Financial and Behavioral Economic Factors Associated With HIV Testing In AIDS-Affected Adolescents in Uganda: A Cross-Sectional Analysis

Provision of free HIV counseling and testing services (HCTS) helps remove financial barriers to care. Little is known on whether uptake of free HCTS by households impoverished by AIDS is influenced by financial and behavioral economic factors. We examined use of free HCTS by employment status, cash savings, food/income security, and present-bias preferences among 346 adolescent AIDS orphans and their household members in Uganda. HIV testing was low for all. Adolescents cared for by present-biased guardians (those who disproportionately weighted the present while discounting the future) were more likely to be HIV tested (OR=2.64, 95%CI:1.04–6.70) than adolescents cared for by guardians who weighted future gains. Guardians (OR=2.02; 95% CI:1.19–3.41) and non-guardian adults (OR=2.38; 95% CI:1.30–4.34) in households with savings were more likely to have been tested. Financially-insecure households (OR=0.59, 95%CI:0.35–0.97) were less likely to have been tested. Interventions addressing would-be HIV testers' economic needs may prove beneficial.