Uptake and correlates of HIV testing among men in Malawi: evidence from a national population–based household survey

BACKGROUND: HIV testing is one of the key strategies in the HIV/AIDS prevention and control programmes. However, studies examining utilization of this service by men in Malawi are limited. The aim of this study was to assess the uptake and determinants of HIV testing among men in Malawi. METHODS: Secondary data analysis was conducted on cross-sectional household data for 7478 men aged 15 to 54 years drawn from the 2015-16 Malawi Demographic and Health Survey. Descriptive statistics, bivariate and multivariable logistic regression analyses were performed to identify the socio-demographic, behavioral and health service related factors that are associated with HIV testing service utilisation by men in Malawi. All analyses were performed using the complex sample analysis procedure of the Statistical Package for the Social Sciences version 22.0 to account for the multistage sampling used in Demographic Health Survey. RESULTS: Overall, 69.9% of the participants had ever been tested for HIV. The results indicate that age, region of residence, marital status, covered by health insurance, education and age at first sexual debut are significant predictors of HIV testing among men in Malawi. In particular, men who were in the age group 30-39 years (AOR = 3.00; 95% CI = 2.35-3.82), married (AOR = 3.03; 95% CI = 2.51-3.65), those with secondary or above education (AOR = 3.02; 95% CI = 2.33-3.91), and those who had health insurance (AOR = 1.66; 95% CI = 1.05-2.63) were likely to utilise HIV testing service than their counterparts. CONCLUSION: The findings suggest that HIV testing services and programmes need to target younger unmarried men aged 15-19, men with low level or no education and expand HIV testing services to the central and southern regions of Malawi. Targeting the undiagnosed men living with HIV in a timely manner is a crucial and necessary step not only for achieving the UNAIDS' 90-90-90 targets but for individuals to benefit from antiretroviral treatment and to sustainably reduce population-level HIV transmission.