Abstract:

HIV testing stands out as a pivotal HIV preventive measure in the face of increasing HIV transmission risk behaviors. This study examined the relationship between HIV transmission risk behaviors and HIV testing among men aged 15 to 64 years in Cameroon. The dataset from the 2018 Cameroon Demographic and Health Survey (N=6978) were utilized. Chi-square tests examined the prevalence and association between HIV testing and HIV transmission risk behaviors. Multivariate logistic regression was fitted to predict the odds of HIV testing. About 58.7% had tested for HIV. Specifically, 55.8% of men who never tested for HIV were aged 15 and 24 years and 73% who never tested for HIV did not use a condom during their most recent sex. Remarkably, 27.3% of men aged 15-64 years who have never been tested for HIV also had multiple sexual partners, while 26.7% that never tested for HIV also did not use condom when engaging in paid sex. Regression results indicated that men aged 15-59 years who had multiple sexual partners (AOR=1.83, 95% CI=1.57-2.14, p<.001), a recent STI (AOR=1.40, 95% CI=1.18-1.66, p<.001), condom use during sex (AOR=1.30, 95% CI=1.10-1.53, p=.022) and paid for sex (AOR=1.19, 95% CI=1.01-1.41, p=.037), were associated with higher odds of testing for HIV compared to those who did not. HIV prevention efforts should focus on addressing the public health implications of unsafe sexual practices among men, devising innovative strategies for scaling up HIV testing among the vulnerable younger age groups and regions with lower HIV testing rates in Cameroon.

References:

[1] Szabo, R. and R.V., 2000, Short, How does male circumcision protect against HIV infection? BMJ, 320(7249): p. 1592-1594.

[2] Matlin, S. and N. Spence, 2000, The gender aspects of the HIV/AIDS pandemic, Commonwealth Secretariat.

[3] Nyarko, S.H. and C. Sparks, 2020, Levels and determinants of HIV testing uptake among Ghanaian men. African Journal of AIDS Research, 2020(1): p. 40-47.

[4] Darteh, E.K., J. Amo-Adjei, and K. Awusabo-Asare, 2014, Correlates of HIV testing among young people in Ghana. Journal of HIV/AIDS & Social Services, 13(3): p. 219-233.

[5] Asaolu, I.O., et al., 2016, Predictors of HIV testing among youth in sub-Saharan Africa: a cross-sectional study, PloS one, 11(10): p. e0164052.

[6] Meka, A.F.Z., et al., 2020, Challenges and barriers to HIV service uptake and delivery along the HIV care cascade in Cameroon, Pan African Medical Journal, 36(1).

[7] Phiri, M., et al., 2022, Examining differentials in HIV transmission risk behaviour and its associated factors among men in Southern African countries, Humanities and Social Sciences Communications, 9(1): p. 295.

[8] Herr, S.W., et al., 2012, High school health‐education teachers' perceptions and practices related to teaching HIV prevention, Journal of School Health, 82(11): p. 514-521.

[9] Nubed, C.K. and J.-F.T.K. Akoachere, 2016, Knowledge, attitudes and practices regarding HIV/AIDS among senior secondary school students in Fako Division, South West Region, Cameroon. BMC Public Health, 16(1): p. 847.

[10] Pinkerton, S.D., 2007, How many sexually-acquired HIV infections in the USA are due to acute-phase HIV transmission? Aids, 21(12): p. 1625-9.

[11] Marks, G., et al., 2005, Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: implications for HIV prevention programs, JAIDS Journal of Acquired Immune Deficiency Syndromes, 39(4): p. 446-453.

[12] Weinhardt, L.S., et al., 1999, Effects of HIV counseling and testing on sexual risk behavior: a meta-analytic review of published research, 1985-1997, American journal of public health, 89(9): p. 1397-1405.

[13] Marks, G., N. Crepaz, and R.S. Janssen, 2006, Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA, Aids, 20(10): p. 1447-1450.

