Self-reported non-receipt of HIV test results: A silent barrier to HIV epidemic control in Mozambique.

Abstract

INTRODUCTION:People living with HIV (PLHIV) and who are aware of their HIV status can access and benefit from antiretroviral therapy (ART) with subsequent individual and public health benefits; however, many PLHIV are unaware of their HIV status. We assessed the magnitude and determinants of self-reported non-receipt of HIV test results in adults aged 15-59 years old in Mozambique. METHODS:We performed a secondary analysis of data from the 2015 Mozambique Immunization indicators, Malaria and HIV/AIDS (IMASIDA 2015). Eligible adults (15-59 years) from each selected household were interviewed and data on sociodemographic characteristics, HIV knowledge, attitudes and behaviors, and HIV testing history were collected. Multivariable logistic regression assessed factors associated with self-reported non-receipt of HIV test results. Population representative estimates were calculated. RESULTS:13,028 (90.8%) of 14,343 eligible participants were interviewed. A total of 6,654 (51.1%) respondents had previously been tested for HIV and were included in the analysis. Of these, 308 (4.6%; 95% CI: 3.70-5.77) self-reported not having received HIV test results. In the multivariable analysis, previous sexually transmitted infection (aOR: 2.76; 95% CI: 1.44-5.31), HIV stigmatizing attitudes (aOR: 1.96; 95% CI: 1.14-3.37), and lack of decision-making power towards health care seeking (aOR: 2.51; 95% CI: 1.39-4.52) were associated with non-receipt of HIV test results. Whereas, secondary or higher education (aOR: 0.25; 95% CI: 0.12-0.54), higher HIV knowledge (aOR: 0.47; 95% CI: 0.26-0.86), and age between 30-34 and 35-39 years old (aOR 0.47; 95% CI: 0.28-0.80; and aOR: 0.49; 95% CI: 0.27-0.90, respectively), were associated with receipt of HIV test results. CONCLUSIONS:In this nationally representative survey, self-reported non-receipt of HIV test results was high and of public health relevance. These findings suggest adaptation of HIV counseling and testing programs emphasizing individualized approaches that target the youngest, least educated and the poorest individuals, especially those living in rural areas.