Socio-economic differences in the uptake of HIV testing and associated factors in South Africa

Abstract Background Improved understanding of barriers to HIV testing is important for reaching the first of the UNAIDS 90–90-90 targets, which states that 90% of HIV positive individuals ought to know their HIV status. This study examined socio-economic status (SES) differences in HIV testing uptake and associated factors among youth and adults 15 years and older in South Africa. Methods This study used data from a national cross-sectional, population-based household survey conducted in 2017 using a multi-stage sampling design. A composite SES score was created using multiple correspondence analyses of household assets; households were classified into wealth quintiles and dichotomised into low SES/poorest (lowest 3 quintiles) and high SES/less-poor (highest 2 quintiles). Bivariate and multivariate logistic regression models were used to examine factors associated with the uptake of HIV testing in low and high SES households. Results HIV testing uptake was 73.8 and 76.7% among low and high SES households, respectively, both of which were below the first 90 targets. Among both low and high SES households, increased HIV testing uptake was significantly associated with females than males. The decreased likelihood was significantly associated with residing in rural formal areas than urban areas, those with no education or low levels of educational attainment and alcohol drinkers among low SES households. Whites and Indians/Asians had a decreased likelihood than Black Africans in high SES households. Conclusions HIV testing interventions should target males, residents in rural formal areas, those with no or low education and those that consume alcohol in low SES households, including Whites and Indians/Asians from high SES households in order to bridge socio-economic disparities in the uptake of HIV testing. This should entail expanding HIV testing beyond traditional centres for voluntary counselling and testing through outreach efforts, including mobile testing and home-based testing.

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Socio-economic Status and Associated Factors in the Uptake of HIV Testing: Findings from the South African Population-based National Household Survey Conducted in 2017

10.21203/rs.3.rs-108686/v1 ◽

2020 ◽

Author(s):

Sean Jooste ◽

Musawenkosi Mabaso ◽

Myra Taylor ◽

Alicia North ◽

Yolande Shean ◽

...

Keyword(s):

Hiv Testing ◽

Perceived Risk ◽

Negative Impact ◽

Economic Status ◽

Household Survey ◽

Population Based ◽

Hiv Treatment ◽

Cluster Sampling ◽

Cross Sectional ◽

Testing Uptake

Abstract Background: Improved understanding of barriers to HIV testing is important for reaching the first of the UNAIDS 90-90-90 targets, which states that 90 percent of HIV positive individuals ought to know their HIV status. This study examined socioeconomic status (SES) factors and related covariates associated with HIV testing uptake in the general population in South Africa. Information on SES and HIV testing may impact the HIV treatment and care cascade and prevention of HIV transmission. Methods: This study used data obtained from a national cross-sectional, population-based household survey conducted in 2017 using a multi-stage stratified random cluster sampling design. A composite SES score was created using multiple correspondence analyses of household assets; households were classified into wealth quintiles and dichotomized into low SES/poorest (lowest 3 quintiles) and high SES/less-poor (highest 2 quintiles). Bivariate and multivariate logistic regression models were fitted to analyse associations between the uptake of HIV testing and a set of socio-demographic and HIV-related variables. Results: HIV testing uptake was 73.8% and 76.7% among low and high SES household, respectively, both of which were below the first 90 target. The findings showed increased uptake of HIV testing was associated with being female and having a higher educational level independent of SES. Decreased uptake of HIV testing was associated with being from White and Indian/Asian race groups, residing in rural formal areas, alcohol consumption, and high self-perceived risk of HIV infection.Conclusions: We found that HIV testing uptake was similar for people from both low and high SES. However, interventions aimed at improving HIV testing in order to reach the first 90 target, should target males, all race groups, those with low education attainment, and those residing in rural formal areas. Reaching the first target will require efforts to improve community knowledge, and awareness about the negative impact of alcohol use and address HIV risk perception.

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Prevalence and factors associated with intimate partner violence among the adolescent girls and young women in South Africa: findings the 2017 population based cross-sectional survey

BMC Public Health ◽

10.1186/s12889-021-11183-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jacqueline Mthembu ◽

Musawenkosi Mabaso ◽

Sarah Reis ◽

Khangelani Zuma ◽

Nompumelelo Zungu

Keyword(s):

