Barriers and facilitators associated with HIV testing uptake in South African health facilities offering HIV Counselling and Testing

Mohlabane, Neo; Tutshana, Bomkazi; Peltzer, Karl; Mwisongo, Aziza

doi:10.4102/hsag.v21i0.938

Cited by 44 publications

(60 citation statements)

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“…A recent evaluation of the HIV lay counselling and testing profession in SA interviewed 32 lay counsellors from 62 health facilities. Staff self‐reported counselling an average of 12 clients per day and testing only 9‐25 clients on busy clinics days, which is a fraction of the total number of patients that present for care . Due to the time demands of providing HTS, clinicians provided only a small proportion of HTS sessions (15%), similar to prior observations .…”

Section: Discussionsupporting

confidence: 70%

“…In a recent South African study across 67 health facilities, 18% of clinic attendees had never tested for HIV. (20) Unless changes are made to HTS delivery in facilities like those we observed, these individuals may remain untested. Overall acceptance of HTS, when offered, appeared comparable to 73% uptake (95% CI: 55-87) of facility-based HIV testing, pooled across 12 health facilities in sub-Saharan Africa [16].…”

Section: Discussionmentioning

confidence: 91%

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HIV testing services in healthcare facilities in South Africa: a missed opportunity

et al. 2019

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IntroductionSouth Africa (SA) has the world's highest burden of HIV infection (approximately 7.2 million), yet it is estimated that 23.5% women and 31.5% of men are unaware that they are living with HIV. The 2015 national South African HIV testing guidelines mandate the universal offer of HIV testing services (HTS) in all healthcare facilities.MethodsA multi‐prong approach was used from January 2017 to June 2017 to evaluate the current implementation of HTS in ten facilities in the Ekurhuleni District of SA. First, we conducted patient exit interviews to quantify engagement in HTS services. Second, we systematically mapped the flow of individual patients through the clinic.ResultsWe conducted a total of 2989 exit interviews and followed 568 patients for value stream mapping. Overall self‐reported testing acceptance was high at 84.7% (244), but <10% of the patients (288) were offered testing. Female patients were more likely to be offered testing (233/2046, 11.4% vs. 55/943, 5.8% in males; chi‐square p < 0.005), and also more likely to accept testing (203/233, 87.1% vs. 41/55, 74.6% in males; chi‐square p = 0.02). Value stream mapping revealed that patients offered HIV testing had a total visit time of 51 minutes more (95% CI: 30‐72) compared to those not offered testing.ConclusionsThe poor delivery of HTS appears to be due to a failure to recommend HTS and the added time burden placed on those accepting testing. There were significant differences in both the offer and acceptance of testing by gender. Health system issues need to be addressed to improve HTS delivery.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 91%

HIV testing services in healthcare facilities in South Africa: a missed opportunity

et al. 2019

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“…The equation above has been extensively applied to numerous real life situations [27,[33][34][35]. The quantity to the left of the equal sign is called a logit.…”

Section: Materials and Methodologymentioning

confidence: 99%

An Assessment of HIV Counselling and Testing (HCT) Service Utilization in Nigeria: A Binary Logistic Regression Approach

Jospeh¹

2019

IJHPEBS

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HIV infection remains the most challenging health and development crisis in the last two decades as it continues to create health and socioeconomic challenges in many parts of Nigeria and the world at large. HIV counselling and testing (HCT) can identify infection in early stages as it involves analysis of body fluids for the presence of antigens or antibodies produced in response to HIV and these are key to controlling the HIV epidemics. As a result, certain factors are considered in this study as deterrents to HCT service utilization in Nigeria applying the k-order binary logistic regression model using a structured questionnaire developed by the research team in some selected states in SouthWest of Nigeria. The sociodemographic details of respondents reveals that out of 788 people (out of 800 administered questionnaires) that were interviewed, 452 (57.4%) have had HCT while 336 (42.6%) never had HCT. Age 15-19 (the adolescent) with 68.1% are the groups with the highest respondents with HCT uptake. The chi-square test of independence also reveals that age, gender, religion, and marital status are not related with HCT uptake while ethnic, educational status, place of residence are associated with decision on HCT uptake. The binary logistic regression of HCT uptake on the investigated socio-demographic details of respondents reveals the age group (50 and above) has the highest odds of up-taking HCT while those in the group 25-29 years has the least. Male respondents have a slightly higher odds compared to female and the Yoruba ethnic group are the most likely to utilize HCT. Results also revealed that traditionalist are the most likely to utilize HCT (1.635) with the Christianity (with 1.000) being the least. Those who are single/never married has a non-significant highest odds (1.092) among the marital status considered while those who are separated/divorced has the least (0.712). The odds of utilizing HCT is least among those with no formal education. People with Primary education are about three times more likely to take HCT compared to those with no formal education. Rural settlers are about three times (2.818) more likely to uptake HCT in comparison with those who reside in urban centres. Finally, employment status of respondents is insignificant to HCT uptake, although the odds in favour of those that are schooling is highest (1.175), followed by those that are self-employed (1.013).

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“…10.21203/rs.2.12584/v2 South Africa, where stigma and low rates of risk perception were noted as significant barriers to HIV testing (7)(8)(9)(10)(11)(12). Likewise, individuals with more negative attitudes towards HIV were less likely to seek testing (10).…”

Section: Doimentioning

confidence: 99%

The Impact of HIV Knowledge and Attitudes on HIV Testing Acceptance among Patients in an Emergency Department in the Eastern Cape, South Africa

Ryan

Hahn

Rao

et al. 2019

Preprint

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Background: Transmission of HIV in South Africa continues to be high due to a large proportion of individuals living with undiagnosed HIV. Uptake of HIV testing is influenced by a multitude of factors including the patient’s knowledge and beliefs about HIV. Methods: This study sought to quantify the impact of knowledge and attitudes on HIV testing acceptance in an emergency department by co-administering a validated HIV knowledge and attitudes survey to patients who were subsequently offered HIV testing. Results: During the study period 223 patients were interviewed and offered HIV testing. Individuals reporting more negative overall attitudes (p = 0.006), higher levels of stigma to HIV testing (p<0.001), and individuals who believed their test was confidential (p<0.001) were more likely to accept an HIV test. Conclusions: Interventions focused on improving patient perceptions around testing confidentiality will likely have the greatest impact on testing acceptance in the emergency department.

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Barriers and facilitators associated with HIV testing uptake in South African health facilities offering HIV Counselling and Testing

Cited by 44 publications

References 0 publications

HIV testing services in healthcare facilities in South Africa: a missed opportunity

HIV testing services in healthcare facilities in South Africa: a missed opportunity

An Assessment of HIV Counselling and Testing (HCT) Service Utilization in Nigeria: A Binary Logistic Regression Approach

The Impact of HIV Knowledge and Attitudes on HIV Testing Acceptance among Patients in an Emergency Department in the Eastern Cape, South Africa

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