Background: Realization of the ambitious 90-90-90 target to end the HIV epidemic depends hugely on the success of the first 90 that targets to have 90% of all people living with HIV knowing their HIV status by 2020. This analysis assesses the magnitude and characteristics of caregivers of orphaned and vulnerable children (OVC) who tested for HIV but never showed up to received their test results in Tanzania.
Methods: Data originate from a community-based, USAID-funded Kizazi Kipya Project that seeks to increase uptake of HIV/AIDS services by OVC and their caregivers in Tanzania. Caregivers who were served by the project during January-March 2017 in 18 regions of Tanzania with complete information on their HIV status, household socioeconomic status and socio-demographic characteristics were analyzed. HIV status was self-reported. Multilevel mixed-effects logistic regression was performed, with those that tested for HIV but did not receive test results forming the outcome.
Results: The analysis included 59,683 caregivers of OVC, 71.2% of whom were females and the rest males. Of this, 37.2% (n=22,186) reported that they tested for HIV but never waited to receive test results. The rest received their test results, whereby 44.6% and 18.2% were HIV negative and positive respectively. Multivariate analysis showed that fleeing HIV test results was significantly higher among males than females (OR=1.21, 95% CI 1.15-1.27), singles (OR=1.13, 95% CI 1.04-1.24) and widows/widowers (OR=1.12, 95% CI 1.07-1.18) than married, those without health insurance (OR=1.38, 95% CI 1.30-1.47) and age 61+ than 18-30 (OR=1.72, 95% CI 1.58-1.88). Better education and wealth status were protective factors (P< 0.001).
Conclusions: An outstanding number of caregivers who test for HIV flee test results, suggesting lack of confidence in unpleasant results, thus a missed opportunity for timely care and treatment services for those that may be infected. While better education, economic strengthening and expanding health insurance coverage appear imperative aspects to improve uptake of HIV test results, an attention is needed for men, the unmarried and the elderly.