Estimating the Prevalence of over- and Under-Reporting in HIV Testing, Status and Treatment in Rural Northeast South Africa: A Comparison of a Survey and Clinic Records

Leslie, Hannah H; Kabudula, Chodziwadziwa Whiteson; West, Robin; Dufour, Mi‐Suk Kang; Julien, Aimée; Masilela, Nkosinathi; Tollman, Stephen; Pettifor, Audrey; Kahn, Kathleen; Lippman, Sheri A.

doi:10.1007/s10461-023-04045-9

Cited by 1 publication

(2 citation statements)

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“…Discrepancies may also be due to reluctance to report positive results among participants in our study, as found elsewhere in South Africa. 4 Informal project staff discussions with CHW in the PS arm confirmed that many CHW felt participants were choosing not to report positive results. The likely underreporting is evidenced in the data: only 2% of participants reported reactive results in the PS arm, vs. 6.44% of participants reporting reactive results utilizing the anonymous SMS service.…”

Section: Discussionmentioning

confidence: 99%

“…2 , 3 While 66% of men (aged 15+) reported testing for HIV within the past year in the 2017 national survey 2 studies have also documented substantial overreporting of HIV testing, particularly among men. 4 Estimates of the proportion of men living with HIV who know their status in South Africa vary widely, from as low as 45% 2 , 5 to modeled estimates as high as 82%. 6 Despite national HIV testing campaigns, male clinic attendance remains low, leading to disparities in HIV-related care and wellbeing 7 , 8 and continued transmission to partners.…”

Section: Introductionmentioning

confidence: 99%

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Results of the Sukuma Ndoda (“Stand up, Man”) HIV self-screening and assisted linkage to care project in Johannesburg: a quasi-experimental pre-post evaluation

Lippman,

Grignon,

Ditshwane

et al. 2024

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: HIV testing rates among South African men lag behind rates for women and national targets. Community-based HIV self-screening (HIVSS) distribution and follow-up by community health workers (CHWs) is a scalable option to increase testing coverage, diagnosis, and treatment initiation. We provided HIVSS and assisted linkage to care to men not recently tested (within the past 12 months) residing in high-HIV-burden areas of Johannesburg. Methods: CHWs distributed HIVSS in 6 clinic catchment areas. Follow-up to encourage confirmatory testing and antiretroviral therapy initiation was conducted through personal support (PS) or an automated short message service (SMS) follow-up and linkage system in 3 clinic areas each. Using a quasi-experimental pre–post design, we compared differences in the proportion of men testing in the clinic catchment areas during the HIVSS campaign (June–August 2019) to the 3 months prior (March–May 2019) and compared treatment initiations by assisted linkage strategy. Results: Among 4793 participants accepting HIVSS, 62% had never tested. Among 3993 participants with follow-up data, 90.6% reported using their HIVSS kit. Testing coverage among men increased by 156%, from under 4% when only clinic-based HIV testing services were available to 9.5% when HIVSS and HIV testing services were available (z = −11.6; P < 0.01). Reported test use was higher for men followed through PS (99% vs. 68% in SMS); however, significantly more men reported reactive self-test results in the SMS group compared with PS (6.4% vs. 2.0%), resulting in more antiretroviral therapy initiations in the SMS group compared with PS (23 vs. 9; P < 0.01). Conclusions: CHW HIVSS distribution significantly increases testing among men. While PS enabled personalized follow-up, reporting differences indicate SMS is more acceptable and better aligned with expectations of privacy associated with HIVSS.

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Section: Discussionmentioning

confidence: 99%