HIV testing and self‐testing coverage among men and women in South Africa: an exploration of related factors

• Published in: Tropical medicine & international health 2021-02, Vol.26 (2), p.214-227
• Main Authors: Awopegba, Oluwafemi Emmanuel, Ologunowa, Taiwo Olubunmi, Ajayi, Anthony Idowu
• Format: Article
• Language: English
• Subjects: Adolescents; HIV; HIV testing; Human immunodeficiency virus; media exposure; Medical tests; Men; multilevel analysis; self‐testing; Sexually transmitted diseases; South Africa; STD; Teenagers; Women
• ISSN: 1360-2276; 1365-3156
• DOI: 10.1111/tmi.13514

Objectives Uptake of HIV testing is critical to halting the spread of HIV. Our study aimed to examine the coverage of HIV testing and self‐testing and the individual‐level, household‐level and community‐level factors associated with HIV testing and self‐testing awareness. Methods We analysed data of 12 312 men and women from 2016 SADHS and used multilevel mixed‐effects models to examine the factors associated with uptake of HIV testing and self‐testing awareness. Results About 80% of participants had ever tested for HIV, and 64% had tested in the past year. Only 49% of adolescents aged 15–19 years had ever tested for HIV compared with over 80% of adults. Self‐testing awareness was low (22%), and only 2.9% of respondents had ever self‐tested for HIV. The odds of having ever tested for HIV were significantly higher among respondents who were aged 25–29 (AOR: 4.02; 95% CI: 3.27–4.95), had a higher level of education (AOR: 3.18; 95% CI: 2.19–4.61), were married (AOR: 1.63; 95% CI: 1.36–1.94), had high media exposure (AOR: 1.23; 95% CI: 1.06–1.44) and had ever had sex (AOR: 5.57; 95% CI: 4.67–6.64), but lower among men (AOR: 0.39; 95% CI: 0.35–0.44). Conclusion In conclusion, HIV testing coverage is high in South Africa relative to most countries in sub‐Saharan Africa, but falls short of the UNAIDS first 95. We found no evidence of socioeconomic and geographic inequalities in access to HIV testing. However, adolescents had a lower level of HIV testing uptake, suggesting a need for interventions to expand testing in this age group. Objectifs Le recours au dépistage du VIH est essentiel pour enrayer la propagation du VIH. Notre étude vise à examiner la couverture du dépistage du VIH et de l'auto‐dépistage et les facteurs au niveau individuel, familial et communautaire associés au dépistage du VIH et à la sensibilisation à l'auto‐dépistage. Méthodes Nous avons analysé les données de 12.312 hommes et femmes de la SADHS 2016 et utilisé des modèles à effets mixtes à plusieurs niveaux pour examiner les facteurs associés à l'adoption du dépistage du VIH et à la sensibilisation à l'auto‐dépistage. Résultats Environ 80% des participants ont déjà subi un test de dépistage du VIH et 64% l'ont fait au cours de l'année écoulée. Seuls 49% des adolescents âgés de 15 à 19 ans avaient déjà subi un test de dépistage du VIH contre plus de 80% des adultes. La connaissance de l'auto‐dépistage était faible (22%) et seulement 2,9% des personnes interrogées s'étaient déjà autotestées p