Original Research - Special Collection: UNAIDS Targets for 2030

Geographical variation in HIV testing in South Africa: Evidence from the 2017 national household HIV survey

Sean Jooste, Musawenkosi Mabaso, Myra Taylor, Alicia North, Yolande Shean, Leickness C. Simbayi, Tarylee Reddy, Leonard Mwandingi, Tenielle Schmidt, Portia Nevhungoni, Samuel Manda, Khangelani Zuma
Southern African Journal of HIV Medicine | Vol 22, No 1 | a1273 | DOI: https://doi.org/10.4102/sajhivmed.v22i1.1273 | © 2021 Sean Jooste, Musawenkosi Mabaso, Myra Taylor, Alicia North, Leickness Chisamu Simbayi, Tarylee Reddy, Leonard Mwandingi, Tenielle Schmidt, Portia Nevhungoni, Samuel Manda, Khangelani Zuma | This work is licensed under CC Attribution 4.0
Submitted: 28 May 2021 | Published: 31 August 2021

About the author(s)

Sean Jooste, Human Sciences Research Council, Cape Town, South Africa; and, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
Musawenkosi Mabaso, Human Sciences Research Council, Durban, South Africa
Myra Taylor, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
Alicia North, Human Sciences Research Council, Cape Town, South Africa
Yolande Shean, Human Sciences Research Council, Cape Town, South Africa
Leickness C. Simbayi, Human Sciences Research Council, Cape Town, South Africa; and, Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa
Tarylee Reddy, South African Medical Research Council, Durban, South Africa
Leonard Mwandingi, Human Sciences Research Council, Cape Town, South Africa; and, Division of Epidemiology and Biostatistics, Stellenbosch University, Cape Town, South Africa; and, Ministry of Health and Social Sciences, Windhoek, Namibia
Tenielle Schmidt, Human Sciences Research Council, Durban, South Africa
Portia Nevhungoni, South African Medical Research Council, Pretoria, South Africa
Samuel Manda, South African Medical Research Council, Pretoria, South Africa; and, Department of Statistics, University of Pretoria, Pretoria, South Africa
Khangelani Zuma, Human Sciences Research Council, Pretoria, South Africa; and, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa


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Abstract

Background: Identification of the geographical areas with low uptake of HIV testing could assist in spatial targeting of interventions to improve the uptake of HIV testing.

Objectives: The objective of this research study was to map the uptake of HIV testing at the district level in South Africa.

Method: The secondary analysis used data from the Human Sciences Research Council’s 2017 National HIV Prevalence, Incidence, Behaviour and Communication Survey, where data were collected using a multistage stratified random cluster sampling approach. Descriptive spatial methods were used to assess disparities in the proportion of those ever tested for HIV at the district level in South Africa.

Results: The districts with the highest overall coverage of people ever having tested for HIV (> 85%) include West Rand in Gauteng, Lejweleputswa and Thabo Mofutsanyane in Free State, and Ngaka Modiri Molema in North-West. These provinces also had the least variation in HIV testing coverage between their districts. Districts in KwaZulu-Natal had the widest variation in coverage of HIV testing. The districts with the lowest uptake of HIV testing were uMkhanyakude (54.7%) and Ugu (61.4%) in KwaZulu-Natal and Vhembe (61.0%) in Limpopo. Most districts had a higher uptake of HIV testing amongst female than male participants.

Conclusion: The uptake of HIV testing across various districts in South Africa seems to be unequal. Intervention programmes must improve the overall uptake of HIV testing, especially in uMkhanyakude and Ugu in KwaZulu-Natal and Vhembe in Limpopo. Interventions must also focus on enhancing uptake of HIV testing amongst male participants in most districts. Strategies that would improve the uptake of HIV testing include HIV self-testing and community HIV testing, specifically home-based testing.


Keywords

HIV; HIV testing; thematic mapping; districts; South African

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