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

Abstract

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.