Academic journal article Gender & Behaviour

The Impact of HIV Testing on Current Use of Modern Family Planning among Women and Men in Uganda

Academic journal article Gender & Behaviour

The Impact of HIV Testing on Current Use of Modern Family Planning among Women and Men in Uganda

Article excerpt

Slightly more than 30 years after it was first discovered, the Acquired ImmuneDeficiency Syndrome (AIDS), caused by the Human Immunodeficiency Virus (HIV) continues to pose an existential dilemma in countries with large HIV/AIDS epidemics. This is because of the severe illness, stigma and discrimination caused by the disease (Schweitzer, Mizwa & Ross, 2010), which also impedes voluntary uptake of HIV testing, disclosure of HIV positive status and HIV prevention efforts (Pharis, Hoa, Tishelma, Marrone, Chuc, Brugha, et al., 2011). Yet HIV testing and knowing the test result are the most important gateway to prevention of the infection for uninfected individuals and treatment of those already infected (Ayiga, Nambooze, Nalugo, Kaye & Katamba, 2013). The treatment of infected individuals also contributes to the prevention of further spread of HIV to others sexually and through Mother to Child Transmission (MTCT) by lowering viral load (Cohen, Chen, MaCauley, Gamble, Hosseinipour & Kumarasamy, et al., 2011).

Although the prevalence of HIV test, which is a procedure for determining the HIV status of individuals by detecting the presence of HIV-1 and HIV-2 antibodies in blood or saliva, is increasing for both women and men in sub-Saharan Africa, it is still low and it is hampered by a number of factors including the fear of positive test result (MacKeller, Hou & Whallen, 2011); the already perceived positive HIV status by people in high risk groups (Ayiga et al., 2013); and the belief that one is not at risk of HIV infection (Schwarcz, Richards, Frank, Wenzel, Hsu, Chin, et al., 2011). Additionally, the fear that it will be known by others that one has tested for HIV or other people will come to know that the test result was positive impedes voluntaiy HIV testing (Joseph, Fasula, Morgan, Sturkey, Alvarez, Margolis, et al., 2011). Most of the above reasons for not taking HIV tests have been observed to apply to women and men (Ostermann, Reddy, Shorter, Muiruri, Mtalo, Itemba, et al., 2011; Matovu & Makumbi, 2007) and are therefore likely to influence HIV prevention behaviours of women and men similarly.

However, there are specific circumstances that place men more than women at increased risk of contracting HIV that may contribute to their reluctance to take HIV test. These include the high degree of mobility of some men and frequent use of substances such as alcohol (Lurie, Williams, Zuma, Mkaya-Mwamburi, Garnett, Sturm, et al., 2003); risk-taking behaviour among men working in all-male settings such as the militaiy (Wagner, Aunon, Kaplan, Rana, Khouri, Tohme & Mokhbat, 2012); the positive wealth gradient effect which suggests that wealth increases men's risk of HIV infection (Fox, 2010); the masculinity and patriarchy norms which promotes sexual adventure, leisure and courage among men (Siu, Wight & Seeley, 2014); and fewer HIV testing opportunities due to greater access barriers faced by men (Mitchell, Cockcroft, Lamothe &Andersson, 2010).

The use of modern family planning methods, which is the voluntaiy action by individuals to prevent or delay pregnancy, is one of the important ways of preventing HIV transmission in countries with large HIV epidemics. Despite the known benefits of family planning to the general population, and HIV infected women in particular, uptake of family planning has remained low in sub-Saharan African countries with large HIV/AIDS epidemics (Homsy, Bunnell, Moore, King, Malamba, Nakityo, et al., 2009) where one in four women of reproductive age have an unmet need for family planning, which is a situation in which women want to delay or stop childbearing but could not do so (Darroch, Sedgh & Ball, 2011). This is in the backdrop of the acknowledgement that most women, particularly HIV infected women, do not want any more children, implying that many of these women are exposed to the risk of unintended childbearing (Nakaie, Toun, Nozaki, Yamaguchi, Sasaki, Kakimoto, et al. …

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