Inequities in the utilization of HIV counseling and testing services among undergraduates in mainland China
Abstract Background HIV counseling and testing (HCT) is provided free of charge on college campuses, but very few studies have examined whether HCT uptake is equitably distributed. This cross-sectional study aimed to compare the relative importance of various determinants of HCT uptake among undergr...
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2021
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oai:doaj.org-article:484f470208c442539be8b3ea3b628aca2021-12-05T12:09:21ZInequities in the utilization of HIV counseling and testing services among undergraduates in mainland China10.1186/s12889-021-12252-z1471-2458https://doaj.org/article/484f470208c442539be8b3ea3b628aca2021-12-01T00:00:00Zhttps://doi.org/10.1186/s12889-021-12252-zhttps://doaj.org/toc/1471-2458Abstract Background HIV counseling and testing (HCT) is provided free of charge on college campuses, but very few studies have examined whether HCT uptake is equitably distributed. This cross-sectional study aimed to compare the relative importance of various determinants of HCT uptake among undergraduates in mainland China so as to assess and subsequently to suggest ways to eliminate inequities in its use, guided by the Andersen’s behavioral model. Methods A total of 10,665 eligible undergraduates were conveniently selected to complete an online survey. Hierarchical logistic regression analyses were performed to identify the factors associated with HCT utilization. Results Only 7.7% of undergraduates had utilized HCT services. HCT uptake was inequitably distributed, since it was mainly determined by predisposing and enabling factors rather than by need factors. Further analysis indicated that HCT uptake was significantly related to two need factors, one enabling factor and six predisposing factors. Those with a higher need [i.e., perceiving themselves to be at higher risk of acquiring HIV infection (AOR = 2.76, 95% CI:2.02–3.78) and engaging in condomless sex (AOR = 1.29, 95% CI:1.00–1.67)] and those with more resources [i.e., being knowledgeable of local AIDS service organization (AOR = 1.59, 95% CI:1.37–1.85)] were more likely to utilize HCT services. Compared to non-heterosexual men, non-heterosexual women (AOR = 0.51, 95% CI:0.37–0.72), heterosexual men (AOR = 0.44, 95% CI:0.33–0.57) and women (AOR = 0.31, 95%CI: 0.24–0.41) were less likely to utilize HCT service. Furthermore, those with more knowledge (AOR = 0.80, 95% CI:0.69–0.94) and taking a positive attitude towards HCT services [i.e, expressing their willingness to utilize HCT services (AOR = 0.68, 95% CI:0.56–0.81) and having recognized the necessity to provide HTC services in the local university (AOR = 0.46, 95% CI:0.36–0.57)] were less likely to utilize HCT services. However, medical students (AOR = 1.34, 95% CI: 1.15–1.56) and non-freshmen (AOR = 1.22, 95% CI:1.03–1.45) were more likely to utilize HCT services. Conclusions To increase HCT uptake and simultaneously reduce the remaining inequities, a comprehensive intervention should be continued to target non-heterosexual men and non- freshmen and those with a higher need for HCT services, conduct health education, improve the availability and accessibility of HIV testing services.Jihong ZhanGuochen FuLei WuMingliang PanYuli YangZhuo ChenYu CaoYong LiHao WangBixiang WangRuyi DuYanting XiongWei LiuNuo XuXiaobao XiaQianqian LiFang RuanJunfang WangBMCarticleHCT servicesUtilizationInequitiesUndergraduatesChinaPublic aspects of medicineRA1-1270ENBMC Public Health, Vol 21, Iss 1, Pp 1-13 (2021) |
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EN |
| topic |
HCT services Utilization Inequities Undergraduates China Public aspects of medicine RA1-1270 |
| spellingShingle |
HCT services Utilization Inequities Undergraduates China Public aspects of medicine RA1-1270 Jihong Zhan Guochen Fu Lei Wu Mingliang Pan Yuli Yang Zhuo Chen Yu Cao Yong Li Hao Wang Bixiang Wang Ruyi Du Yanting Xiong Wei Liu Nuo Xu Xiaobao Xia Qianqian Li Fang Ruan Junfang Wang Inequities in the utilization of HIV counseling and testing services among undergraduates in mainland China |
