Tanzanian trip could influence East African policies on HIV testing

The fieldwork findings of a University of Northampton expert could help to influence East African governments’ policies on HIV testing.

HIV has long been viewed as a disease of poverty in sub-Saharan Africa, however, data from Demographic Health Surveys (DHS) has shown that this is not necessarily the case.

Tanzania’s wealthiest quintile of the population has the highest rates of HIV prevalence, according to the Tanzanian Commission for AIDS 2013. This pattern is repeated in a number of countries in sub-Saharan Africa, and especially in East Africa.

In relation to HIV testing, there is also an assumption that policy and programmes designed to encourage testing should focus on the poor. This is also questionable, as whilst the wealthiest are more likely to report having ever taking a HIV test, they are just as likely to refuse to give a blood sample in national surveys as the poor (see Long and Deane 2015 for a discussion).

The DHS data also shows that differences in testing rates by wealth quintile are not enough to account for the differences in HIV prevalence by wealth quintile, so that effectively there are as many wealthy men who are HIV positive and have never taken a HIV test as there are poor men who are HIV positive and have never taken a HIV test.

Dr Kevin Deane of the University’s Faculty of Business & Law, has teamed up with Dr Joyce Wamoyi and John Changalucha of Tanzania’s National Institute for Medical Research to explore the attitudes of wealthier men towards HIV testing, and the barriers to testing they may face.

Dr Deane recently spent five weeks in Tanzania with the aim of interviewing 25 owners/regional managers of the main businesses and public institutions in Mwanza city, in the north of the country.

He said: “We tried multiple ways of approaching our participants. Turning up at the main business premises uninvited has yielded a few appointments, but mostly we have been contacting them through networks that the research community here have, as this is a sensitive topic that is targeting a rarely-researched population, and introductions are proving necessary.

“This process involved a lot of waiting around, appointments being put back or delayed, but in general the businessmen and regional managers were open to talking to us once we got in front of them and explained the project.

“Whilst it is too early to comment on the overall findings, a number of interesting themes are emerging that relate to testing practices, risk behaviours, and stigma that is still present within this specific social group. Data analysis will progress over the next few months, and then our findings will be written up in the form of a policy brief and journal articles.”

Dr Deane added: “We hope the findings of this research will have important implications for the design of policies and/or interventions to encourage HIV testing amongst wealthy men in Tanzania and other sub-Saharan African countries, particularly in East Africa, which have similar patterns of HIV prevalence, wealth and HIV testing.”

The research is being funded by a British Academy/Leverhulme Trust grant of £10,000.

Dr Deane’s main area of expertise is the HIV/AIDS epidemic in sub-Saharan Africa, with a focus on migration/population mobility, transactional sex, the roles of wealth and poverty and the developmental impact.