A Comprehensive Survey Analysis

Authors: Mrs Yashmita Naidoo (CEO of HIVSA), Dr Venessa Timmerman (PHD) and Mr Siraaj Adams (MBA, MPH).

HIVSA is an NGO that commissioned the national survey.

Introduction

HIV testing is the first step in linkage to HIV care, including prevention or treatment services. The United Nations Joint Programme on HIV/AIDS has set interim 95-95-95 targets: that 95% of people living with HIV know their HIV status, 95% of these are to be initiated onto antiretroviral treatment (ART), and that 95% of these should be virally suppressed by the end of 2030(1). Alternative HIV testing strategies are needed to overcome barriers to traditional clinic-based testing; HIV self-testing (HST) is one modality that offers promise in reaching individuals who experience barriers to clinic-based testing.

In December 2023, HIVSA conducted a comprehensive survey targeting 500 female respondents in South Africa, aged between 20 and 35 years. An important objective of the survey was to assess the current landscape of HIV self-testing in the country. With representation from all nine provinces, this survey delved into crucial aspects of awareness, testing patterns, and the potential acceptance of online purchase options for HIV testing kits.

Method

A survey was created digitally and hosted on the Choma website, comprising of the following categories: personal details, e-commerce habits, financial wellness, sexual and reproductive health, family planning and health and wellness. Each category was presented as a separate page, with a progress bar to indicate how much of the survey had been completed.

All survey submissions were saved and stored in a cloud-based platform for our data analyst to generate a report from, and our marketing team to track submission numbers. Once we had identified a plateau or slowing of survey submissions, we generated reports from 469 submissions.

Our survey submission collection period was from the 27^th of December 2023 to the 15^th of January 2024, when it was observed that survey submissions had slowed significantly.

Key Survey Findings

1. Understanding the Respondents
2. Description of Participants based on the Graph

Our diverse pool of respondents provided a holistic representation of South African women in the specified age group. Their insights offer a valuable snapshot of the prevailing attitudes and behaviours related to HIV testing.

3. Willingness to Purchase Online

Notably, 52.4% of the respondents expressed a willingness to purchase HIV testing kits online. This finding underscores a growing openness to utilizing online platforms for obtaining essential healthcare resources.

4. Awareness of HIV Status

A staggering 91.4% of respondents reported being aware of their HIV status. This high level of awareness is a positive indicator of the effectiveness of existing HIV awareness and testing initiatives in South Africa.

5. HIV Testing Patterns

Over 60% of respondents revealed that they had undergone HIV testing within the last three months. The frequency in testing pattern is encouraging and suggests a proactive approach to monitoring one’s health status.

6. Regional Representation

Our survey reached respondents across all nine provinces in South Africa, ensuring a geographically diverse sample. The inclusion of perspectives from different regions enhances the reliability and applicability of our findings, considering the diverse healthcare landscape in South Africa.

7. Online Purchase and Accessibility

The willingness of 52.4% of the respondents to buy HIV testing kits online indicates a potential shift in the accessibility and distribution of essential healthcare tools. This trend aligns with the global movement toward digital health solutions, emphasizing convenience and privacy.

8. The Significance of HIV Awareness

The exceptionally high rate of HIV awareness (91%) among our respondents showcases the effectiveness of awareness campaigns and healthcare education in South Africa. It suggests that efforts to destigmatize HIV testing and encourage regular screenings have made a positive impact.

9. Encouraging Proactive Healthcare

The finding that over 60% of respondents have undergone HIV testing in the last three months reflects a proactive and responsible approach to healthcare. Regular testing is crucial for early detection and timely intervention, contributing to overall public health improvement.

Conclusion

Research in 2020, found that the vast majority (95%) of young women chose HIVST over clinic-based HCT.

The insights gained from our survey paint a promising picture of the state of HIV self-testing awareness and practices among South African women aged 20 to 35. The data reveals a willingness to embrace online avenues for purchasing testing kits, a high level of HIV awareness, and a commendable commitment to regular testing. These findings not only shed light on the current landscape but also provide valuable information for shaping future healthcare policies and interventions related to HIV testing in South Africa. As we move forward, it is imperative to build upon these positive trends, ensuring continued accessibility and acceptance of online healthcare platforms.

References:

1. UNAIDS. Understanding fast-track targets. Accelerating action to end the AIDS epidemic by 2030 [document on the Internet]. UNAIDS, 2015. [cited September 28, 2021]; p. 12. Available from: https://www.unaids.org/sites/default/files/media_asset/201506_JC2743_Understanding_FastTrack_en.pdf [Google Scholar]
2. Audrey Pettifor, HIV self-testing among young women in rural South Africa: A randomized controlled trial comparing clinic-based HIV testing to the choice of either clinic testing or HIV self-testing with secondary distribution to peers and partners. 2020