South African ◽

Adolescent Girls ◽

Young Women ◽

Partner Violence ◽

Urban Areas ◽

Population Based ◽

Intimate Partner ◽

Low Ses ◽

Cross Sectional ◽

Factors Associated

Abstract Background Evidence indicate that intimate partner violence (IPV) is disturbingly high among South African adolescent girls and young women (AGYW). Understanding prevalence and risk factors for IPV among these emerging adults is critical for developing appropriate interventions to prevent adverse health outcomes later in life. This study investigates the prevalence and factors associated with lifetime physical IPV experience among AGYW, aged 15–24 years, using the South African national HIV prevalence, incidence, behaviour and communication survey conducted in 2017. Methods The data used in this secondary analysis was obtained from a cross-sectional, population-based household survey data, conducted using a multi-stage stratified random cluster sampling approach. Multivariate stepwise backward logistic regression modelling was used to determine factors associated with IPV. Results Of 716 AGYW that responded to the two commonly answered questions on IPV, 13.1% (95% CI: 9.6–17.6) indicated that they experienced IPV. The odds of reporting experiences of IPV were significantly lower among AGYW residing in high SES households [AOR = 0.09 (95% CI: 0.02–0.47), p = 0.004] than low SES households, and those residing in rural informal/tribal areas [AOR = 0.01 (95% CI: 0.00–0.22), p = 0.004] than urban areas. AGYW experiencing IPV had higher odds of reporting psychological distress compared to their counterparts [AOR = 4.37 (95% CI, 0.97–19.72), p = 0.054]. Conclusion The findings highlight the need for targeted structural and psychosocial interventions in low SES households and especially in urban areas.

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High Prevalence of Self-Reported Undiagnosed HIV despite High Coverage of HIV Testing: A Cross-Sectional Population Based Sero-Survey in South Africa

PLoS ONE ◽

10.1371/journal.pone.0025244 ◽

2011 ◽

Vol 6 (9) ◽

pp. e25244 ◽

Cited By ~ 38

Author(s):

Katharina Kranzer ◽

Nienke van Schaik ◽

Unice Karmue ◽

Keren Middelkoop ◽

Elaine Sebastian ◽

...

Keyword(s):

South Africa ◽

Hiv Testing ◽

Population Based ◽

High Coverage ◽

Cross Sectional ◽

High Prevalence ◽

Undiagnosed Hiv

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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

AIDS Research and Treatment ◽

10.1155/2016/4842814 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9

Author(s):

Sphiwe Madiba ◽

Mathildah Mokgatle

Keyword(s):

South Africa ◽

High School ◽

Hiv Testing ◽

Household Survey ◽

Cross Sectional Study ◽

Cross Sectional ◽

North West ◽

Hiv Testing And Counseling ◽

Hiv Test ◽

Testing And Counseling

Background. A formative assessment of the implementation of HIV testing and counseling (HTC) at school showed high acceptability and willingness to test among learners. However, the success of the proposed HTC depends on the support and acceptability of key stakeholders, including the parents. The aim of the study was to assess the opinions and acceptability of the implementation of HTC at school among parents of adolescents in high school.Methods. This was a cross-sectional household survey conducted with parents of adolescents attending high schools in educational districts in North West and Gauteng provinces, South Africa.Results. A total of 804 parents participated, and 548 (68.3%) were biological mothers, 85 (10.6%) were fathers, and the remaining were other relatives including grandmothers. Almost all (n=742, 92.9%) parents were in support of implementation and provision of HTC at school, 701 (87.7%) would allow their children to be tested at school, 365 (46%) felt that parental consent was not needed to test at school, and 39.4% preferred to receive the HIV test results with their children.Conclusion. Parents accept the roll-out of an HTC program at school and have a role to play in supporting children who test positive for HIV.

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Cognitive functioning and associated factors in older adults in South Africa

South African Journal of Psychiatry ◽

10.4102/sajpsychiatry.v18i4.368 ◽

2012 ◽

Vol 18 (4) ◽

pp. 7 ◽

Cited By ~ 2

Author(s):

K Peltzer ◽

N Phaswana-Mafuya

Keyword(s):

South Africa ◽

Cognitive Functioning ◽

Associated Factors ◽

Digit Span ◽

Subjective Health ◽

Population Based ◽

Adult Health ◽

Subjective Health Status ◽

Cross Sectional ◽

Healthcare Needs

Objective. To investigate cognitive functioning and associated factors in a national probability sample of older South Africans who participated in the Study of Global AGEing and Adult Health (SAGE) in 2008.Methods. In 2008 we conducted a national population-based cross-sectional study with a sample of 3 840 adults aged ≥50 years in South Africa. We administered a questionnaire surveying socio-demographic characteristics, health variables, and anthropometric and blood pressure measurements. Multivariate regression analyses were used to assess the association of socio-demographic factors and health variables with cognitive functioning. Results. Mean variables in the sample were: 5.9 recalled words, a verbal fluency of 9.9 words in a specified category (animals), a forward and backward digit span of 5.2 and 3.2, respectively, and an overall mean cognition score of 48.5. Higher overall cognitive functioning (a combination of memory and executive functioning) was positively associated with: younger age; white, Indian/Asian or coloured ethnicity; being married; a higher level of education; greater wealth; a higher level of physical activity; a greater quality of life; and a better subjective health status.Conclusions. Our findings can be used to refine future projections of cognitive function and healthcare needs in ageing middle-income societies such as those in South Africa.

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Anaemia prevalence and determinants in under 5 years children: findings of a cross-sectional population-based study in Sudan

BMC Pediatrics ◽

10.1186/s12887-020-02434-w ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Khalid Abdelmutalab Elmardi ◽

Ishag Adam ◽

Elfatih Mohamed Malik ◽

Abdalla Ahmed Ibrahim ◽

Asma Hashim Elhassan ◽

...

