Exploring repeat HIV testing among men who have sex with men in Cape Town and Port Elizabeth, South Africa

Abstract

Despite the high prevalence of HIV among men who have sex with men (MSM) – and the general adult population – in South Africa, there is little data regarding the extent to which MSM seek repeat testing for HIV. This study explores reported histories of HIV testing, and the rationales for test seeking, among a purposive sample of 34 MSM in two urban areas of South Africa. MSM participated in activity-based in-depth interviews that included a timeline element to facilitate discussion. Repeat HIV testing was limited among participants, with three-quarters having two or fewer lifetime HIV tests, and over one-third of the sample having one or fewer lifetime tests. For most repeat testers, the time gap between their HIV tests was greater than the one-year interval recommended by national guidelines. Analysis of the reasons for seeking HIV testing revealed several types of rationale. The reasons for a first HIV test were frequently one-time occurrences, such as a requirement prior to circumcision, or motivations likely satisfied by a single HIV test. For MSM who reported repeat testing at more timely intervals, the most common rationale was seeking test results with a sex partner. Results indicate a need to shift HIV test promotion messaging and programming for MSM in South Africa away from a one-off model to one that frames HIV testing as a repeated, routine health maintenance behavior.

Keywords:

• MSM
• HIV testing
• South Africa
• qualitative

Funding

This study was supported by the National Institute of Allergy and Infectious Diseases [grant number R01AI094575], and was facilitated by the Emory Center for AIDS Research [grant number P30AI050409]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Additional information

Funding

Funding: This study was supported by the National Institute of Allergy and Infectious Diseases [grant number R01AI094575], and was facilitated by the Emory Center for AIDS Research [grant number P30AI050409]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.