Perceptions about the acceptability and prevalence of HIV testing and factors influencing them in different communities in South Africa

Abstract

HIV counselling and testing (HCT) is considered important because it is an entry point to a comprehensive continuum of care for HIV/AIDS. The South African Department of Health launched an HCT campaign in April 2010, and this reached 13,269,746 people by June 2011, of which 16% tested HIV positive and 400,000 of those were initiated into antiretroviral treatment. The overall objective of this project was to gain insight into the general perceptions about HIV testing in the different South African communities. Factors influencing testing in these communities were also explored. Discussions with twelve focus groups (FG) of 8–12 participants each were conducted with male and female participants recruited from both urban formal and informal communities in Cape Town and Durban. Participants included four racial groups represented by different age groups as follows: adolescents (12–17 years), youth (18–24 years) and adults (25 years and older). Data were analyzed using thematic coding. Among the key themes that emerged from the findings were the inaccurate perception of risk, fear of testing HIV positive, stigma and discrimination. Participants from both African and Indian FGs reported being less likely to do self-initiated HIV testing and counselling, while those from the FG consisting of young whites were more likely to learn about their HIV status through blood donations and campus HIV testing campaigns. Most FGs said they were likely to test if they understood the testing process better and also if the results are kept confidential. The present findings reiterate the importance of spreading positive messages and ensuring confidentiality for HIV testing in a society where there is still some stigma associated with people living with HIV/AIDS. This can partly be accomplished by the continuation of the national HCT campaign, which has been a considerable success in the fight against HIV/AIDS in South Africa during the past two years.

Parents Support Implementation of HIV Testing and Counseling at School: Cross-Sectional Study with Parents of Adolescent Attending High School in Gauteng and North West Provinces, South Africa

“…However, the small proportion of parents who had never been tested is important as well, particularly when they showed low personal risk perception of HIV transmission. The perception of having no risk of HIV infection is a key reason for not being tested among different populations in South Africa [22, 23]. …”

Scaling a waterfall: a meta‐ethnography of adolescent progression through the stages of HIV care in sub‐Saharan Africa

“…Debilitating experiences with stigma were described in every study, manifesting as internalized, anticipated and externalized barriers to progression through all stages of the cascade. Anticipated stigma (fears surrounding social exclusion) was common at the individual level, negatively influencing motivations to obtain an HIV diagnosis [39][40][41][42][43][44][45][46] and to follow up on test results [44,45]. This was reinforced by experiences with external stigma at other levels including: family neglect or ostracism from peers [39,40,43,[47][48][49][50], community gossip [41][42][43]46], discrimination in school [49,[51][52][53][54] or lack of empathy from health care workers (HCW) [45,50,[55][56][57].…”

“…Anticipated stigma (fears surrounding social exclusion) was common at the individual level, negatively influencing motivations to obtain an HIV diagnosis [39][40][41][42][43][44][45][46] and to follow up on test results [44,45]. This was reinforced by experiences with external stigma at other levels including: family neglect or ostracism from peers [39,40,43,[47][48][49][50], community gossip [41][42][43]46], discrimination in school [49,[51][52][53][54] or lack of empathy from health care workers (HCW) [45,50,[55][56][57]. Such social conditions reinforced barriers to HIV care linkage, retention in HIV services and adherence; with ALHIV often choosing to prioritize secrecy around their disease status over unintended disclosure [48,[51][52][53][54][55][57][58][59][60].…”

“…Self-efficacy to adapt to a life with HIV Adolescents understood that the event of receiving an HIV positive diagnosis would require them to make lifestyle changes that, in many instances, they lacked confidence to adopt. Fear surrounding the ability to manage the consequences of a positive diagnosis frequently created a barrier to testing [39,40,42,43,47]. Such diminished self-efficacy similarly affected ALHIVs' capacity to maintain new health behaviours over time, such as the ART adherence necessary to achieve viral suppression, due to frustration surrounding the ongoing nature of treatment or side effects [48][49][50][51][52][53]57,58,60,61].…”

Percepción de la vivencia del acceso oportuno al diagnóstico del VIH, en personas viviendo con VIH/SIDA: Acceso oportuno al test de VIH

“…Por otro lado, la acogida percibida por parte de los profesionales al momento del examen, son coincidentes con lo mencionado en otras investigaciones 9,13,14 . La literatura reporta evidencia de otros elementos facilitadores propios del centro de salud como factores organizacionales, que no fueron expresados por este grupo, tales como el ofrecimiento oportuno del test y el tratamiento oportuno [13][14][15] . Por otro lado, la sugerencia realizada por alguna persona cercana al núcleo familiar o por amigos cercanos de hacerse el examen 10 y el apoyo social 12 son también facilitadores, sin embargo, no fueron descritos por los participantes en este estudio.…”