62
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Risk perception and HIV testing
The uptake of HIV testing in each of the different risk categories was compared. The results are as shown in the tables below:
Table 4.6: Risk Perception and Uptake of HIV Testing
Risk perception History of HIV testing Total
Tested Not tested
Low chance 200 (39.8%) 303(60.2%) 503(100%)
High chance 19(30.2%) 44 (69.8%) 63(100%)
Total 219 (38.7%) 347 (61.3%) 566(100%)
There was no significant difference in uptake of HIV testing between those who felt they had a low risk of infection and those who felt they had a high risk. (Fischer’s exact x2=2.176 df = 1 p=0.140).
The crude odds ratio was 1.529 (CI 0.858 – 2.695)
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The results were stratified by knowledge to determine if level of knowledge was a confounder as shown in the table below:
Table 4.7: Knowledge, Risk Perception and Uptake of HIV Testing
Risk perception
Good knowledge Poor knowledge
Tested Not tested
Total
Tested Not tested
Total
Low chance 197(40.6%) 288(59.4%) 485(100%) 3(16.7%) 15(83.3%) 18(100%)
High chance
19 (31.7%) 41(68.3%) 60(100%) 0 (0%) 3 (100%) 3(100%)
Total 216 (39.6%) 329 (60.4%) 545(100%) 3 (14.3%) 18(85.7%) 21(100%)
The Mantel-Haenszel adjusted odds ratio was 1.519 (CI 0.867 – 2.695). The percentage difference between the crude (1.529) and adjusted odds ratios was calculated and found to be less than 10%
(1.529-1.519/1.529 x 100 = 0.66 %), indicating that knowledge had no significant confounding effect.
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Risk perception HIV testing and Gender
The relationship between risk perception and HIV testing was stratified by gender as shown in the tables below:
Table 4.8: Risk Perception and Uptake of HIV Testing (Men)
Risk perception
History of HIV testing
Tested Not tested Total
Low chance
83(35.0%) 154(65.0%) 237(100%)
High chance
6 (25.0%) 18(75.0%) 24(100%)
Total
89 (34.1) 172 (65.9) 261(100%)
The proportions of those who had not tested were highest amongst men who felt they had a high chance of infection but the difference in uptake of HCT amongst the different categories was not statistically significant ( x2=0.974 df = 1 p=0.324) .
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The results were stratified by gender and the findings were as shown below:
Table 4.9: Risk Perception and Uptake of HIV Testing (Women)
Risk perception
History of HIV testing
Tested Not tested Total
Low chance 117 (44.0%) 149(56.0%) 266(100%)
High chance 13 (33.3%) 26(66.7%) 39(100%)
Total 130(42.6%) 175 (57.4%) 305(100%)
The proportions of women who had not undergone a HIV test was highest amongst those who felt they had a high chance of getting infected but the difference in uptake of HIV testing amongst the different categories was not statistically significant ( x2= 1.578 df = 1, p= 0.209) .
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Risk behaviour
Responses to questions on high risk behaviour were as shown in the table below:
Table 4.10: Response to Questions on High Risk Behaviour
Risk behaviour
Men Women Significance test
YES (%) NO (%) YES (%) NO (%) X2 P
Have you ever had sex?
226(83.7) 44(16.3) 302(92.9) 23(7.1) 12.545 0.000
Have you had sex with a non-marital
partner in last 12 months?
125(46.3) 145(53.7) 112(34.6) 212(65.4) 8.448 0.000
Have you engaged in extra-marital sex without a condom in
the last 12 months
76(28.3) 193(71.7) 75(23.1) 250(76.9) 2.08 0.150
A significant proportion of women were sexually active compared to men whilst a significant proportion of men engaged in extramarital sex compared to women.
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Risk assessment
Respondents’ assessed risk based on their total scores (score < 5‘low risk’ or score>5 ‘high risk’).
More men were assessed as having a high risk compared to women and the observation was statistically significant. The chart below shows the results:
Figure 4.9: Risk Assessment in Men and Women
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Comparison of assessed and perceived risk
Respondent’s perceived risk was compared to their risk assessment. The results are as shown in the tables below:
Table 4.11: Perceived Risk versus Assessed Risk
Perceived risk
Assessed risk
Low High Total
Low chance 381(75.7%) 122(24.3%) 503(100%)
High chance 18(28.6%) 45(71.4%) 63(100%)
Total 399(70.5%) 167(29.5%) 566(100%)
There was a significant difference between respondents perceived risk and their assessed risk (x2=59.9 df = 1 p=0.000).
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Perceived and assessed risk was compared for both men and women and the results were as shown below:
Table 4.12: Comparison of Perceived and Assessed Risks by Gender
Gender Assessed risk same as perceived risk
Assessed risk different from perceived risk
Total
Men 171 (65.5%) 90(34.5%) 261(100%)
Women 255(83.6%) 50(16.4%) 305(100%)
Total 426(75.3%) 140(24.7%) 566(100%)
A greater proportion of women assessed their risk correctly compared to men. The Kappa score for men was 0.148 whilst that for women was 0.437. Using a Kappa scale recommended by Altman 130 where: < 0.20 – poor, 0.20 -0.40 – fair, 0.41 – 0.60- moderate, 0.61 – 0.80 – good and 0.81 –1.00- very good, the results indicated that women have a better perception of their risk compared to men.
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Uptake of HIV testing in the two risks was analysed and results are as shown in the table below:
Table 4.13: Assessed Risk and Uptake of HIV Testing
Assessed risk
History of HIV testing
Total
Tested Not tested
Low risk 174(41.1%) 249 (58.9%) 423(100%)
High risk 52 (30.0%) 121 (70.0%) 173(100%)
Total 226 (37.9%) 370(62.1%) 596(100%)
A greater proportion of persons who were assessed as high risk had not undergone a HIV test compared to those who were assessed as having a low risk. This difference was statistically significant (x2= 6.40 df = 1, p= 0.011).
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The results were stratified and analysed by gender. The uptake of testing amongst men is as shown in the tables below:
Table 4.14: Assessed Risk and Uptake of HIV Testing (Men)
Assessed risk History of HIV testing
Tested Not tested Total
Low risk 59 (35.1%) 109(64.9%) 168(100%)
High risk 32 (31.4%) 70(68.6%) 102(100%)
Total
91(33.7%) 179 (66.3%) 270(100%)
There was no statistical significant difference in uptake of HIV testing between the two risk groups amongst the men (x2= 0.399 df = 1, p= 0.528).
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Table 4.15: Assessed Risk and Uptake of HIV Testing (Women)
History of HIV testing
Assessed risk
Tested Not tested Total
Low risk 115 (45.1%) 140(54.9%) 255(100%)
High risk 20 (28.2%) 51(71.8%) 71(100%)
Total 135(41.4%) 191(58.6%) 326(100%)
Amongst women, there was a statistical significant difference in uptake of HIV testing between those assessed as high risk and those assessed as low risk ( x2= 6.56df = 1, p= 0.010)
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4.6: STIGMA AND UPTAKE OF HIV TESTING