HIV testing and self‐testing coverage among men and women in South Africa: an exploration of related factors

Abstract Objectives Uptake of HIV testing is critical to halting the spread of HIV. Our study aimed to examine the coverage of HIV testing and self‐testing and the individual‐level, household‐level and community‐level factors associated with HIV testing and self‐testing awareness. Methods We analysed data of 12 312 men and women from 2016 SADHS and used multilevel mixed‐effects models to examine the factors associated with uptake of HIV testing and self‐testing awareness. Results About 80% of participants had ever tested for HIV, and 64% had tested in the past year. Only 49% of adolescents aged 15–19 years had ever tested for HIV compared with over 80% of adults. Self‐testing awareness was low (22%), and only 2.9% of respondents had ever self‐tested for HIV. The odds of having ever tested for HIV were significantly higher among respondents who were aged 25–29 (AOR: 4.02; 95% CI: 3.27–4.95), had a higher level of education (AOR: 3.18; 95% CI: 2.19–4.61), were married (AOR: 1.63; 95% CI: 1.36–1.94), had high media exposure (AOR: 1.23; 95% CI: 1.06–1.44) and had ever had sex (AOR: 5.57; 95% CI: 4.67–6.64), but lower among men (AOR: 0.39; 95% CI: 0.35–0.44). Conclusion In conclusion, HIV testing coverage is high in South Africa relative to most countries in sub‐Saharan Africa, but falls short of the UNAIDS first 95. We found no evidence of socioeconomic and geographic inequalities in access to HIV testing. However, adolescents had a lower level of HIV testing uptake, suggesting a need for interventions to expand testing in this age group.