Conformity and communal decision-making: First-tester effects on acceptance of home-based HIV counseling and testing in Uganda
- Published
- Accepted
- Subject Areas
- Epidemiology, HIV, Public Health
- Keywords
- HIV counseling and testing, community health workers
- Copyright
- © 2018 Armstrong-Hough et al.
- Licence
- This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ Preprints) and either DOI or URL of the article must be cited.
- Cite this article
- 2018. Conformity and communal decision-making: First-tester effects on acceptance of home-based HIV counseling and testing in Uganda. PeerJ Preprints 6:e27006v2 https://doi.org/10.7287/peerj.preprints.27006v2
Abstract
Background: Individuals’ observation of how group members ahead of them behave can profoundly shape their perceptions, judgements, and subsequent behaviors. Moreover, social influence theories from the sociology of networks suggest that individuals’ social status and social network position determine the scope of their influence on other group members. We set out to examine the role of conformity and communal decision-making in shaping individual decisions to test for HIV during home-based TB contact investigation in Kampala, Uganda.
Methods: We analyzed the HIV testing decisions of individuals who were offered free, optional, home-based HIV testing during a home visit by community health workers. We used generalized estimating equations (GEE) to estimate how the testing decision made by the first individual in a household offered testing influenced the subsequent testing decisions of other household members.
Results: Community health workers visited 55 households with two or more eligible household members and offered 160 individuals HIV testing. Seventy-five (47%) declined the test. Individuals in households where the first person invited declined HIV testing had four times the risk of declining themselves (RR: 3.96, 95% CI: 1.7-9.0, p=0.001) compared to individuals in households where the first person invited agreed to HIV testing, controlling for individual age and gender.
Conclusions: The decision of the first individual offered HIV testing seems to influence the decisions of subsequent household members when they are also offered testing. Even when results are confidential, individual decisions may be shaped by the testing behavior of the first household member offered the test.
Author Comment
This preprint is an interim research product. It has not yet been submitted for peer review. This version updates the abstract.