| description |
Abstract Background HIV counseling and testing (HCT) is provided free of charge on college campuses, but very few studies have examined whether HCT uptake is equitably distributed. This cross-sectional study aimed to compare the relative importance of various determinants of HCT uptake among undergraduates in mainland China so as to assess and subsequently to suggest ways to eliminate inequities in its use, guided by the Andersen’s behavioral model. Methods A total of 10,665 eligible undergraduates were conveniently selected to complete an online survey. Hierarchical logistic regression analyses were performed to identify the factors associated with HCT utilization. Results Only 7.7% of undergraduates had utilized HCT services. HCT uptake was inequitably distributed, since it was mainly determined by predisposing and enabling factors rather than by need factors. Further analysis indicated that HCT uptake was significantly related to two need factors, one enabling factor and six predisposing factors. Those with a higher need [i.e., perceiving themselves to be at higher risk of acquiring HIV infection (AOR = 2.76, 95% CI:2.02–3.78) and engaging in condomless sex (AOR = 1.29, 95% CI:1.00–1.67)] and those with more resources [i.e., being knowledgeable of local AIDS service organization (AOR = 1.59, 95% CI:1.37–1.85)] were more likely to utilize HCT services. Compared to non-heterosexual men, non-heterosexual women (AOR = 0.51, 95% CI:0.37–0.72), heterosexual men (AOR = 0.44, 95% CI:0.33–0.57) and women (AOR = 0.31, 95%CI: 0.24–0.41) were less likely to utilize HCT service. Furthermore, those with more knowledge (AOR = 0.80, 95% CI:0.69–0.94) and taking a positive attitude towards HCT services [i.e, expressing their willingness to utilize HCT services (AOR = 0.68, 95% CI:0.56–0.81) and having recognized the necessity to provide HTC services in the local university (AOR = 0.46, 95% CI:0.36–0.57)] were less likely to utilize HCT services. However, medical students (AOR = 1.34, 95% CI: 1.15–1.56) and non-freshmen (AOR = 1.22, 95% CI:1.03–1.45) were more likely to utilize HCT services. Conclusions To increase HCT uptake and simultaneously reduce the remaining inequities, a comprehensive intervention should be continued to target non-heterosexual men and non- freshmen and those with a higher need for HCT services, conduct health education, improve the availability and accessibility of HIV testing services. |
| format |
article |
| author |
Jihong Zhan Guochen Fu Lei Wu Mingliang Pan Yuli Yang Zhuo Chen Yu Cao Yong Li Hao Wang Bixiang Wang Ruyi Du Yanting Xiong Wei Liu Nuo Xu Xiaobao Xia Qianqian Li Fang Ruan Junfang Wang |
| author_facet |
Jihong Zhan Guochen Fu Lei Wu Mingliang Pan Yuli Yang Zhuo Chen Yu Cao Yong Li Hao Wang Bixiang Wang Ruyi Du Yanting Xiong Wei Liu Nuo Xu Xiaobao Xia Qianqian Li Fang Ruan Junfang Wang |
| author_sort |
Jihong Zhan |
| title |
Inequities in the utilization of HIV counseling and testing services among undergraduates in mainland China |
| title_short |
Inequities in the utilization of HIV counseling and testing services among undergraduates in mainland China |
| title_full |
Inequities in the utilization of HIV counseling and testing services among undergraduates in mainland China |
| title_fullStr |
Inequities in the utilization of HIV counseling and testing services among undergraduates in mainland China |
| title_full_unstemmed |
Inequities in the utilization of HIV counseling and testing services among undergraduates in mainland China |
| title_sort |
inequities in the utilization of hiv counseling and testing services among undergraduates in mainland china |
| publisher |
BMC |
| publishDate |
2021 |
| url |
https://doaj.org/article/484f470208c442539be8b3ea3b628aca |
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