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RESEARCH ARTICLE

Stigma, sexual risk and desire for HIV tests in Ghana

Emmanuel F. Koku
+ Author Affiliations
- Author Affiliations

Department of Culture and Communication, 3141 Chestnut Street, Drexel University, Philadelphia, PA 19104, USA. Email: emmanuelkoku@drexel.edu

Sexual Health 8(1) 110-119 https://doi.org/10.1071/SH09095
Submitted: 30 August 2009  Accepted: 5 July 2010   Published: 24 January 2011

Abstract

Background: Although various HIV prevention and treatment programs have been implemented in Ghana since 2003, desire for and uptake of HIV testing is still low, owing largely to HIV-related stigma. This study examined the effect of stigma on desire for HIV testing, while controlling for socio-demographic and other influences. Method: The study used data from the 2003 Ghana Demographic and Health Survey to regress desire for an HIV test on levels of stigma while controlling for selected socio-demographic, socio-cognitive and socio-behavioural covariates. Results: The study revealed significant associations between several socio-demographic and socio-cognitive variables and the desire for an HIV test. For example, both male (adjusted odds ratio (AOR) = 0.41; 95% confidence interval (CI) = 0.24–0.72) and female (AOR = 0.62; 95% CI = 0.41–0.93) respondents in the wealthiest households, and those who know someone infected with HIV (AOR = 0.65; 95% CI = 0.43–1.00) have lower odds of desiring an HIV test. The study showed a significant but negative interaction between risky sexual behaviours and community stigma (AOR = 0.44; 95% CI = 0.19–0.67), indicating that the positive effect of risky sex on HIV testing is attenuated among females who live in communities with high levels of stigma. Conclusion: Since community-level education and risk reduction programs have demonstrable influences on reducing HIV stigma, it is imperative that the Ghana government’s ongoing anti-stigma campaigns and other HIV prevention programs recognise the role of community stigma in influencing HIV testing decisions, especially in the context of risky sexual behaviours.

Graphical Abstract Image

Additional keywords: Africa, gender, readiness for testing, screening.


Acknowledgement

The author would like to thank Measure DHS for access to the Ghana Demographic Health Survey’s unrestricted survey data files (http://www.measuredhs.com/accesssurveys/), which it is authorised to distribute, at no cost, for legitimate academic research.


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