Keyword(s):

Malaria Infection ◽

Economic Status ◽

Haemoglobin Concentration ◽

Household Survey ◽

Population Based ◽

Cross Sectional Study ◽

Severe Anaemia ◽

Outcome Variable ◽

Cross Sectional ◽

Maternal Anaemia

Abstract Background Early childhood is an age at risk of anaemia and its deleterious consequences. In Sudan, there is limited evidence on the prevalence and determinant of anaemia in under-five children. This study was conducted in Sudan to assess the prevalence of anaemia in children and to identify its determinants. Methods We conducted a household survey involving children aged 6 months to 5 years in November 2016. A representative population was sampled across rural, urban and camps settlements across 18 states in Sudan. We used a pre-designed questionnaire data collection. Haemoglobin (Hb) level and malaria infection were checked. In this cross-sectional study, we dichotomized the outcome variable and performed logistic regression analyses. Results A total of 3094 children under 5 years enrolled in the study, 1566 (50.6%) of them were female and 690 (22.3%) of them were under 2 years old. Anaemia prevalence in the whole cohort (6 months - < 5 years) was 49.4% and the mean haemoglobin concentration was 108.1 (standard deviation (SD): 15.4) g/L. The prevalence in younger (6 months - < 2 years) children (61.9%) was higher than in older (2 - < 5 years) children (45.6%) (p < 0.001). Severe anaemia (Hb < 70 g/L) prevalence in the whole population was 1.6%. Age (Odds ratio (OR) 2.25, 95% confidence interval (95%CI) 1.75–2.90, p < 0.001), type of place of residence (OR 0.37, 95%CI 0.18–0.74, p = 0.005), maternal anaemia (OR 1.74, 95%CI 1.39–2.17, p < 0.001), and malaria infection (OR 2.82, 95%CI 1.56–5.11, p < 0.001) were the identified predictors of anaemia in the whole cohort. In younger children, only the economic class was an anaemia predictor, with a lower anaemia risk among the rich wealth class (OR 2.70, 95%CI 1.29–5.62, p = 0.008). However, in older children, three anaemia predictors were identified. These are maternal anaemia (OR 1.79, 95%CI 1.40–2.28, < 0.001), malaria infection (OR 2.77, 95%CI 1.48–5.21, p = 0.002), and type of residency (where camps’ residents were less likely affected with anaemia than rural children (OR 0.38, 95%CI 0.17–0.87, p = 0.022)). Conclusions About half of the under-5 children in Sudan are anaemic, with worse prevalence in younger children. Efforts targeted at improving socio-economic status, decreasing maternal anaemia and childhood malaria infection may mitigate this alarming trend.

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Actual Versus Perceived HIV Testing Norms, and Personal HIV Testing Uptake: A Cross-Sectional, Population-Based Study in Rural Uganda

AIDS and Behavior ◽

10.1007/s10461-017-1691-z ◽

2017 ◽

Vol 22 (2) ◽

pp. 616-628 ◽

Cited By ~ 17

Author(s):

Jessica M. Perkins ◽

Viola N. Nyakato ◽

Bernard Kakuhikire ◽

Pamela K. Mbabazi ◽

H. Wesley Perkins ◽

...

Keyword(s):

Hiv Testing ◽

Population Based ◽

Cross Sectional ◽

Population Based Study ◽

Testing Uptake

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National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM): household survey component methods

Revista de Saúde Pública ◽

10.1590/s1518-8787.2016050006156 ◽

2016 ◽

Vol 50 (suppl 2) ◽

Cited By ~ 8

Author(s):

Sotero Serrate Mengue ◽

Andréa Dâmaso Bertoldi ◽

Alexandra Crispim Boing ◽

Noemia Urruth Leão Tavares ◽

Tatiane da Silva Dal Pizzol ◽

...

Keyword(s):

National Survey ◽

Urban Areas ◽

Comprehensive Evaluation ◽

Household Survey ◽

Population Based ◽

Cross Sectional ◽

Rational Use ◽

Rational Use Of Medicines ◽

And Gender ◽

The Impact

ABSTRACT OBJECTIVE To describe methodological aspects of the household survey National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM) related to sampling design and implementation, the actual obtained sample, instruments and fieldwork. METHODS A cross-sectional, population-based study with probability sampling in three stages of the population living in households located in Brazilian urban areas. Fieldwork was carried out between September 2013 and February 2014. The data collection instrument included questions related to: information about households, residents and respondents; chronic diseases and medicines used; use of health services; acute diseases and events treated with drugs; use of contraceptives; use of pharmacy services; behaviors that may affect drug use; package inserts and packaging; lifestyle and health insurance. RESULTS In total, 41,433 interviews were carried out in 20,404 households and 576 urban clusters corresponding to 586 census tracts distributed in the five Brazilian regions, according to eight domains defined by age and gender. CONCLUSIONS The results of the survey may be used as a baseline for future studies aiming to assess the impact of government action on drug access and use. For local studies using a compatible method, PNAUM may serve as a reference point to evaluate variations in space and population. With a comprehensive evaluation of drug-related aspects, PNAUM is a major source of data for a variety of analyses to be carried out both at academic and government level.

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