Desire for, and uptake of HIV tests by Ghanaian women: the relevance of community level stigma.

Voluntary counseling and testing (VCT) has been recognized as the crux of HIV surveillance, prevention and treatment programs. Since 2000, Ghana government has launched a number of HIV prevention and treatment programs intended to increase VCT services. Despite these efforts, uptake of testing is still low, though many women reported interest in getting tested. The disconnect between intention and action is attributable to several factors, including HIV-related stigma. The study used data from the 2003 Ghana Demographic and Health Survey and fitted complementary log-log models to regress women's desire for and uptake of an HIV test on levels of personal and community stigma. Consistent with findings from previous research, the study revealed significant associations between a number of socio-demographic and socio-cognitive variables and the desire for and uptake of an HIV test by Ghanaian women. Most significantly, the study showed that widespread stigma in the community exert greater negative effects on individuals who endorse stigmatizing beliefs and predispositions, compared to their peers with more favorable attitudes. Since community level educational and risk reduction programs have demonstrable influences on reducing HIV stigma, it is imperative that the Ghana government's ongoing anti-stigma campaigns and other HIV prevention programs take cognizance of the role of community stigma in influencing HIV testing.