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Individual and jurisdictional factors associated with voluntary HIV testing in Canada: Results of a national survey, 2011

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Abstract

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HIV testing remains a central strategy for HIV prevention for its ability to link those who test positive to treatment and support. In Canada, national guidelines have recently changed as part of standard primary care to recommend voluntary HIV testing for those aged 16–64 years. Using results from a nationally representative survey, we examined individual and jurisdictional factors associated with voluntary testing.

Methods

A total of 2,139 participants were sampled using a regionally stratified, two-stage recruitment process. English or French interviews (by phone or online) were conducted during May 2011. Voluntary testing was defined as testing at least once for reasons other than blood donation, insurance purposes, immigration screening or research participation. Weighted logistic regression analysis (including socio-demographic, sexual activity, HIV/AIDS knowledge and jurisdictional factors of HIV prevalence and anonymous testing availability) were conducted for the overall sample, and stratified by sex.

Results

Twenty-nine percent (29%) of survey participants reported at least one lifetime voluntary HIV test. For the full-sample model, the following were associated with increased odds of testing: age <60 years, female sex, sexual minority status, perceived HIV knowledge, casual sex partner in previous year, and living in a higher-prevalence jurisdiction. For men, the strongest factor related to testing was sexual minority status (OR = 5.15, p < 0.001); for women, it was having a casual sex partner in the previous year (OR = 2.57, p = 0.001). For both men and women, residing in a jurisdiction with lower HIV prevalence decreased odds of testing.

Discussion

Sex differences should be considered when designing interventions to increase testing uptake. Jurisdictional factors, including HIV prevalence and testing modality, should be investigated further.

Résumé

Objectif

Le dépistage du VIH demeure une stratégie centrale en matière de prévention du virus, car il permet d’aiguiller les personnes séropositives vers les traitements et le soutien disponibles. Au Canada, les lignes directrices nationales ont changé récemment dans le cadre des soins primaires normalisés, et l’on recommandemaintenant le dépistage volontaire du VIH pour les 16 à 64 ans. À l’aide des résultats d’une enquête représentative nationale, nous avons examiné les facteurs individuels et les facteurs liés à la région administrative associés au dépistage volontaire.

Méthodes

En tout, 2 139 participants ont été échantillonnés selon un processus de recrutement en deux étapes, stratifié selon la région. Des entretiens en anglais ou en français (par téléphone ou en ligne) ont été menés en mai 2011. Le dépistage volontaire était défini comme étant un dépistage au moins une fois pour une raison autre que pour donner du sang, à des fins d’assurance ou de contrôle des immigrants ou pour participer à une étude de recherche. Des analyses de régression logistique pondérées (incluant les facteurs sociodémographiques, d’activité sexuelle, de connaissance du VIH et du sida et les facteurs de prévalence du VIH et de disponibilité du dépistage anonyme selon la région administrative) ont été menées pour l’échantillon global, puis stratifiées selon le sexe.

Résultats

Vingt-neuf p. cent (29 %) des participants de l’enquête ont déclaré avoir subi au moins un dépistage volontaire du VIH au cours de leur vie. Pour le modèle utilisant l’échantillon entier, les facteurs suivants ont été associés à une probabilité de dépistage accrue: l’âge <60 ans, le sexe féminin, le statut de minorité sexuelle, les connaissances perçues du VIH, une ou un partenaire sexuel occasionnel au cours de l’année antérieure et le fait de vivre dans une région administrative à prévalence élevée de VIH. Chez les hommes, le facteur le plus fortement lié au dépistage était le statut de minorité sexuelle (RC = 5,15, p < 0,001); chez les femmes, c’était d’avoir eu une ou un partenaire sexuel occasionnel au cours de l’année antérieure (RC = 2,57, p = 0,001). Chez les deux sexes, le fait de vivre dans une région administrative où la prévalence du VIH était plus faible réduisait la probabilité du dépistage.

Discussion

RÉSULTATS: Il faudrait tenir compte des différences entre les sexes lorsqu’on conçoit des interventions pour accroître le recours au dépistage. Les facteurs comme la prévalence du VIH et les modalités de dépistage dans la région administrative devraient faire l’objet d’études plus poussées.

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Authors and Affiliations

  1. Public Health and Social Policy, University of Victoria, B202e, HSD, PO Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada

    Catherine A. Worthington PhD

  2. The CIHR Social Research Centre in HIV Prevention, Toronto, ON, Canada

    Catherine A. Worthington PhD, Liviana M. Calzavara PhD, Samantha J. White MSc, Dan Allman PhD & Mark W. Tyndall MD, ScD, FRCPC

  3. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    Liviana M. Calzavara PhD, Samantha J. White MSc & Dan Allman PhD

  4. Division of Infectious Diseases, The Ottawa Hospital, Ottawa, ON, Canada

    Mark W. Tyndall MD, ScD, FRCPC

  5. Department of Medicine, University of Ottawa, Ottawa, ON, Canada

    Mark W. Tyndall MD, ScD, FRCPC

Authors
  1. Catherine A. Worthington PhD
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  2. Liviana M. Calzavara PhD
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  5. Mark W. Tyndall MD, ScD, FRCPC
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Correspondence to Catherine A. Worthington PhD.

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Conflict of Interest: None to declare.

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Worthington, C.A., Calzavara, L.M., White, S.J. et al. Individual and jurisdictional factors associated with voluntary HIV testing in Canada: Results of a national survey, 2011. Can J Public Health 106, e4–e9 (2015). https://doi.org/10.17269/CJPH.106.4625

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  • DOI: https://doi.org/10.17269/CJPH.106.4625

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