Geographical Variation in HIV Testing in South Africa: Evidence from the 2017 National Household HIV Survey

Overview

Journal South Afr J HIV Med

Specialty Infectious Diseases

Date 2021 Sep 15

PMID 34522430

Citations 4

Authors

Sean Jooste

Musawenkosi Mabaso

Myra Taylor

Alicia North

Yolande Shean

Leickness C Simbayi

Tarylee Reddy

Leonard Mwandingi

Tenielle Schmidt

Portia Nevhungoni

Samuel Manda

Khangelani Zuma

Affiliations

Soon will be listed here.

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.

Citing Articles

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.

Jaiteh M, Phalane E, Shiferaw Y, Phaswana-Mafuya R JMIR Res Protoc. 2025; 14:e59916.

PMID: 39870368 PMC: 11811654. DOI: 10.2196/59916.

Spatial analysis and associated risk factors of HIV prevalence in Botswana: insights from the 2021 Botswana AIDS Impact Survey (BAIS V).

Simela S, Kelepile M, Sebobi T BMC Infect Dis. 2025; 25(1):69.

PMID: 39815215 PMC: 11736943. DOI: 10.1186/s12879-025-10464-x.

Spatial mapping and predictors of ever-tested for HIV in adolescent girls and young women in Ethiopia.

Shimbre M, Tunja A, Bodicha B, Gedefaw Belete A, Hailgebereal S, Fornah L Front Public Health. 2024; 12:1337354.

PMID: 38633231 PMC: 11021716. DOI: 10.3389/fpubh.2024.1337354.

Impact of youth lay health workers on HIV service delivery in South Africa: A pragmatic cluster randomized trial of the Youth Health Africa program.

Tollefson D, Dasgupta S, Setswe G, Reeves S, Charalambous S, Duerr A PLoS One. 2023; 18(11):e0294719.

PMID: 38033029 PMC: 10688901. DOI: 10.1371/journal.pone.0294719.

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.

Tilahun W, Tesfie T PLoS One. 2023; 18(11):e0293227.

PMID: 38032924 PMC: 10688645. DOI: 10.1371/journal.pone.0293227.

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