ArticleBMC public health2020
Use and awareness of and willingness to self-test for HIV: an analysis of cross-sectional population-based surveys in Malawi and Zimbabwe.
Article in BMC public health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed, 41 citations in OpenAlex.
- Do community measures impact the effectiveness of a community led HIV testing intervention. Secondary analysis of an HIV self-testing intervention in rural communities in Zimbabwe.BMC infectious diseases · 2023Trial
- Did you hear about HIV self-testing? HIV self-testing awareness after community-based HIVST distribution in rural Zimbabwe.BMC infectious diseases · 2022Trial
- Trial
- Trends in HIV self-testing uptake in Africa: A modeling study of population-based surveys and HIV testing program data.PLoS medicine · 2026Article
- Facility-Level Associations Between Use of a Digital Health Platform for Voluntary Counseling and Testing and HIV Testing Outcomes in the Urban Primary Health Care Centers of Guangzhou, China: Cross-Sectional Study.Journal of medical Internet research · 2026Article
- The loss to follow-up of participants excluded from the NAMSAL trial: a retrospective cohort study.Scientific reports · 2025Article
- Empowering Vulnerable Communities Through HIV Self-Testing: Post-COVID-19 Strategies for Health Promotion in Sub-Saharan Africa.International journal of environmental research and public health · 2025Article
- Unlocking self-testing: predictors of HIV self-testing kit use among reproductive-aged women in tanzania; a multilevel analysis of the 2022 demographic and health survey.AIDS research and therapy · 2025Article
- Article
- Prevalence and factors associated with awareness and use of HIV self-testing kits among young women aged 15-24 in Ghana.AIDS research and therapy · 2025Article
- Who has never tested for HIV following a community-based distribution of HIV self-test kits? Establishing associated predictors in rural Zimbabwe.PLOS global public health · 2025Article
- Advances in HIV self-testing: Systematic review of current developments and the road ahead in high-burden countries of Africa.SAGE open medicine · 2024Review
- Article
- The association between HIV self-test awareness and recent HIV testing uptake in the male population in Gambia: data analysis from 2019-2020 demographic and health survey.BMC infectious diseases · 2023Article
- HIV self-testing: a cross-sectional survey conducted among students at a tertiary institution in Johannesburg, South Africa in 2020.Journal of public health in Africa · 2023Article
- Uptake of HIV Self-Testing and Associated Factors Among Female Sex Workers at Non-Governmental HIV Testing Facilities in Debre Markos and Bahir Dar Towns, Northwest Ethiopia, 2022.HIV/AIDS (Auckland, N.Z.) · 2023Article
- Impact of voluntary testing on infectious disease epidemiology: A game theoretic approach.PloS one · 2023Article
- Factors associated with HIV-positive status awareness among adults with long term HIV infection in four countries in the East and Southern Africa region: A multilevel approach.PLOS global public health · 2023Article
- Characteristics of users of HIV self-testing in Kenya, outcomes, and factors associated with use: results from a population-based HIV impact assessment, 2018.BMC public health · 2022Article
- Assessment of knowledge and acceptability of HIV self-testing among students of selected universities in southwest Nigeria: an online cross-sectional study.The Pan African medical journal · 2022Article
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Authors and funding
12 authors at 8 institutions in 6 countries.
Funding
Abstract
backgroundMany southern African countries are nearing the global goal of diagnosing 90% of people with HIV by 2020. In 2016, 84 and 86% of people with HIV knew their status in Malawi and Zimbabwe, respectively. However, gaps remain, particularly among men. We investigated awareness and use of, and willingness to self-test for HIV and explored sociodemographic associations before large-scale implementation.
methodsWe pooled responses from two of the first cross-sectional Demographic and Health Surveys to include HIV self-testing (HIVST) questions in Malawi and Zimbabwe in 2015-16. We investigated sociodemographic factors and sexual risk behaviours associated with previously testing for HIV, and past use, awareness of, and future willingness to self-test using univariable and multivariable logistic regression, adjusting for the sample design and limiting analysis to participants with a completed questionnaire and valid HIV test result. We restricted analysis of willingness to self-test to Zimbabwean men, as women and Malawians were not systematically asked this question.
resultsOf 31,385 individuals, 31.2% of men had never tested compared with 16.5% of women (p < 0.001). For men, the likelihood of having ever tested increased with age. Past use and awareness of HIVST was very low, 1.2 and 12.6%, respectively. Awareness was lower among women than men (9.1% vs 15.3%, adjusted odds ratio [aOR] = 1.55; 95% confidence interval [CI]: 1.37-1.75), and at younger ages, and lower education and literacy levels. Willingness to self-test among Zimbabwean men was high (84.5%), with greater willingness associated with having previously tested for HIV, being at high sexual risk (highest willingness [aOR = 3.74; 95%CI: 1.39-10.03, p < 0.009]), and being ≥25 years old. Wealthier men had greater awareness of HIVST than poorer men (p < 0.001). The highest willingness to self-test (aOR = 3.74; 95%CI: 1.39-10.03, p < 0.009) was among men at high HIV-related sexual risk.
conclusionsIn 2015-16, many Malawian and Zimbabwean men had never tested for HIV. Despite low awareness and minimal HIVST experience, willingness to self-test was high among Zimbabwean men, especially older men with moderate-to-high HIV-related sexual risk. These data provide a valuable baseline against which to investigate population-level uptake of HIVST as programmes scale up. Programmes introducing, or planning to introduce, HIVST should consider including relevant questions in population-based surveys.
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