Provision of HIV testing services and its impact on the HIV positivity rate in the public health sector in KwaZulu-Natal: a ten-year review

Figures & data

Figure 1. Total number of HIV tests conducted, the cumulative number of HIV tests and the KZN province’s target for the number of HIV tests between 2009/2010 and 2018/2019.

Table 1. Mean, standard deviation, ANOVA and Bonferroni post hoc analysis of the total number of HIV tests conducted at the 11 districts in the province between 2009/2010 and 2018/2019.

District	Total number of HIV tests conducted per district
	Mean	SD	p value	Post hoc
Amajuba^1	138 828.60	32 943.59	0.000	0.000^2,1
eThekwini^2	763 390.70	29 6973.57		1.00
Harry Gwala^3	153 026.70	34 533.56		0.000^2,3
iLembe^4	139 244.80	28 793.29		0.000^2,4
King Cetshwayo^5	231 157.60	63 937.91		0.000^2,5
Ugu^6	221 972.20	62 804.75		0.000^2,6
uMgungundlovu^7	232 962.10	71 422.96		0.000^2,7
uMkhanyakude^8	137 063.00	32 541.54		0.000^2,8
uMzinyathi^9	169 499.30	57 366.70		0.000^2,9
uThukela^10	139 485.50	29 116.29		0.000^2,10
Zululand^11	208 600.20	45 263.45		0.000^2,11

Abbreviation: SD, standard deviation.

Note: Superscript numbers indicate significant differences between the sample groups (ANOVA, p < 0.05)

Table 2. ANOVA test comparison for the total number of HIV tests conducted at the 11 districts in KZN by the study period.

Period	Total number of HIV tests conducted
	Mean	SD	p value
2009/2010	104 883.18	66 477.740	0.312
2010/2011	169 586.45	85 055.516
2011/2012	212 031.73	152 211.932
2012/2013	204 350.00	142 105.602
2013/2014	230 384.18	154 648.877
2014/2015	241 175.73	176 218.367
2015/2016	238 794.64	215 329.589
2016/2017	287 720.73	264 068.511
2017/2018	279 447.09	252 583.223
2018/2019	336 381.45	311 918.121

Abbreviation: SD, standard deviation.

Table 3. Mean and standard deviation of the number of tests per 100 000 population between the 11 districts in the province over the ten-year study period.

District	HIV tests conducted (per 100 000 population) per district
	Mean	SD	p value	Post hoc
Amajuba^1	25 685.27	5467.831	0.000	1.00
eThekwini^2	21 125.44	7523.789		1.00
Harry Gwala^3	31 539.20	6001.316		0.012^2,3
iLembe^4	21 134.05	3569.086		0.012^3,4
King Cetshwayo^5	24 291.59	6119.158		1.00
Ugu^6	29 705.26	7364.475		0.014^6,10
uMgungundlovu^7	21 417.88	5538.069		0.018^3,7
uMkhanyakude^8	20 767.43	4320.843		0.018^8,9
uMzinyathi^9	30 900.67	9665.775		0.040^7,9
uThukela^10	19 420.70	3984.774		0.003^9,10
Zululand^11	25 129.47	4497.421		1.000

Abbreviation: SD, standard deviation

Note: Superscript numbers indicate significant differences between the sample groups (ANOVA, p < 0.05)

Table 4. ANOVA test comparison for the number of HIV tests conducted per 100 000 population between the 11 Districts in KZN over the ten-year period

Period	Number of HIV tests conducted (per 100 000 population)
	Mean	SD	p value	Post hoc
2009/2010^1	12 650.38	2767.927	0.000	0.000^10,1
2010/2011^2	20 984.14	4878.613		0.000^10,2
2011/2012^3	24 243.05	3540.622		0.020^10,3
2012/2013^4	23 290.44	4663.849		0.004^10,4
2013/2014^5	26 170.98	5615.794		0.286^10,5
2014/2015^6	26 309.45	5012.362		0.340^10,6
2015/2016^7	24 265.38	5302.994		0.020^10,7
2016/2017^8	28 650.95	7439.715		1.000^10,8
2017/2018^9	27 424.37	5429.319		1.000^10,9
2018/2019^10	32 480.82	6810.686		1.000

Abbreviation: SD, standard deviation.

Note: Superscript numbers indicate significant differences between the sample groups (ANOVA, p < 0.05).

Table 5. ANOVA test comparison for the HIV testing rate at the 11 Districts in KZN.

District	HIV testing rate per district
	Mean	SD	p value
Amajuba	99.9	4.7	0.337
eThekwini	90.7	12.0
Harry Gwala	96.3	3.4
iLembe	102.3	13.3
King Cetshwayo	94.1	16.8
Ugu	100.6^3	9.1
uMgungundlovu	103.0	16.8
uMkhanyakude	99.1	2.3
uMzinyathi	96.2	3.8
uThukela	98.7	5.0
Zululand	103.4	21.2

Abbreviation: SD, standard deviation.

Table 6. ANOVA test comparison for the HIV testing rate at the 11 Districts in KZN by the study period.

