Community perceptions of repeat HIV-testing: experiences of the ANRS 12249 Treatment as Prevention trial in rural South Africa

Joanna Orne-Gliemann (1, 2) , Thembelihle Zuma (3) , Jeremiah Chikovore (4) , Natasha Gillespie (4) , Merridy Grant (3) , Collins Iwuji (3, 5) , Joseph Larmarange (6, 3) , Nuala Mcgrath (5, 7, 8) , France Lert (9) , John Imrie (3, 8, 10)

1 ISPED - Institut de Santé Publique, d'Epidémiologie et de Développement
2 BPH - Bordeaux population health
3 UKZN - University of KwaZulu-Natal [Durban, Afrique du Sud]
4 Human Sciences Research Council [Pretoria, South Africa]
5 Africa Centre for Health and Population Studies
6 CEPED - UMR_D 196 - Centre population et développement
7 University of Southampton
8 UCL - University College of London [London]
9 CESP - Centre de recherche en épidémiologie et santé des populations
10 WITS - University of the Witwatersrand [Johannesburg]

In the context of the ANRS 12249 Treatment as Prevention (TasP) trial, we investigated perceptions of regular and repeat HIV-testing in rural KwaZulu-Natal (South Africa), an area of very high HIV prevalence and incidence. We conducted two qualitative studies, before (2010) and during the early implementation stages of the trial (2013-2014), to appreciate the evolution in community perceptions of repeat HIV-testing over this period of rapid changes in HIV-testing and treatment approaches. Repeated focus group discussions were organized with young adults, older adults and mixed groups. Repeat and regular HIV-testing was overall well perceived before, and well received during, trial implementation. Yet community members were not able to articulate reasons why people might want to test regularly or repeatedly, apart from individual sexual risk-taking. Repeat home-based HIV-testing was considered as feasible and convenient, and described as more acceptable than clinic-based HIV-testing, mostly because of privacy and confidentiality. However, socially regulated discourses around appropriate sexual behaviour and perceptions of stigma and prejudice regarding HIV and sexual risk-taking were consistently reported. This study suggests several avenues to improve HIV-testing acceptability, including implementing diverse and personalised approaches to HIV-testing and care, and providing opportunities for antiretroviral therapy initiation and care at home.

Mots clés: South Africa HIV testing community UTT treatment as prevention; South Africa; HIV; testing; community; UTT; treatment as prevention

Domaines: Démographie; Santé publique et épidémiologie

Joanna Orne-Gliemann, Thembelihle Zuma, Jeremiah Chikovore, Natasha Gillespie, Merridy Grant, et al.. Community perceptions of repeat HIV-testing: experiences of the ANRS 12249 Treatment as Prevention trial in rural South Africa. AIDS Care, 2016, 28 (sup3), pp.14 - 23. ⟨10.1080/09540121.2016.1164805⟩. ⟨ird-03886090⟩