Stata dataset.

Sub-Saharan Africa, the epicenter of the HIV epidemic, has seen significant reductions in new infections over the last decade. Although most new infections have been reported among women, particularly adolescent girls, men are still disadvantaged in accessing HIV testing, care, and treatment services. Globally, men have relatively poorer HIV testing, care, and treatment indices when compared with women. Gender norms and the associated concept of masculinity, strength, and stereotypes have been highlighted as hindering men’s acceptance of HIV counseling and testing. Therefore, men’s suboptimal uptake of HIV testing services will continue limiting efforts to achieve HIV epidemic control. Thus, this study aimed to identify individual, neighborhood, and country-level determinants of sub-optimal HIV testing among men in Sub-Saharan African countries. We analyzed demographic and health datasets from surveys conducted between 2016 and 2020 in Sub-Saharan African Countries. We conducted multivariable multilevel regression analysis on 52,641 men aged 15–49 years resident in 4,587 clusters across 10 countries. The primary outcome variable was ever tested for HIV. HIV testing services uptake among men in these ten Sub-Saharan African countries was 35.1%, with a high of 65.5% in Rwanda to a low of 10.2% in Guinea. HIV testing services uptake was more likely in men with increasing age, some form of formal education, in employment, ever married, and residents in relatively wealthier households. We also found that men who possessed health insurance, had some form of weekly media exposure, and had accessed the internet were more likely to have ever received an HIV test. Unlike those noted to be less likely to have ever received an HIV test if they had discriminatory attitudes towards HIV, comprehensive HIV knowledge, recent sexual activity, and risky sexual behavior were positive predictors of HIV testing services uptake among men. Furthermore, men in communities with high rurality and illiteracy were less likely to receive an HIV test. Individual and community-level factors influence the uptake of HIV testing among Sub-Saharan African men. There was evidence of geographical clustering in HIV testing uptake among men at the community level, with about two-thirds of the variability attributable to community-level factors. Therefore, HIV testing programs will need to design interventions that ensure equal access to HIV testing services informed by neighborhood socioeconomic conditions, peculiarities, and contexts.作为人类免疫缺陷病毒（Human Immunodeficiency Virus，HIV）疫情的震中区域，撒哈拉以南非洲在过去十年间的新增HIV感染病例数已实现显著下降。尽管多数新增HIV感染病例报告见于女性群体，尤其是青春期少女，但男性在获取HIV检测、护理与治疗服务方面仍处于劣势地位。全球范围内，相较于女性，男性的HIV检测、护理与治疗相关指标均相对偏低。社会性别规范以及与之相关的男子气概、力量观念与刻板印象，被证实为阻碍男性接受HIV咨询与检测的核心阻碍因素。因此，男性对HIV检测服务的参与度不足，将持续制约艾滋病疫情防控工作的开展。有鉴于此，本研究旨在明确撒哈拉以南非洲国家男性HIV检测参与度不足的个体、社区及国家层面影响因素。本研究分析了2016至2020年间在撒哈拉以南非洲国家开展的人口与健康调查数据集。本研究针对10个国家、4587个调查聚类群内的52641名年龄介于15至49岁的男性开展了多变量多层回归分析。本研究的主要结局变量为“是否曾接受HIV检测”。上述10个撒哈拉以南非洲国家的男性HIV检测服务参与率为35.1%，各国差异显著：卢旺达最高，达65.5%；几内亚最低，仅为10.2%。年龄越大、接受过一定正规教育、处于就业状态、曾有婚史以及居住于相对富裕家庭的男性，其HIV检测服务参与率更高。本研究同时发现，拥有医疗保险、每周接触一定媒体以及曾使用互联网的男性，更有可能曾接受HIV检测。相较于对HIV持有歧视性态度的男性更易出现检测参与不足的情况，全面的HIV认知、近期性行为与危险性行为均为男性HIV检测服务参与的正向预测因子。此外，居住于高乡村化程度与高文盲率社区的男性，其接受HIV检测的可能性更低。个体与社区层面的因素均可影响撒哈拉以南非洲男性的HIV检测服务参与度。研究证实，男性HIV检测服务参与度在社区层面存在地理聚集性特征，约三分之二的变异可归因于社区层面因素。因此，HIV检测项目应结合社区的社会经济状况、特殊性与具体情境，设计针对性干预措施以保障男性公平获取HIV检测服务。