Correlates of HIV testing among women in Ghana: some evidence from the Demographic and Health Surveys.

Ghana's strategic framework for controlling HIV/AIDS endorses voluntary HIV testing as an important strategy toward risk reduction and HIV/AIDS prevention. Yet, like other sub-Saharan African countries, utilization of testing services in Ghana is very low. Using the 2003 Ghana Demographic and Health Surveys and applying both complementary and negative log-log models, this study investigates the correlates of HIV testing among women aged 15-49. Two major dependent variables are considered, "ever tested for AIDS" and "wanting to test for AIDS." Results show that majority of Ghanaian women have not tested for HIV but say they want to do so. Having tested for HIV is strongly related to respondents' knowledge about someone dead of AIDS and other socio-economic and demographic variables such as education, region of residence, rural-urban residence, religion, and marital status. Majority of Ghanaian women do not know where to get an HIV test, although knowing where to get a test was significantly related to wanting to get the test done. To increase voluntary testing for HIV among women in Ghana it is recommended that testing services be made more accessible and visible especially to those residing in rural areas who may be economically disadvantaged. Interventions, including routine checking of HIV serostatus among patients seeking healthcare in clinics and home/work-based testing programs, must be encouraged as ways of expanding access among women in Ghana.

Race and ethnic disparities in cervical cancer screening in a safety-net system.

OBJECTIVES: The three objectives of this research were: 1) to examine the use of Pap smear tests among low-income women, including minority and immigrant women who were patients in a safety-net healthcare system; 2) to identify policy relevant variables that could lead to changes in use of Pap smear screening services for these women; and 3) to contribute to the literature on use of Pap smear screening, especially among minorities and immigrants. The Behavioral Model for Vulnerable Populations was used as the theoretical framework. METHODS: Pap smear screening predictors were examined using telephone interviews with a random sample of women aged 18-60, including 465 Non-Hispanic Whites, 285 African Americans, 164 Hispanic Americans, and 256 Hispanic immigrants, enrolled in a safety-net healthcare system in Texas in Fall 2000. Binary logistic regression analysis was used. RESULTS: The research revealed that Non-Hispanic Whites were most likely to have been screened ever and in the past 3 years, followed by African Americans, Hispanic immigrants, and Hispanic Americans. Among Hispanics, immigrants were most likely to have had Pap smear screening, supporting the "healthy immigrant hypothesis." Older women were most likely to have ever been screened, with younger women, most likely in the past year. Having a usual source of healthcare and a checkup for current pregnancy increased screening, while competing needs (food, clothing, housing) affected screening negatively. CONCLUSIONS: Culturally competent, community-based care for women is needed to increase Pap smear screening among minority groups, especially Hispanic immigrant and Hispanic American women.