Trends in HIV testing and associated factors among men in South Africa: evidence from 2005, 2008 and 2012 national population-based household surveys.
OBJECTIVE
In Sub-Saharan African countries, including South Africa, uptake of human immunodeficiency virus (HIV) testing among men remains a major challenge. Few studies have explored HIV testing uptake among men and factors that influence their testing behaviours. This article explores trends in HIV testing uptake and associated factors among men aged 15 years and older in South Africa using national HIV population-based household surveys conducted in 2005, 2008 and 2012.


METHODS
A multistage cross-sectional design was used in the three nationally representative household-based surveys.


METHODS
P-trend Chi-squared statistic was used to analyze changes in HIV testing in relation to demographic factors, and HIV-related risk behaviours across the three surveys. Univariate and multivariate logistic regression models were used to assess the associations between ever testing for HIV, demographic factors and HIV-related risk behaviours.


RESULTS
HIV testing uptake among men was 28% in 2005, 43% in 2008 and 59% in 2012. A trend was also observed in HIV testing by sociodemographic factors, but differences existed within variables. HIV testing uptake was mainly influenced by the effects of selected population characteristics. Reduced likelihood of HIV testing was significantly associated with males aged 15-24 years, Black African race group, being single and unemployed, those residing in urban informal and rural informal areas, and those men who ever had sex.


CONCLUSIONS
The observed sociodemographic differentials suggest that an effective expansion strategy for HIV testing needs to prioritize those most unlikely to test as identified by the current findings.
Human Sciences Research Council, South Africa. Electronic address: tmakusha@hsrc.ac.za.
T
T
Makusha
Human Sciences Research Council, South Africa.
M
M
Mabaso
DST-NRF Centre of Excellence in Human Development, South Africa.
L
L
Richter
Human Sciences Research Council, South Africa.
C
C
Desmond
Human Sciences Research Council, South Africa.
S
S
Jooste
Human Sciences Research Council, South Africa.
L
L
Simbayi
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000175:diagnosis*; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data* / Q000639:trends*; D008875:Middle Aged; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology; D055815:Young Adult
HIV testing; Men's health-seeking behaviours; South Africa; Testing trends among men