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A multilevel analysis of the determinants of HIV testing in Zimbabwe: evidence from the demographic and health surveys

Magadi, Monica Akinyi; Gazimbi, Martin Marufu


Monica Akinyi Magadi

Martin Marufu Gazimbi


Introduction Zimbabwe is still burdened with HIV epidemic and the government has an ambitious aim in the post-2015 era to end the AIDS epidemic by 2030. To achieve this, the government has set up the 90-90-90 strategic milestones to be achieved by 2020. It is daunting task to increase HIV testing uptake from current estimate of 56%to 90% to meet these targets. The current government’s initiative requires an understanding of determinants of HIV testing. Objectives The specific objectives of this study are to: (i) identify the individual and community-level determinants of HIV testing, focussing on predisposing, enabling and perceived need factors (PREP); and (ii) establish gender differences. Material and Methods We applied multilevel logistic regression models to nationally-representative samples of 17,797women and 14,587 men from the 2005/6 and 2010/11 Zimbabwe Demographic and Health Surveys to examine the determinants of HIV testing. Results HIV testing uptake increased significantly between 2005/6 and 2010/11, especially for women (females OR=5.60; males OR=2.57). Most PREP factors associated with HIV testing are largely consistent with patterns in Southern Africa (e.g. higher uptake by women and those who are wealthier), but unique patterns have also emerged. In particular, results reveal important gender differences: rural residence is associated with lower uptake of HIV testing for women (OR=0.74) but higher for men (OR=1.16); community wealth is a more important factor in enabling HIV testing than household wealth for women, but the converse is true for men; and individual-level, rather than community-level stigma is important for women, while for men, it is community-level stigma that is important. Conclusion Observed gender disparities in determinants of HIV testing calls for gender specific response. Couple-oriented HIV counselling and testing services where men accompany their spouse to HIV screening during pregnancy may help increase HIV testing uptake for males and reduce gender disparities.


Magadi, M. A., & Gazimbi, M. M. (2017). A multilevel analysis of the determinants of HIV testing in Zimbabwe: evidence from the demographic and health surveys. HIV/AIDS Research and Treatment: Open Journal, 4(1), 14-31.

Journal Article Type Article
Acceptance Date Jan 17, 2017
Online Publication Date Dec 28, 2017
Publication Date Jan 20, 2017
Deposit Date Jan 23, 2017
Publicly Available Date Jan 23, 2017
Journal HIV/AIDS research and treatment : open journal
Publisher Openventio
Peer Reviewed Not Peer Reviewed
Volume 4
Issue 1
Pages 14-31
Keywords HIV testing; Community-level determinants; Gender disparity; Multilevel analysis; Demographic and health surveys; Zimbabwe
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Copyright Statement
©2017 Gazimbi MM. This is an open access article distributed under<br /> the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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