Clients' perceptions and satisfaction with HIV counselling and testing: A cross-sectional study in 56 HCT sites in South Africa.

Gladys Matseke,Karl Peltzer,Neo Mohlabane

doi:10.4102/phcfm.v8i1.1173

Gladys Matseke, Karl Peltzer + Show 1 more

Open Access

https://doi.org/10.4102/phcfm.v8i1.1173

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Abstract

BackgroundClient satisfaction serves as a predictor for acceptance of HIV counselling and testing (HCT) services. Therefore, the study of clients’ perception and satisfaction may offer insights on how to improve HCT programmes.Aim and settingThe aim of this study was to assess clients’ satisfaction with HCT as well as describe perceived barriers to and facilitators of HIV testing by HCT clients in South Africa.MethodsA cross-sectional survey was conducted through interviews with 498 clients purposefully selected at the end of an HCT visit at 56 HCT sites throughout the country.ResultsAll the 498 study participants had tested for HIV with 98.8% receiving their results. Most (88.2%) reported testing for HIV before. The vast majority (75.5%) of clients reported that they had decided to be tested for HIV by themselves. High levels of satisfaction with HCT service (89.8%), low levels (27.7%) of difficulty in making the decision to have an HIV test and high levels of perceived confidentiality (94.6%) of the HIV test results were reported in this study. The most cited perceived barrier to HIV testing was lack of awareness about the HCT service (98%), while staff attitudes (37%), confidentiality (29.6%) and privacy (23.6%) were perceived facilitators. In multivariate logistic regression, staff attitude was significantly associated with client satisfaction (p < 0.05).ConclusionHigh levels of client satisfaction with HCT services were observed. Various barriers to and facilitators of – including staff attitude – HCT were identified which can help guide the improvement of HCT services in South Africa.

Highlights

HIV counselling and testing (HCT) has become widely available in South Africa over the recent years, with more than 4500 public HCT sites.[1]
Because of numerous factors related to clients and health systems, as indicated in various studies, uptake of HCT remains low in South Africa.[1]
A cross-sectional survey was conducted through exit interviews of HCT clients in 56 HCT sites, in eight provinces in South Africa, over a period of 8 months from February to October 2012

Summary

Introduction

HIV counselling and testing (HCT) has become widely available in South Africa over the recent years, with more than 4500 public HCT sites.[1]. Client-related factors that served as barriers to HIV testing included fear of diagnosis or doubts about HIV status,[2,3,4,5,6] fear of disclosure of HIV test results[7] and lack of awareness of testing sites.[8] Distance to the HCT facility and lack of confidentiality in health facilities can be barriers in accessing HIV testing services.[9] Additional factors include fear of stigmatisation,[3,4,9,10] transport difficulties[11] and low risk perception.[9] Peltzer et al.[9] cited reasons such as knowing one’s status already, not understanding the group counselling process, long waiting times, disliking the counselling process and partner dynamics as obstacles to the utilisation of HIV testing services. Client satisfaction serves as a predictor for acceptance of HIV counselling and testing (HCT) services. The study of clients’ perception and satisfaction may offer insights on how to improve HCT programmes

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