ArticleJournal of the International AIDS Society2019
HIV testing services in healthcare facilities in South Africa: a missed opportunity.
Article in Journal of the International AIDS Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Barriers and facilitators to facility HIV self-testing in outpatient settings in Malawi: a qualitative study.BMC public health · 2021Trial
- Global burden of HIV and drug-resistant tuberculosis co-infection and its attributable risk factors, 1990 to 2021, with projections to 2031.BMC infectious diseases · 2025Article
- Preference for HIV testing among community residents in Yunnan Province, China: results from a discrete choice experiment.BMC health services research · 2025Article
- Assessing the preparedness of primary healthcare facilities for the implementation of universal test and treat in uThukela District, South Africa: a cross-sectional study.BMJ public health · 2025Article
- Recent South African court rulings on failing to disclose HIV status to sexual partners.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2024Article
- HIV prevalence and access to HIV testing and care in patients with psychosis in South Africa.The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa · 2023Article
- Facilitators and barriers to implementing provider-initiated HIV counselling and testing at the clinic-level in Ekurhuleni District, South Africa.Implementation science communications · 2022Article
- Cost-effectiveness of Routine Provider-Initiated Testing and Counseling for Children With Undiagnosed HIV in South Africa.Open forum infectious diseases · 2022Article
- Digitally supported HIV self-testing increases facility-based HIV testing capacity in Ekurhuleni, South Africa.Southern African journal of HIV medicine · 2022Article
- Understanding factors influencing utilization of HIV prevention and treatment services among patients and providers in a heterogeneous setting: A qualitative study from South Africa.PLOS global public health · 2022Article
- Findings from a novel and scalable community-based HIV testing approach to reduce the time required to complete point-of-care HIV testing in South Africa.BMC health services research · 2021Article
- Taking the Test: A Qualitative Analysis of Cultural and Contextual Factors Impacting Neuropsychological Assessment of Xhosa-Speaking South Africans.Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists · 2021Article
- The Role of Value Stream Mapping in Healthcare Services: A Scoping Review.International journal of environmental research and public health · 2021Article
- Article
- HIV testing services in healthcare facilities in South Africa: a missed opportunity.Journal of the International AIDS Society · 2019Article
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Authors and funding
7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionSouth Africa (SA) has the world's highest burden of HIV infection (approximately 7.2 million), yet it is estimated that 23.5% women and 31.5% of men are unaware that they are living with HIV. The 2015 national South African HIV testing guidelines mandate the universal offer of HIV testing services (HTS) in all healthcare facilities.
methodsA multi-prong approach was used from January 2017 to June 2017 to evaluate the current implementation of HTS in ten facilities in the Ekurhuleni District of SA. First, we conducted patient exit interviews to quantify engagement in HTS services. Second, we systematically mapped the flow of individual patients through the clinic.
resultsWe conducted a total of 2989 exit interviews and followed 568 patients for value stream mapping. Overall self-reported testing acceptance was high at 84.7% (244), but <10% of the patients (288) were offered testing. Female patients were more likely to be offered testing (233/2046, 11.4% vs. 55/943, 5.8% in males; chi-square p < 0.005), and also more likely to accept testing (203/233, 87.1% vs. 41/55, 74.6% in males; chi-square p = 0.02). Value stream mapping revealed that patients offered HIV testing had a total visit time of 51 minutes more (95% CI: 30-72) compared to those not offered testing.
conclusionsThe poor delivery of HTS appears to be due to a failure to recommend HTS and the added time burden placed on those accepting testing. There were significant differences in both the offer and acceptance of testing by gender. Health system issues need to be addressed to improve HTS delivery.
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