HIV Testing, Household and Reproductive Health Decision-Making: The Role of Women Autonomy in a Nationally...

Women's autonomy plays a critical role in decision-making of health service use. This study aims to evaluate the relationship between Human Immunodeficiency Virus (HIV) testing and decision-making autonomy among Cambodian women aged 15-49.

We used data from the 2021-2022 Cambodia Demographic and Health Survey (DHS) and our sample consisted of currently married/cohabiting women aged 15-49 (N = 13,755). The outcome variable was "ever been tested for HIV." Covariates were household decision-making and reproductive health decision-making scores, socio-demographic characteristics (age, place of residency, education, wealth quintiles, and employment status), and HIV knowledge (HIV self-test kits, drugs to prevent HIV in babies during pregnancy, antiretroviral [ARV] drugs, and pre-exposure prophylaxis).

Sixty-one percent of studied women reported ever being tested for HIV. The logistic regression results revealed that women with a higher household decision-making score (aOR = 2.09, p < 0.001), reproductive health decision-making score (aOR = 1.72, p < 0.001), from 25 to 29 age groups (aOR = 2.21, p < 0.001), with a higher education (aOR = 1.96, p = 0.001), from the richest groups (aOR = 1.73, p < 0.001), had knowledge of HIV test kits but never get tested (aOR = 1.38, p = 0.035), heard of drugs to avoid HIV transmission to babies during pregnancy (aOR = 1.21, p < 0.001), and heard of ARV drugs (aOR = 1.28, p < 0.001) were more likely to get tested for HIV than their counterparts. Women living in rural areas (aOR = 0.56, p < 0.001) and those who had discriminatory attitudes (aOR = 0.76, p = < 0.001) were less likely to get HIV tests than those in urban areas and those without discrimination.

Findings revealed that greater autonomy is important for health care use, particularly HIV testing for women in Cambodia.