HIV Screening Patterns in sub-Saharan Africa: Evidence from the Demographic and Health Survey Data 2003-2007.

An unknown phenomenon nearly thirty years ago, the Human Immunodeficiency Virus (HIV) and its later stage of Acquired Immunodeficiency Syndrome (AIDS) has caused an estimated 25 million deaths. Current international and national efforts are focused on improving the distribution of life-preserving medications to those infected and supporting ongoing prevention policies and programs. To determine the scope of the resources necessary, and ensure that all those infected are successfully treated, more people need to know their individual HIV status – i.e., more people need to be screened for HIV. International experts demand more details about the provision of care and services and have suggested provider-initiated HIV screening as a method of getting more people screened in a timely manner, particularly in sub-Saharan Africa. However, little has been published on the characteristics of sub-Saharan Africans who use HIV screening, and how they compare to those who do not use such services. Based on retrospective analyses of nationally-representative population-based Demographic and Health Survey (DHS) data, this dissertation consists of three empirical papers which describe in detail patterns of HIV screening utilization in sub-Saharan Africa. These papers will contribute to the scientific discourse on the extension and expansion of HIV screening services, and the development of comprehensive prevention policies. The first paper is a broad overview of screening patterns of sub-Saharan African women and men from 23 countries. The second paper describes the predicted probability of being HIV infected among sexually-active Basotho and Swazi men who, according to the DHS surveys, have never been tested for HIV. The third paper, through the lens of the Health Care Utilization Theory, describes the different factors associated with completing the HIV screening process receiving HIV test results among sexually active Zimbabwean men and women.Ph.D.Health Behavior & Health EducationUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/77826/1/chela_1.pd