Cascade of provider-initiated HIV testing and counselling at specific life events (pregnancy, STIs, marriage plan) in Côte d’Ivoire
Aim In Côte d’Ivoire, only 57.8% of women and 37.0% of men have been HIV-tested at least once, which is insufficient to control the epidemic. The objective of this study is to describe at a population level if an HIV test was offered and performed at specific life-events where provider-initiated HIV testing is recommended. Method/Issue A cross-sectional telephone survey was conducted in 2017 among a representative sample of 3 867 individuals from the general population in Côte d'Ivoire. For each individual, the occurrence of the following events over the past 5 years was documented: birth of a child, Sexually Transmitted Infections—STIs, marriage. For each of these events, they were asked (i) if they have consulted a health professional, (ii) if they were offered an HIV test during that consultation and (iii) if they accepted it. The factors associated with each of these three steps were analyzed in separate logistic regression models stratified by type of event. Results/Comments While 63.7% of women were HIV-tested during their last pregnancy, only 16.9% of men were tested during their partner’s last pregnancy and this proportion fell to 13.4% for people with an STI and 14.5% for people who got married. These levels of HIV testing were mainly driven by a lack of medical consultation (except for pregnant women) and a lack of testing proposal (except for pre-marital check-up). Testing acceptability was high. Discussion Improving HIV testing coverage in Côte d’Ivoire requires (i) facilitating attendance to health services in case of STIs, marriage plans and pregnancy—for men—and (ii) strengthening routine testing proposal during these occasions.