Email this article 
Hide
Show all
Original Research - Special Collection: UNAIDS Targets for 2030
Geographical variation in HIV testing in South Africa: Evidence from the 2017 national household HIV survey
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 AfricaMusawenkosi 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
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
Metrics
Total abstract views: 6044Total article views: 5956
Crossref Citations
1. Spatial variation of premarital HIV testing and its associated factors among married women in Ethiopia: Multilevel and spatial analysis using 2016 demographic and health survey data
Werkneh Melkie Tilahun, Tigabu Kidie Tesfie, Mohammed Feyisso Shaka
PLOS ONE vol: 18 issue: 11 first page: e0293227 year: 2023
doi: 10.1371/journal.pone.0293227
2. Spatial analysis and associated risk factors of HIV prevalence in Botswana: insights from the 2021 Botswana AIDS Impact Survey (BAIS V)
Sethunya R. Simela, Matlhogonolo Kelepile, Thabo I. Sebobi
BMC Infectious Diseases vol: 25 issue: 1 year: 2025
doi: 10.1186/s12879-025-10464-x
3. HIV screening and associated factors among adolescent girls and young women in Tanzania: analysis of the 2022 demographic and health survey data
Elihuruma Eliufoo Stephano, Linus Paul Rweyemamu, Tian Yusheng, Li Yamin, Theresia Ambrose Ottaru, Christopher Hariri Mbotwa
BMC Public Health vol: 25 issue: 1 year: 2025
doi: 10.1186/s12889-025-24544-9
4. Self-reported HIV testing and treatment among migrants from northeast South Africa: A cross-sectional, population-based analysis
Rachel R. Yorlets, F. Xavier Goméz-Olivé, Carren Ginsburg, Sadson Harawa, Kathleen Kahn, Stephen Tollman, Mark Collinson, Mark Lurie
Southern African Journal of HIV Medicine vol: 26 issue: 1 year: 2025
doi: 10.4102/sajhivmed.v26i1.1666
5. Exploring Determinants of HIV/AIDS Self-Testing Uptake in South Africa Using Generalised Linear Poisson and Geographically Weighted Poisson Regression
Emmanuel Fundisi, Simangele Dlamini, Tholang Mokhele, Gina Weir-Smith, Enathi Motolwana
Healthcare vol: 11 issue: 6 first page: 881 year: 2023
doi: 10.3390/healthcare11060881
6. Spatial mapping and predictors of ever-tested for HIV in adolescent girls and young women in Ethiopia
Mulugeta Shegaze Shimbre, Abayneh Tunja, Belay Boda Bodicha, Abebe Gedefaw Belete, Samuel Hailgebereal, Lovel Fornah, Wei Ma
Frontiers in Public Health vol: 12 year: 2024
doi: 10.3389/fpubh.2024.1337354
7. Spatial Heterogeneity in Determinants of No Condom Use at First Sex in South Africa
Tholang Mokhele, Thabiso Moeti, Emmanuel Fundisi, Inbarani Naidoo, Frederick Tshitangano, Gina Weir-Smith
The Open Public Health Journal vol: 17 issue: 1 year: 2024
doi: 10.2174/0118749445306739240322062514
8. The Application of Machine Learning Algorithms to Predict HIV Testing Using Evidence from the 2002–2017 South African Adult Population-Based Surveys: An HIV Testing Predictive Model
Musa Jaiteh, Edith Phalane, Yegnanew A. Shiferaw, Haruna Jallow, Refilwe Nancy Phaswana-Mafuya
Tropical Medicine and Infectious Disease vol: 10 issue: 6 first page: 167 year: 2025
doi: 10.3390/tropicalmed10060167
9. The Application of Machine Learning Algorithms to Predict HIV Testing in Repeated Adult Population–Based Surveys in South Africa: Protocol for a Multiwave Cross-Sectional Analysis
Musa Jaiteh, Edith Phalane, Yegnanew A Shiferaw, Refilwe Nancy Phaswana-Mafuya
JMIR Research Protocols vol: 14 first page: e59916 year: 2025
doi: 10.2196/59916
10. Impact of youth lay health workers on HIV service delivery in South Africa: A pragmatic cluster randomized trial of the Youth Health Africa program
Deanna Tollefson, Sayan Dasgupta, Geoffrey Setswe, Sarah Reeves, Salome Charalambous, Ann Duerr, Samuel Bosomprah
PLOS ONE vol: 18 issue: 11 first page: e0294719 year: 2023
doi: 10.1371/journal.pone.0294719
11. Effectiveness of Linkage to Care and Prevention Interventions Following HIV Self-Testing: A Global Systematic Review and Meta-analysis
Oluwafemi Atanda Adeagbo, Oluwaseun Abdulganiyu Badru, Claude Ngwayu Nkfusai, Luchuo Engelbert Bain
AIDS and Behavior vol: 28 issue: 4 first page: 1314 year: 2024
doi: 10.1007/s10461-023-04162-5
12. A Culturally Sensitive Psychosocial Support Programme for Orphans and Vulnerable Children in Vhembe District, South Africa
Livhuwani Precious Matshepete, Lufuno Makhado, Ntsieni Stella Mashau
Public Health Challenges vol: 4 issue: 2 year: 2025
doi: 10.1002/puh2.70053
13. Estimating the Prevalence of over- and Under-Reporting in HIV Testing, Status and Treatment in Rural Northeast South Africa: A Comparison of a Survey and Clinic Records
Hannah H. Leslie, Chodziwadziwa W. Kabudula, Rebecca L. West, Mi-Suk Kang Dufour, Aimée Julien, Nkosinathi G. Masilela, Stephen M. Tollman, Audrey Pettifor, Kathleen Kahn, Sheri A. Lippman
AIDS and Behavior vol: 27 issue: 10 first page: 3248 year: 2023
doi: 10.1007/s10461-023-04045-9
14. Spatial mapping of HIV testing and antiretroviral therapy initiation uptake among the adolescents and youth in rural KwaZulu-Natal, South Africa
Mulugeta Shegaze Shimbre, Andrew Gibbs, Nondumiso Mthiyane, Jaco Dreyer, Natsayi Chimbindi, Nigel Garrett, Andrew Tomita, Maryam Shahmanesh
AIDS Care first page: 1 year: 2026
doi: 10.1080/09540121.2025.2611339