Abstract
Aim
The primary objective of this study was to investigate temporal changes in HIV testing rates and quantify the degree to which these trends can be attributed to certain socio-economic characteristics, as well as exposure to information sources.
Subjects and methods
Data from a nationally representative sample of 30,020 sexually active black Africans who participated in the first, second, third and fourth South African National HIV, Behaviour and Health Surveys conducted in 2002, 2005, 2008 and 2012, respectively. Multivariable logistic regression models and population-attributable risks were calculated for the socio-economic characteristics and the information sources.
Results
The socio-economic characteristics of the survey participants remained stable over time, while HIV testing rates increased substantially from 20% in 2002 to 70% in 2012. However, there was little improvement in condom use rates. Combined impact of education, employment and geographical locations were associated with increased levels of HIV testing rates. Most of the survey participants (> 80%) were exposed to several mass-media and interpersonal information sources. The combined impact of mass-media tools on HIV testing rates ranged between 48 and 60%, while 40–50% of the HIV tests were collectively attributed to the interpersonal information sources.
Conclusion
We observed significant temporal changes in population-level impacts of several key socio-economic characteristics and information sources on HIV testing rates. Widespread nationwide HIV awareness efforts led to significant increases in access to testing facilities and substantial increases in HIV testing rates over time. However, this increase was not mirrored in condom use behaviour.
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Acknowledgements
The current study used the secondary data from a study supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (CDC) under the terms of 3U2GGH000570 and the South African National AIDS Council (SANAC). All the views in this study are solely the responsibility of the authors and do not necessarily represent the official views of the CDC or the SANAC.
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HW and TR prepared the research proposal. TR extracted the data. HW and TR merged the data. HW conducted the analysis and prepared the first draft. Both authors interpreted the results. Both authors approved the final draft.
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Ethical approvals were received from the Research Ethics Committee of the Human Sciences Research Council, South Africa (REC: 5/17/11/10); the Associate Director of Science of the National Centre for HIV and AIDS, Viral Hepatitis, STD and TB Prevention at the Centers for Disease Control and Prevention (CDC) in Atlanta, GA, USA.
The study protocol has received approval by the Human Sciences Research Council (HSRC) Research Ethics Committee (REC: 5/17/11/10) and by the CDC. In addition, the principle investigators of the study have received additional approval from the SABSSM data curation team on June 5, 2018.
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Wand, H., Reddy, T. Temporal trends in correlates of HIV testing uptake in South Africa: evaluation and population-level impacts of socio-economic factors and information sources. J Public Health (Berl.) 30, 195–203 (2022). https://doi.org/10.1007/s10389-020-01271-6
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DOI: https://doi.org/10.1007/s10389-020-01271-6