Huerga, H., Van Cutsem, G., Ben Farhat, J., et al. Journal of Acquired Immune Deficiency Syndromes (May 2016), e-publication ahead of print.
This study assessed the prevalence of HIV testing, HIV positivity awareness, antiretroviral therapy (ART) uptake, and viral suppression in KwaZulu Natal, South Africa, and investigated factors associated with being untested, unaware, untreated, and virally unsuppressed. From July to October 2013, the authors surveyed a total of 2,377 households. At participants' homes they conducted interviews, administered HIV tests, and collected blood to test for antiretroviral drugs, CD4 levels, and viral load. Men and persons under age 35 accounted for most of the untested people (63.3% and 75.5%, respectively). Individuals aged less than 35 years and women accounted for most of the status-unaware HIV-positive people (73.2% and 68.7%); in need of treatment (66.4% and 65.2%); and with a viral load above 1,000 cp/mL (66.3% and 71.1%). Reasons for these findings included lower access to testing and treatment in people under age 35 and the higher proportion of women in the population in this area (62.3%). Additionally, people with more than one sexual partner were more likely to be untested, unaware, and untreated. The authors concluded that programs should prioritize increasing access to testing and treatment for young people and women, and should also adapt HIV testing strategies to better target men.