The gendered experience of HIV testing: factors associated with prior testing differ among men and women in rural Tanzania

HIV testing remains below UNAIDS 90-90-90 goals in sub-Saharan Africa. The aim of this study was to understand gender-specific factors related to HIV testing in Kisarawe, Tanzania. Informed by Social Action Theory, we analyzed cross-sectional data from a population-based random sample using bivariate and multivariate logistic regression to identify the contextual, behavioral, and interpersonal factors associated with prior HIV testing - specifically, any prior testing and testing within the past year. Of 644 participants, 63.1% of men and 85.5% of women reported ever testing for HIV. Younger men and women (aged 18-25 years) had significantly lower odds of prior HIV testing compared with older participants. For men, low levels of anticipated stigma and having ever talked about HIV were both positively associated with any prior testing. Men who knew if a sexual partner had received an HIV test had almost three times the odds of receiving a recent HIV test compared to men with no knowledge of their partners' testing status (aOR = 2.96, 95% CI: 1.22-7.17, p = 0.01). For women, knowing someone who is HIV-positive was associated with increased odds of any prior testing (aOR = 2.74, 95% CI: 1.24-6.07, p = 0.01). Gender-specific, proactive interventions are needed to increase testing uptake, especially for young people and men.