Utility Restructuring and the Environment

Background: To determine differences among persons who provided blood specimens for HIV testing compared with those who did not among those interviewed for the population-based Zimbabwe Young Adult Survey (YAS). Methods: Chi-square analysis of weighted data to compare demographic and behavioral data of persons interviewed who provided specimens for anonymous testing with those who did not. Prevalence estimation to determine the impact if persons not providing specimens had higher prevalence rates than those who did. Results: Comparing those who provided specimens with those who did not, there was no significant difference by age, residence, education, marital status, perceived risk, sexual experience or number of sex partners for women. A significant difference by sexual experience was found for men. Prevalence estimates did not change substantially when prevalence was assumed to be two times higher for persons not providing specimens. Conclusion: When comparing persons who provided specimens for HIV testing with those who did not, few significant differences were found. If those who did not provide specimens had prevalence rates twice that of those who did, overall prevalence would not be substantially affected. Refusal to provide blood specimens does not appear to have contributed to an underestimation of HIV prevalence. Background Many countries in sub-Saharan African have conducted national population-based surveys that include HIV-1 testing. Although such surveys represent a major technical advance over convenience samples such as surveys in antenatal care settings, they introduce other technical issues. The representativeness of such surveys is an issue as exclusion of individuals who were not at home during the survey period or who refuse to participate can bias the results, possibly leading to an underestimation or overestimation of national HIV prevalence. The risk of HIV infection among persons who do not participate in the survey because they refuse or are not at home, or who agree to be interviewed but refuse to be tested may be difPublished: 5 July 2007 BMC Public Health 2007, 7:145 doi:10.1186/1471-2458-7-145 Received: 22 January 2007 Accepted: 5 July 2007 This article is available from: http://www.biomedcentral.com/1471-2458/7/145 © 2007 McNaghten et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.