title: HIV testing rates, prevalence, and knowledge among outpatients in Durban, South Africa: Time trends over four years.
abstract: The HIV public health messages in South Africa have increased. Our objective was to evaluate changes over time in HIV testing behaviour, prevalence and knowledge. We prospectively enrolled adults (≥18 years) prior to HIV testing at one urban and one peri-urban outpatient department in Durban, South Africa. A baseline questionnaire administered before testing included the number of prior HIV tests and four knowledge items. We used test results to estimate previously undiagnosed HIV prevalence among those tested. We assessed linear trends over enrollment. From November 2006 to August 2010, 5229 subjects enrolled and 4877 (93%) were HIV tested and had results available. Subjects reporting prior testing over time increased, from 13% in study year 1 to 42% in year 4 (linear trend p < 0.001). The HIV prevalence among those tested declined steadily and significantly over time, from 64% of enrollees in study year 1 to 39% in the final year (linear trend p < 0.001). The percentage of subjects who recognised that medicine can help people with HIV live longer increased from 80% in study year 1 to 96% in study year 4. Rates of HIV testing have increased and prevalence among those tested has decreased in outpatients in Durban, South Africa.
authors.affiliation: Division of Pediatric Infectious Disease, Mattel Children's Hospital UCLA, David Geffen School of Medicine, CA, USA Division of Infectious Diseases, Boston Children's Hospital, Boston, MA, USA Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA lynnramirez@mednet.ucla.edu.
authors.forename: Lynn
authors.initials: L
authors.lastname: Ramirez-Avila
authors.affiliation: Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA Division of General Medicine, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Regan
authors.affiliation: McCord Hospital, Durban, South Africa.
authors.forename: Senica
authors.initials: S
authors.lastname: Chetty
authors.affiliation: McCord Hospital, Durban, South Africa.
authors.forename: Janet
authors.initials: J
authors.lastname: Giddy
authors.affiliation: St. Mary's Hospital, Mariannhill, Durban, South Africa.
authors.forename: Douglas
authors.initials: D
authors.lastname: Ross
authors.affiliation: Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, USA Departments of Epidemiology and Health Policy and Management, Harvard School of Public Health, Boston, MA, USA Division of Rheumatology, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Katz
authors.affiliation: Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA Division of General Medicine, Massachusetts General Hospital, Boston, MA, USA Departments of Epidemiology and Health Policy and Management, Harvard School of Public Health, Boston, MA, USA Center for AIDS Research, Harvard Medical School, Boston, MA, USA Division of Infectious Disease, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Freedberg
authors.affiliation: Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA Division of General Medicine, Massachusetts General Hospital, Boston, MA, USA Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, USA Departments of Epidemiology and Health Policy and Management, Harvard School of Public Health, Boston, MA, USA Division of Rheumatology, Brigham and Women's Hospital, Boston, MA, USA Center for AIDS Research, Harvard Medical School, Boston, MA, USA Departments of Epidemiology and Biostatistics, Boston University School of Public Health, Boston, MA, USA.
authors.forename: Elena
authors.initials: E
authors.lastname: Losina
authors.affiliation: Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA Division of General Medicine, Massachusetts General Hospital, Boston, MA, USA Center for AIDS Research, Harvard Medical School, Boston, MA, USA Division of Infectious Disease, Massachusetts General Hospital, Boston, MA, USA Division of Infectious Disease, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Rochelle P
authors.initials: RP
authors.lastname: Walensky
authors.affiliation: Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA Division of General Medicine, Massachusetts General Hospital, Boston, MA, USA Center for AIDS Research, Harvard Medical School, Boston, MA, USA Division of Infectious Disease, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Ingrid V
authors.initials: IV
authors.lastname: Bassett
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D011446:Prospective Studies; D013019:South Africa / Q000453:epidemiology
keywords: AIDS; HIV; HIV knowledge; HIV prevalence; HIV testing; South Africa; epidemiology; time trends