Original Research

Acceptability and performance of dual HIV/syphilis testing in male circumcision clients, 2021

Tendesayi Kufa, Ocean Tobaiwa, Ewaldé Cutler, Beverley Singh, Zinhle Brukwe, Venessa Maseko, Erushka Pillay, Philip Dorrell, Khumbulani Moyo, Lindokuhle Zondi, Yogan Pillay, Sean Patrick, Adrian Puren
Southern African Journal of HIV Medicine | Vol 25, No 1 | a1571 | DOI: https://doi.org/10.4102/sajhivmed.v25i1.1571 | © 2024 Tendesayi Kufa, Ocean Tobaiwa, Ewaldé Cutler, Beverley Singh, Zinhle Brukwe, Venessa Maseko, Erushka Pillay, Philip Dorrell, Khumbulani Moyo, Lindokuhle Zondi, Yogan Pillay, Sean Patrick, Adrian Puren | This work is licensed under CC Attribution 4.0
Submitted: 30 January 2024 | Published: 30 August 2024

About the author(s)

Tendesayi Kufa, Centre for HIV and Sexually Transmitted Infections, National Institute for Communicable Diseases, Johannesburg, South Africa; and, School of Public Health, Faculty of Medicine, University of the Witwatersrand, Johannesburg, South Africa
Ocean Tobaiwa, Clinton Health Access Initiative, Pretoria, South Africa
Ewaldé Cutler, Centre for HIV and Sexually Transmitted Infections, National Institute for Communicable Diseases, Johannesburg, South Africa
Beverley Singh, Centre for HIV and Sexually Transmitted Infections, National Institute for Communicable Diseases, Johannesburg, South Africa
Zinhle Brukwe, Centre for HIV and Sexually Transmitted Infections, National Institute for Communicable Diseases, Johannesburg, South Africa
Venessa Maseko, Centre for HIV and Sexually Transmitted Infections, National Institute for Communicable Diseases, Johannesburg, South Africa
Erushka Pillay, Clinton Health Access Initiative, Pretoria, South Africa
Philip Dorrell, Clinton Health Access Initiative, Pretoria, South Africa
Khumbulani Moyo, Right to Care, Centurion, South Africa
Lindokuhle Zondi, Right to Care, Centurion, South Africa
Yogan Pillay, Clinton Health Access Initiative, Pretoria, South Africa
Sean Patrick, School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
Adrian Puren, Centre for HIV and Sexually Transmitted Infections, National Institute for Communicable Diseases, Johannesburg, South Africa; and, Department of Virology, School of Pathology, Faculty of Medicine, University of the Witwatersrand, Johannesburg, South Africa

Abstract

Background: Dual HIV/syphilis testing may be an acceptable intervention to identify men with sexually transmitted infections (STIs) and at risk of HIV acquisition.

Objectives: We sought to determine the acceptability, and performance of dual HIV/syphilis testing among men attending voluntary medical male circumcision (VMMC) services at six public sector facilities in Gauteng.

Method: This was a cross-sectional study at VMMC facilities. Men ≥ 18 years were enrolled. The men had (1) a questionnaire administered, (2) on-site dual HIV/syphilis testing with First Response HIV1+2/Syphilis Combo Card Test by routine lay counsellors, and (3) a blood specimen collected for centralised laboratory testing for HIV and syphilis serology. We evaluated pre-test and post-test acceptability and performance compared to serological testing.

Results: Of the 679 men analysed (median age 32.1 years), 96.7% of HIV-negative men preferred testing for HIV and syphilis simultaneously. Of the 675 men tested for syphilis, 28 (4.7%) tested positive (past or recent). In the laboratory, 43/609 (7.1%) had syphilis infection detected, with 9/609 (1.5%) having recent syphilis. There was sub-optimal sensitivity for HIV detection (90.9%; 95% confidence interval [CI]: 88.5% – 93.3%), and for past/recent syphilis (55.8%; 95% CI: 51.9% – 59.8%), improving to 88.9% (95% CI: 86.4% – 91.4%) for recent syphilis. Specificities were > 99% for HIV and syphilis (past or recent). Post-test acceptability was 96.6% and willingness to pay for future testing was 86.1%.

Conclusion: Dual HIV/syphilis testing was acceptable but had sub-optimal sensitivity for HIV and syphilis. Syphilis detection was adequate for recent infection.


Keywords

male circumcision; HIV; syphilis; dual testing; acceptability; performance

Sustainable Development Goal

Goal 3: Good health and well-being

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