[14] Ossomba, J., et al., 2023, De-medicalized and decentralized HIV testing: a strategy to test hard-to-reach men who have sex with men in Cameroon. Front Public Health, 11: p. 1180813.

[15] The Joint United Nations Programme on HIV and AIDS UNAIDS. Global HIV & AIDS statistics — Fact sheet. 2023 December 25, 2023]; Available from: https://www.unaids.org/en/resources/fact-sheet.

[16] Center for Disease Control and Prevention. Cameroon country profile. 2021 December 25, 2023]; Available from: https://www.cdc.gov/globalhivtb/where-we-work/cameroon/cameroon.html.

[17] National Institute of Statistics (Cameroon) and ICF. 2018 Cameroon DHS summary report. 2020; Available from: https://www.dhsprogram.com/pubs/pdf/SR266/SR266.pdf.

[18] The National AIDS Control Committee Cameroon. National Strategic Plan. 2023 December 25, 2023]; Available from: https://cnls.cm/site/en/plan-strategique-national.

[19] Defo, D., E.A. Kouotou, and J.R. Nansseu, 2017, Failure to return to receive HIV-test results: the Cameroon experience, BMC Research Notes, 10(1): p. 1-5.

[20] Ngangue, P., M.-P. Gagnon, and E. Bedard, 2017, Challenges in the delivery of public HIV testing and counselling (HTC) in Douala, Cameroon: providers perspectives and implications on quality of HTC services, BMC International Health and Human Rights, 17(1): p. 9.

[21] Marks, S.J., et al., 2017, Potential Healthcare Insurance and Provider Barriers to Pre-Exposure Prophylaxis Utilization Among Young Men Who Have Sex with Men, AIDS Patient Care & STDs, 31(11): p. 470-478.

[22] Katirayi, L., et al., 2023, Changing attitudes towards HIV testing and treatment among three generations of men in Cameroon: a qualitative analysis using the Fogg Behavior Model, BMC Public Health, 23(1): p. 501.

[23] Yamanis, T.J., et al., 2017, Social network influence on HIV testing among urban men in Tanzania. AIDS and Behavior, 21: p. 1171-1182.

[24] Hadish, M., et al., 2017, Predictors of high HIV/AIDS risk sexual behaviours: comparison study among Cameroonian and Gabonese youth aged 15-24 years. J HIV Retrovirus, 3: p. 1.

[25] Kouanfack, C., et al., 2021, Use of Trained Non-Medical Staff to Improve Access to HIV Testing Services in Africa: Implementation of the World Health Organization Opt-out Approach in Cameroon, International Journal of Maternal and Child Health and AIDS, 10(1): p. 119.

[26]  Agaba, P.A., et al., 2016, Sexual behavior and risk factors for HIV infection among young people aged 15-24 years in North-Central Nigeria, Journal of Medicine in the Tropics, 18(2): p. 60-67.

[27] Siu, G.E., D. Wight, and J.A. Seeley, 2014, Masculinity, social context and HIV testing: an ethnographic study of men in Busia district, rural eastern Uganda, BMC Public Health, 14(1): p. 1-11.

[28] Denison, J.A., et al., 2008, The HIV testing experiences of adolescents in Ndola, Zambia: do families and friends matter? AIDS care, 20(1): p. 101-105.

[29] Valente, T.W., 2010, Social networks and health: Models, methods, and applications, Oxford University Press.

[30] Babalola, S., 2007, Readiness for HIV testing among young people in northern Nigeria: the roles of social norm and perceived stigma, AIDS and Behavior, 11: p. 759-769.

[31] Pettifor, A., et al., 2010, Factors associated with HIV testing among public sector clinic attendees in Johannesburg, South Africa, AIDS and Behavior, 14: p. 913-921.

[32] Ajuwon, A.J., 2005, Benefits of sexuality education for young people in Nigeria. in Understanding human sexuality seminar series, African Regional Sexuality Resource Centre Lagos.

[33] Fee, N., Youssef M., 1993, Young people, AIDS and STD prevention: experiences of pee approaches in developing countries.