HIV status awareness and associated factors among domestic workers in Kigali, Rwanda

Domestic workers are at risk of sexual violence at their workplace, and recent studies have demonstrated that they have irregular working hours and limited time off, making it difficult to access health care services. Poor access to health services has been linked to poor HIV testing. In this study, we aimed to determine the proportion of domestic workers who are aware of their HIV status in Rwanda and the associated factors related to their unawareness. This cross-sectional study design involved 884 domestic workers in Kigali. We employed questions regarding awareness of HIV status adopted from previously published literature. Descriptive statistics was conducted to determine the proportion of domestic workers who are unaware of HIV status, and logistic regression was performed to identify the associated factors related to their unawareness. The mean age was 21.3 (Standard Deviation of 3.5), and the findings revealed that 29.43% of domestic workers were unaware of their HIV status. Factors associated with unawareness of HIV status were age below 18 (adjusted odds ratio [aOR] = 3.34; 95% confidence interval [CI]: 1.55–7.19, p value = 0.002), male-gender (aOR = 2.00, 95% CI: 1.40–2.86, p value ≤0.001), low level of education (aOR = 1.77, 95% CI: 1.26–2.49, p value ≤0.001), previous history of having unprotected sexual intercourse (aOR = 1.81; 95% CI: 1.19–2.73, p value = 0.005), those who had ever had sex (aOR = 0.59; 95% CI: 0.39–0.89, p value = 0.012), and drug dependence (aOR = 0.68, 95% CI: 0.48–0.96, p value = 0.032). One in three domestic workers is unaware of their HIV status, yet the majority are sexually active. To achieve the 2030 goal of eradicating HIV infection, programs should innovate ways to target this vulnerable group specifically.