Impact of HIV testing on sexual health communication in South Africa

Abstract

Objectives The South African Government recently launched a national campaign to test 15 million South Africans for HIV by 2011. Little is known about how receipt of HIV testing might influence interpersonal communication. To explore these questions, we examine the effects of prior HIV testing on sexual health communication among South Africans. Methods Adults (N = 1,284; 98% Black, 36% women, mean age = 31) residing in a South African township completed street-intercept surveys. Results Of the 1,284 participants, 811 (63%) had been tested for HIV. Among those who had been tested, 77% tested negative, 12% tested positive, and 11% did not know their test result or refused to answer. Compared to those who had not been tested, participants who had been tested for HIV were more likely to communicate with community members about (a) HIV/AIDS, (b) getting tested for HIV, and (c) using condoms. Testing positive for HIV was associated with communication with sexual partners about condom use. Among participants who had been tested for HIV, exploratory analyses revealed that those who had engaged in sexual health communication with community members or sexual partners reported more condom-protected sex than those who had not engaged in sexual health communication. Conclusions HIV testing is associated with sexual health communication among South African community members and sexual partners. Offering HIV testing to all South Africans may increase communication and lead to reductions in sexual risk.

HIV Testing Practices of South African Township MSM in the Era of Expanded Access to ART

“…A few men referred to their partner’s risk behavior as a motivation to test. Tlotliso (21) for instance mentioned that one of his partners, with whom he was having unprotected sex, had sex with a man who was HIV positive. Kabelo (39) said “We are human and we have sex and even with your partner you don’t always use condoms and you don’t know what he gets up to even though you are faithful.”…”

“…They used terms such as: “felt good,” “happy,” “excited,” and “relieved” or “relaxed.” Some men mentioned publicly sharing or celebrating their HIV-negative status. Tlotliso (21) said: “When I got home I showed [my results] to my mother and put them on the fridge.” Dingani (22) said, “I was so happy, I took out money and me and my friends went to go celebrate.” Another small group of participants described feeling that they had been given an opportunity to make affirmative changes in their lives. For example, Ntsumi (22) who had tested only once, several years prior, and who had more female than male sexual partners, said, “I was happy.…”

“…HIV testing is associated with increased sexual health communication among community members and sexual partners and reduced sexual risk (21), and periodic HIV testing is viewed as a gateway behavior for other HIV prevention actions (22). On a population level, HIV testing is a key part of a scientifically proven approach to reducing HIV transmission.…”

Protective Factors and HIV Risk Behavior Among South African Men

“…33 Similarly, a study in a township near Cape Town, South Africa also found that discussing condom use with sexual partners was associated with increased condom use. 37 …”

Highlights from this issue

“…This work is put nicely in context by Hao et al 's study from China,6 which reports an incidence of 4.17 per 100 person years for HIV, and 7.58 for syphilis. Testing has a role in prevention, as attested in a South African study of HIV testing in relation to sexual health communication,7 and a Scottish study of HIV testing in relation to undiagnosed HIV 8. However, it is clearly not a panacea.…”