AIDS and Behavior

, Volume 14, Issue 4, pp 913–921 | Cite as

Factors Associated with HIV Testing Among Public Sector Clinic Attendees in Johannesburg, South Africa

  • Audrey PettiforEmail author
  • Catherine MacPhail
  • Sujit Suchindran
  • Sinead Delany-Moretlwe
Original Paper


Uptake of VCT remains low in many sub-Saharan African countries. Men and women aged 15 and older were recruited from a family planning, STI, and VCT clinic in inner-city Johannesburg between 2004 and 2005 to take part in a cross-sectional survey on HIV testing (n = 198). Fourty-eight percent of participants reported previously testing for HIV and, of these, 86.9% reported disclosing their status to their sex partner. In multivariable analyses, individuals whose partners had been tested for HIV were more likely to have tested (AOR 2.92; 95% CI: 1.38–6.20). In addition, those who reported greater blame/shame attitudes towards people living with HIV/AIDS were less likely to have tested (AOR 0.35; 95% CI: 0.16–0.77) while those reporting more equitable attitudes towards people living with HIV/AIDS were more likely to have tested (AOR 2.87; 95% CI: 1.20–6.86). Promotion of and increased access to couples HIV testing should be made available within the South African context.


HIV VCT Stigma Couples South Africa 


  1. Allen, S., Karita, E., Chomba, E., Roth, D., Telfair, J., Zulu, I., et al. (2007). Promotion of couples’ voluntary counselling and testing for HIV through influential networks in two African capital cities. BMC Public Health, 7, 349. doi: 10.1186/1471-2458-7-349.CrossRefPubMedGoogle Scholar
  2. Allen, S., Meinzen-Derr, J., Kautzman, M., Zulu, I., Trask, S., Fideli, U., et al. (2003). Sexual behavior of HIV discordant couples after HIV counseling and testing. AIDS (London, England), 17(5), 733–740. doi: 10.1097/00002030-200303280-00012.Google Scholar
  3. Corbett, E. L., Makamure, B., Cheung, Y. B., Dauya, E., Matambo, R., Bandason, T., et al. (2007). HIV incidence during a cluster-randomized trial of two strategies providing voluntary counselling and testing at the workplace, Zimbabwe. AIDS (London, England), 21(4), 483–489. doi: 10.1097/QAD.0b013e3280115402.Google Scholar
  4. Dalal, R., MacPhail, C., Mqhayi, M., Wing, J., Feldman, C., Chersich, M., et al. (2007). Characteristics and outcomes of adult patients discontinuing follow-up at an antiretroviral treatment clinic in Johannesburg, South Africa. Journal of Acquired Immune Deficiency Syndromes, 47(1), 101–107.Google Scholar
  5. Day, J. H., Miyamura, K., Grant, A. D., Leeuw, A., Munsamy, J., Baggaley, R., et al. (2003). Attitudes to HIV voluntary counselling and testing among mineworkers in South Africa: Will availability of antiretroviral therapy encourage testing? AIDS Care, 15(5), 665–672. doi: 10.1080/0954012030001595140.CrossRefPubMedGoogle Scholar
  6. Dunkle, K. L., Stephenson, R., Karita, E., Chomba, E., Kayitenkore, K., Vwalika, C., et al. (2008). New heterosexually transmitted HIV infections in married or cohabiting couples in urban Zambia and Rwanda: An analysis of survey and clinical data. Lancet, 371(9631), 2183–2191. doi: 10.1016/S0140-6736(08)60953-8.CrossRefPubMedGoogle Scholar
  7. Genberg, B. L., Kawichai, S., Chingono, A., Sendah, M., Chariyalertsak, S., Konda, K. A., et al. (2008). Assessing HIV/AIDS stigma and discrimination in developing countries. AIDS and Behavior, 12(5), 772–780. doi: 10.1007/s10461-007-9340-6.CrossRefPubMedGoogle Scholar
  8. Kalichman, S. C., & Simbayi, L. C. (2003). HIV testing attitudes, AIDS stigma, and voluntary HIV counselling and testing in a black township in Cape Town, South Africa. Sexually Transmitted Infections, 79(6), 442–447. doi: 10.1136/sti.79.6.442.CrossRefPubMedGoogle Scholar
  9. King, R., Katuntu, D., Lifshay, J., Packel, L., Batamwita, R., Nakayiwa, S., et al. (2008). Processes and outcomes of HIV serostatus disclosure to sexual partners among people living with HIV in Uganda. AIDS and Behavior, 12(2), 232–243. doi: 10.1007/s10461-007-9307-7.CrossRefPubMedGoogle Scholar
  10. Link, B. G., & Phelan, J. C. (2001). Conceptualizing stigma. Annual Review of Sociology, 27, 363–385. doi: 10.1146/annurev.soc.27.1.363.CrossRefGoogle Scholar
  11. MacPhail, C., Pettifor, A., Coates, T., & Rees, H. (2008a). ‘You must do the test to know your status’: Attitudes to voluntary counseling and testing for HIV among South African youth and their parents. Health Education & Behavior, 35(1), 87–104. doi: 10.1177/1090198106286442.CrossRefGoogle Scholar
  12. MacPhail, C., Pettifor, A., Moyo, W., & Rees, H. (2008b). Factors associated with HIV testing among South African youth aged 15–24 years. AIDS Care (in press).Google Scholar
