Background HIV testing constitutes an entry point for HIV prevention and access to care. Although access to tests has increased in most low- and middle-income countries in recent years, regular HIV testing among high-risk populations remains a challenge. Understanding the determinants of regular HIV testing is the key to improving treatment-as-prevention programs and access to care. This study aimed to identify psychosocial factors associated with the intention to be HIV tested every 3 months among female sex workers (FSWs) in Benin.
Methods We developed an interview questionnaire based on the Theory of Planned Behaviour and other theoretical variables. We interviewed 450 FSWs in their work place. Using Amos software, we applied structural equation modelling to identify the determinants of intention.
Results Previous testing was reported by 87% of FSWs, 40% of whom reported having been tested in the last 3 months. More than half of the FSWs (69%) showed a strong intention to be HIV tested during the next 3 months. The structural model indicates that 55% of the variance in intention is explained in descending order of importance (standardised coefficient weight, b) by perceived control (β = 0.26, P < 0.001); descriptive norms (β = 0.24, P < 0.001); control beliefs (β = 0.22, P < 0.001); habits (β = 0.20, P < 0.001); attitude (β = 0.12, P = 0.01); Perceived risk (β = 0.07, P = 0.03); and normative beliefs (β = 20.07, P = 0.03).
Conclusions This is the first theoretically based study identifying determinants of intention to undergo regular HIV testing among FSWs in sub-Saharan Africa. The results can inform development of interventions to maintain and increase regular HIV testing among FSWs, thus reinforcing primary prevention and supporting early access to care.
The authors have no conflicts of interest to disclose. This study was funded by the Canadian Institutes of Health Research (Grant no. ROH-115205).
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