevalencia de la realización de la prueba de VIH en 42 puntos porcentuales (s.d. = 17 puntos porcentuales), en promedio. Entre los hombres, la percepción de que la realización de la prueba no era la normativa estuvo asociada con nunca haberse hecho la prueba del VIH (AOR = 2.6, 95% CI: 1.7–4.0; p < 0.001). Nuestros resultados sugieren una oportunidad en las intervenciones para enfatizar el carácter común de la realización de la prueba de VIH.

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Acknowledgements

We thank the Emikago Study team, for their assistance with data collection and study administration; and Niels Rosenquist, Sae Takada, Peggy Bartek, Anna Baylor, Nozmo F.B. Mukiibi, and Roberts Muriisa, for their assistance with study administration and infrastructure development.

Funding

This study was supported by Friends of a Healthy Uganda and by a Roybal Center grant through U.S. National Institutes of Health (NIH) P30AG034420. The authors also acknowledge salary support from NIH K23MH096620.

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Authors and Affiliations

  1. Chester M. Pierce, MD Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA, USA

    Jessica M. Perkins & Alexander C. Tsai

  2. Harvard Center for Population and Development Studies, Cambridge, MA, USA

    Jessica M. Perkins, Alexander C. Tsai & S. V. Subramanian

  3. Mbarara University of Science and Technology, Mbarara, Uganda

    Viola N. Nyakato, Bernard Kakuhikire, Alexander C. Tsai & David R. Bangsberg

  4. Uganda National Council for Science & Technology, Kampala, Uganda

    Pamela K. Mbabazi

  5. Hobart and William Smith Colleges, Geneva, NY, USA

    H. Wesley Perkins

  6. Harvard T.H. Chan School of Public Health, Boston, MA, USA

    S. V. Subramanian

  7. Yale University, New Haven, CT, USA

    Nicholas A. Christakis

  8. Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA

    David R. Bangsberg

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  4. Pamela K. Mbabazi
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  5. H. Wesley Perkins
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  6. Alexander C. Tsai
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  7. S. V. Subramanian
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  8. Nicholas A. Christakis
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  9. David R. Bangsberg
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Corresponding author

Correspondence to Jessica M. Perkins.

Ethics declarations

Conflict of interest

Jessica M Perkins declares that she has no conflict of interest. Viola N Nyakato declares that she has no conflict of interest. Bernard Kakuhikire declares that he has no conflict of interest. Pamela K. Mbabazi declares that she has no conflict of interest. H. Wesley Perkins declares that he has no conflict of interest. Alexander C. Tsai declares that he has no conflict of interest. S. V. Subramanian declares that he has no conflict of interest. Nicholas A. Christakis declares that he has no conflict of interest. David R. Bangsberg declares that he has no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Perkins, J.M., Nyakato, V.N., Kakuhikire, B. et al. Actual Versus Perceived HIV Testing Norms, and Personal HIV Testing Uptake: A Cross-Sectional, Population-Based Study in Rural Uganda. AIDS Behav 22, 616–628 (2018). https://doi.org/10.1007/s10461-017-1691-z

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