scholarly journals Do gifts increase consent to home-based HIV testing? A difference-in-differences study in rural KwaZulu-Natal, South Africa

2016 ◽  
pp. dyw122 ◽  
Author(s):  
Mark E McGovern ◽  
Kobus Herbst ◽  
Frank Tanser ◽  
Tinofa Mutevedzi ◽  
David Canning ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Testing ◽  
Difference In Differences ◽  
Home Based ◽  
Kwazulu Natal

scholarly journals Geographical variation in HIV testing in South Africa: Evidence from the 2017 national household HIV survey

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sean Jooste ◽  
Musawenkosi Mabaso ◽  
Myra Taylor ◽  
Alicia North ◽  
Yolande Shean ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Testing ◽  
Secondary Analysis ◽  
District Level ◽  
Cluster Sampling ◽  
North West ◽  
Spatial Targeting ◽  
Home Based ◽  
Self Testing ◽  
Kwazulu Natal

Background: Identification of the geographical areas with low uptake of HIV testing could assist in spatial targeting of interventions to improve the uptake of HIV testing.Objectives: The objective of this research study was to map the uptake of HIV testing at the district level in South Africa.Method: The secondary analysis used data from the Human Sciences Research Council’s 2017 National HIV Prevalence, Incidence, Behaviour and Communication Survey, where data were collected using a multistage stratified random cluster sampling approach. Descriptive spatial methods were used to assess disparities in the proportion of those ever tested for HIV at the district level in South Africa.Results: The districts with the highest overall coverage of people ever having tested for HIV ( 85%) include West Rand in Gauteng, Lejweleputswa and Thabo Mofutsanyane in Free State, and Ngaka Modiri Molema in North-West. These provinces also had the least variation in HIV testing coverage between their districts. Districts in KwaZulu-Natal had the widest variation in coverage of HIV testing. The districts with the lowest uptake of HIV testing were uMkhanyakude (54.7%) and Ugu (61.4%) in KwaZulu-Natal and Vhembe (61.0%) in Limpopo. Most districts had a higher uptake of HIV testing amongst female than male participants.Conclusion: The uptake of HIV testing across various districts in South Africa seems to be unequal. Intervention programmes must improve the overall uptake of HIV testing, especially in uMkhanyakude and Ugu in KwaZulu-Natal and Vhembe in Limpopo. Interventions must also focus on enhancing uptake of HIV testing amongst male participants in most districts. Strategies that would improve the uptake of HIV testing include HIV self-testing and community HIV testing, specifically home-based testing.

scholarly journals Linkage to primary care after home-based blood pressure screening in rural KwaZulu-Natal, South Africa: a population-based cohort study

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e023369 ◽  
Author(s):  
Mark J Siedner ◽  
Kathy Baisley ◽  
Joanna Orne-Gliemann ◽  
Deenan Pillay ◽  
Olivier Koole ◽  
...  
Keyword(s):  
South Africa ◽  
Blood Pressure ◽  
Linkage To Care ◽  
Sampling Weights ◽  
Rural South ◽  
Home Based ◽  
Kwazulu Natal ◽  
Blood Pressure Screening ◽  
The Impact ◽  
Rural South Africa

ObjectivesThe expanding burden of non-communicable diseases (NCDs) globally will require novel public health strategies. Community-based screening has been promoted to augment efficiency of diagnostic services, but few data are available on the downstream impact of such programmes. We sought to assess the impact of a home-based blood pressure screening programme on linkage to hypertension care in rural South Africa.SettingWe conducted home-based blood pressure screening withinin a population cohort in rural KwaZulu-Natal, using the WHO Stepwise Approach to Surveillance (STEPS) protocol.ParticipantsIndividuals meeting criteria for raised blood pressure (≥140 systolic or ≥90 diastolic averaged over two readings) were referred to local health clinics and included in this analysis. We defined linkage to care based on self-report of presentation to clinic for hypertension during the next 2 years of cohort observation. We estimated the population proportion of successful linkage to care with inverse probability sampling weights, and fit multivariable logistic regression models to identify predictors of linkage following a positive hypertension screen.ResultsOf 11 694 individuals screened, 14.6% (n=1706) were newly diagnosed with elevated pressure. 26.9% (95% CI 24.5% to 29.4%) of those sought hypertension care in the following 2 years, and 38.1% (95% CI 35.6% to 40.7%) did so within 5 years. Women (adjusted OR (aOR) 2.41, 95% CI 1.68 to 3.45), those of older age (aOR 11.49, 95% CI 5.87 to 22.46, for 45–59 years vs <30) and those unemployed (aOR 1.71, 95% CI 1.10 to 2.65) were more likely to have linked to care.ConclusionsLinkage to care after home-based identification of elevated blood pressure was rare in rural South Africa, particularly among younger individuals, men and the employed. Improved understanding of barriers and facilitators to NCD care is needed to enhance the effectiveness of blood pressure screening in the region.

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