Period	HIV testing rate
	Mean	SD	p value	Post hoc
2009/2010^1	94.1	2.6	0.000	0.000^1,8
2010/2011^2	88.41	13.9		0.000^1,2
2011/2012^3	93.7	7.2		0.000^1,3
2012/2013^4	96.4	5.9		0.000^1,4
2013/2014^5	97.5	1.7		0.000^1,5
2014/2015^6	98.8	1.1		0.000^1,6
2015/2016^7	98.9	1.8		0.000^1,7
2016/2017^8	120.4	22.5		0.000^1,8
2017/2018^9	98.9	1.7		0.000^1,9
2018/2019^10	98.4	2.7		0.000^1,10

Abbreviation: SD, standard deviation.

Note: Superscript numbers indicate significant differences between the sample groups (ANOVA, p < 0.05).

Figure 2. HIV positivity rate of 15–49 year old in the public sector in KZN between 2009/2010 and 2018/2019.

Table 7. Mean and standard deviation of the HIV positivity rate at the 11 districts in the province over the ten – year study period.

District	HIV positivity rate per district (%)
	Mean	SD	p value
Amajuba^1	12.4	6.4	0.143
eThekwini^2	18.8	9.6
Harry Gwala^3	9.7	5.5
iLembe^4	13.9	5.2
King Cetshwayo^5	13.9	6.7
Ugu^6	11.7	6.3
uMgungundlovu^7	16.3	7.8
uMkhanyakude^8	12.6	6.4
uMzinyathi^9	9.7	7.8
uThukela^10	15.0	7.4
Zululand^11	12.2	6.2

Abbreviation: SD, standard deviation.

Note: Superscript numbers indicate significant differences between the sample groups (ANOVA, p < 0.05).

Table 8. Mean and standard deviation of the HIV positivity rate at the 11 districts in the province over the ten-year study period.

Period	HIV positivity rates
	Mean	SD	p value	Post hoc
2009/2010^1	28.9	4.5	0.000	0.000^8,1
2010/2011^2	19.8	4.0		0.000^8,2
2011/2012^3	15.5	3.5		0.000^8,3
2012/2013^4	13.8	3.6		0.015^8,4
2013/2014^5	11.5	3.4		1.000^8,5
2014/2015^6	11.0	2.6		1.000^8,6
2015/2016^7	10.1	2.3		1.000^8,7
2016/2017^8	8.9	2.2		1.000
2017/2018^9	7.7	1.8		1.000^8,9
2018/2019^10	5.8	1.5		0.929^8,10

Abbreviation: SD, standard deviation.

Note: Superscript numbers indicate significant differences between the sample groups (ANOVA, p < 0.05).

Table 9. Pearson correlation between the HIV positivity rate and its predictors.

		Total number of HIV tests conducted	Number of HIV tests conducted per 100 000 population	HIV positivity rate	HIV testing rate
Total number of HIV tests conducted	Pearson correlation	1	.173	-.102	-.033
	Sig. (2-tailed)		.070	.287	.729
	N	110	110	110	110
Total number of HIV tests conducted per 100 000 population	Pearson correlation	.173	1	-.823**	.212*
	Sig. (2-tailed)	.070		.000	.027
	N	110	110	110	110
HIV positivity rate	Pearson correlation	–.102	–.823**	1	-.324**
	Sig. (2-tailed)	.287	.000		.001
	N	110	110	110	110
HIV testing rate	Pearson correlation	–033	.212*	-.324**	1
	Sig. (2-tailed)	.729	.027	.001
	N	110	110	110	110

**correlation is significant at the 0.01 level (2-tailed).

Table A1. Definition of indicators extracted from webDHIS according to the National Indicator Dataset (NIDS).

INDICATOR NAME:	NIDS VERSION	FACTOR:	DEFINITION:	USE BY THE DEPARTMENT OF HEALTH
TOTAL NUMBER OF HIV TESTS CONDUCTED	2017 and 2020	No.	The total number of HIV tests conducted in all age groups.^2	‘Monitors the impact of the pandemic and assists in better planning for effective combating of HIV and AIDS and decreasing the burden of diseases from TB’.
HIV TESTING RATE	2010	%	The number of clients tested for HIV, as a proportion of the number of clients counselled prior to HIV testing. Antenatal clients are excluded from this indicator.	Assesses the acceptability and uptake of HIV testing by clients visiting the public health facilities (Department of Health, 2019). It is also used as proxy to determine the extent to which the first 90-90-90 target (of 90% of people living with HIV aware of their status) is being achieved (Department of Health, 2019).
HIV POSITIVITY RATE (PREVALENCE IN DHIS) AMONG CLIENTS TESTED	2010	%	The proportion of clients that underwent HIV testing and were found to be HIV positive. This definition excludes antenatal clients.

Department of Health. (2019). The NDOH data dictionary. Department of Health. Retrieved 29/05/2019 from https://dd.dhmis.org/orgunits.html?file = NIDSIntegrated&source = nids&ver = 22b8.

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Data availability statement

Data from the study can be accessed from the KwaZulu-Natal Department of Health’s Data Management and Geographic Information System Unit by completing a Data user agreement form.