  13. Maman, S., Mbwambo, J., Hogan, N., Weiss, E., Kilonzo, G., & Sweat, M. (2003). High rates and positive outcomes of HIV-serostatus disclosure to sexual partners: Reasons or cautious optimism from a voluntary counseling and testing clinics in Dar es Salaam, Tanzania. AIDS and Behavior, 7(4), 372–382. doi: 10.1023/B:AIBE.0000004729.89102.d4.CrossRefGoogle Scholar
  14. Medley, A., Garcia-Moreno, C., McGill, S., & Maman, S. (2004). Rates, barriers and outcomes of HIV serostatus disclosure among women in developing countries: Implications for prevention of mother-to-child transmission programmes. Bulletin of the World Health Organization, 82(4), 299–307.PubMedGoogle Scholar
  15. Miller, A. N., & Rubin, D. L. (2007). Factors leading to self-disclosure of a positive diagnosis in Nairobi, Kenya: People living with HIV/AIDS in the sub-Sahara. Qualitative Health Research, 17(5), 586–598. doi: 10.1177/1049732307301498.CrossRefGoogle Scholar
  16. Morin, S. F., Khumalo-Sakutukwa, G., Charlebois, E. D., Routh, J., Fritz, K., Lane, T., et al. (2006). Removing barriers to knowing HIV status: Same-day mobile HIV testing in Zimbabwe. Journal of Acquired Immune Deficiency Syndromes, 41(2), 218–224. doi: 10.1097/01.qai.0000179455.01068.ab.CrossRefPubMedGoogle Scholar
  17. Mwamburi, D., Dladla, N., Qwana, E., & Lurie, M. (2005). Factors associated with wanting to know HIV results in South Africa. AIDS Patient Care and STDs, 19(8), 518–525. doi: 10.1089/apc.2005.19.518.CrossRefPubMedGoogle Scholar
  18. Painter, T. M. (2001). Voluntary counseling and testing for couples: A high-leverage intervention for HIV/AIDS prevention in sub-Saharan Africa. Social Science and Medicine, 53(11), 1397–1411. doi: 10.1016/S0277-9536(00)00427-5.CrossRefPubMedGoogle Scholar
  19. Petros, G., Airhihenbuwa, C., Simbayi, L., Ramlagan, S., & Brown, B. (2006). HIV/AIDS and ‘othering’ in South Africa: The blame goes on. Culture, Health & Sexuality, 8(1), 67–77. doi: 10.1080/13691050500391489.CrossRefGoogle Scholar
  20. Pettifor, A., Rees, H., Kleinschmidt, I., Steffenson, A., MacPhail, C., Hlongwa-Madikizela, L., et al. (2005). Young people’s sexual health in South Africa: HIV prevalence and sexual behaviours from a nationally representative household survey. AIDS (London, England), 19, 1525–1534. doi: 10.1097/01.aids.0000183129.16830.06.Google Scholar
  21. Project Accept. A Phase III randomized controlled trial of community mobilization, mobile testing, same-day results, and post-test support for HIV in sub-Saharan Africa and Thailand. Accessed 2007.
  22. Sherr, L., Lopman, B., Kakowa, M., Dube, S., Chawira, G., Nyamukapa, C., et al. (2007). Voluntary counselling and testing: Uptake, impact on sexual behaviour, and HIV incidence in a rural Zimbabwean cohort. AIDS (London, England), 21(7), 851–860. doi: 10.1097/QAD.0b013e32805e8711.Google Scholar
  23. Shisana, O., & Simbayi, L. (2002). Nelson Mandela/HSRC study of HIV/AIDS. South African National HIV prevalence, behavioural risks and mass media household survey 2002. Cape Town: Human Sciences Research Council.Google Scholar
  24. Shisana, O., & Simbayi, L. (2005). Nelson Mandela/HSRC study of HIV/AIDS South African National HIV prevalence, behavioural risks and mass media household survey 2005. Cape Town: Human Sciences Research Council.Google Scholar
  25. Sigxashe, T. A., Baggaley, R., & Mathews, C. (2001). Attitudes to disclosure of HIV status to sexual partners. South African Medical Journal, 91(11), 908–909.PubMedGoogle Scholar
  26. Smith, R., & Morrison, D. (2006). The impact of stigma, experience, and group referent on HIV risk assessments and HIV testing intentions in Namibia. Social Science and Medicine, 63(10), 2649–2660. doi: 10.1016/j.socscimed.2006.07.006.CrossRefPubMedGoogle Scholar
  27. The voluntary HIV-1 counseling, testing efficacy study group. (2000). Efficacy of voluntary HIV-1 counselling and testing in individuals and couples in Kenya, Tanzania, and Trinidad: A randomised trial. Lancet, 356, 103–112.CrossRefGoogle Scholar
  28. Valdiserri, R., Holtgrave, D., & West, G. (1999). Promoting early HIV diagnosis and entry into care. AIDS (London, England), 13, 2317–2330. doi: 10.1097/00002030-199912030-00003.Google Scholar
  29. WHO, UNAIDS, & UNICEF. (2007). Towards universal access: Scaling up priority HIV/AIDS interventions in the health sector. Geneva: World Health Organization.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Audrey Pettifor
    • 1
    Email author
  • Catherine MacPhail
    • 2
  • Sujit Suchindran
    • 3
  • Sinead Delany-Moretlwe
    • 2
  1. 1.Department of EpidemiologyUniversity of North CarolinaChapel HillUSA
  2. 2.Reproductive Health and HIV Research UnitUniversity of the WitwatersrandJohannesburgSouth Africa
  3. 3.School of MedicineUniversity of North CarolinaChapel HillUSA

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