ArticleBMJ open2017
Wealth-related inequality in early uptake of HIV testing among pregnant women: an analysis of data from a national cross-sectional survey, South Africa.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 3 syntheses or guidelines pooled it, 23 citations in OpenAlex.
- Explaining inequity in knowledge, attitude, and services related to HIV/AIDS: a systematic review.BMC public health · 2024Pooled it
- Equity in prenatal healthcare services globally: an umbrella review.BMC pregnancy and childbirth · 2024Pooled it
- Inequalities in Access and Utilization of Maternal, Newborn and Child Health Services in sub-Saharan Africa: A Special Focus on Urban Settings.Maternal and child health journal · 2022Pooled it
- Wealth-related inequalities in HIV testing and counselling during antenatal care among reproductive age women in Ethiopia: a decomposition analysis.BMJ public health · 2026Article
- Determinants of wealth-related inequalities in full vaccination coverage among children in Nepal: a decomposition analysis of nationally representative household survey data.BMC public health · 2024Article
- Knowledge and attitude to HIV pre exposure prophylaxis among women in five sub-Saharan African countries: a multilevel model analysis of population-based survey 2021-2022.BMC public health · 2024Article
- Socioeconomic inequalities in uptake of HIV testing during antenatal care: evidence from Sub-Saharan Africa.International journal for equity in health · 2024Article
- Socioeconomic inequality in adults undertaking HIV testing over time in Ethiopia based on data from demographic and health surveys.PloS one · 2024Article
- Article
- HIV care coverage among HIV-positive adolescent girls and young women in South Africa: Results from the HERStory Study.South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde · 2021Article
- Inequalities in Rotavirus Vaccine Uptake in Ethiopia: A Decomposition Analysis.International journal of environmental research and public health · 2020Article
- Women's Empowerment and HIV Testing Uptake: A Meta-analysis of Demographic and Health Surveys from 33 Sub-Saharan African Countries.International journal of MCH and AIDS · 2020Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
Abstract
objectivesWealth-related inequality across the South African antenatal HIV care cascade has not been considered in detail as a potential hindrance to eliminating mother-to-child HIV transmission (EMTCT). We aimed to measure wealth-related inequality in early (before enrolling into antenatal care) uptake of HIV testing and identify the contributing determinants.
designCross-sectional survey. SETTINGS: South African primary public health facilities in 2012.
participantsA national-level sample of 8618 pregnant women. OUTCOME MEASURES: Wealth-related inequality in early uptake of HIV testing was measured using the Erreygers concentration index (CI) further adjusted for inequality introduced by predicted healthcare need (ie, need-standardised). Determinants contributing to the observed inequality were identified using the Erreygers and Wagstaff decomposition methods.
resultsParticipants were aged 13 to 49 years. Antenatal HIV prevalence was 33.2%, of which 43.7% came from the lowest 40% wealth group. A pro-poor wealth-related inequality in early HIV testing was observed. The need-standardised concentration index was -0.030 (95% confidence interval -0.038 to -0.022). The proportion of early HIV testing was significantly better in the lower 40% wealth group compared with the higher 40% wealth group (p value=0.040). The largest contributions to the observed inequality were from underlying inequalities in province (contribution, 65.27%), age (-44.38%), wealth group (24.73%) and transport means (21.61%).
conclusionsOur results on better early uptake of HIV testing among the poorer subpopulation compared with the richer highlights inequity in uptake of HIV testing in South Africa. This socioeconomic difference could contribute to fast-tracking EMTCT given the high HIV prevalence among the lower wealth group. The high contribution of provinces and age to inequality highlights the need to shift from reliance on national-level estimates alone but identify subregional-specific and age-specific bottlenecks. Future interventions need to be context specific and tailored for specific subpopulations and subregional settings.
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