Introduction: The aim of this study was to assess the factors associated with HIV testing among in sexually active women and men in Senegal. Knowledge of HIV status is the gateway to antiretroviral treatment. Despite the adoption of the provider-initiated HIV testing strategy, the rate of HIV testing is still very low in sub-Saharan Africa.
Methods: A secondary analysis of the 2017 Senegal Demographic and Health Survey (DHS) was performed using data on sexually active women age 15-49 and men age 15-59. The outcome variable was the proportion of women and men who reported ever being tested for HIV in the last 12 months before the survey. Descriptive, bivariate, and multivariable logistic regression analyses were performed to identify the sociodemographic, HIV knowledge, media exposure, and behavioral factors associated with HIV testing in Senegal.
Results: The study found that 62% of women and 27% of men were tested for HIV in the last 12 months before the survey. In multivariate analysis, among men the factors independently associated with being tested for HIV were: older age group (50-54); a high level of education; being in the richest household wealth quintile; being married; knowing about the efficacy of HART during pregnancy; and owning a mobile phone. Among women factors independently associated with HIV testing were: older age group (30-34); a high level of education; being in the richest household wealth quintile; being married; knowing about the efficacy of HART during pregnancy; having any sexually transmitted infection (STI) in last 12 months; fearing stigma; owning a mobile phone; and having any number of ANC visits, versus none. By region of residence, compared with the West zone, men in the North and South-East zones were significantly less likely to have been tested for HIV in the 12 months before the survey. Similarly, women in the North, Center, and South-East zones were less likely to be tested for HIV compared with the West zone.
Conclusion: Although HIV remains a public health threat, 73% of men and 38% women in Senegal were not tested for HIV in the last 12 months. Low prevalence of HIV testing makes it difficult to interrupt the transmission chain within the community and to reach the UNAIDS goal for 2020 of 90% of HIV-positive people being aware of their status, 90% of those receiving antiretroviral therapy, and 90% of those virally suppressed. Innovative community-based strategies are needed to address barriers and improve access to HIV testing, particularly for men and for the youngest and poorest populations, and to narrow the disparities in awareness of HIV status in Senegal.