Exploring perceptions of low risk behaviour and drivers to test for HIV among South African youth.

Tshifhiwa Muravha,Claire Botha,Wellington Maruma,Christopher J Hoffmann,Candice M Chetty-Makkan,Salome Charalambous,Claudia Marotta

doi:10.1371/journal.pone.0245542

Abstract

Human Immunodeficiency Virus (HIV) prevalence among South African youth is high, yet HIV testing remains suboptimal. We explored how perceptions of HIV risk and behaviours informed decisions to test for HIV. This study was conducted from April 2018 to March 2019 in Ekurhuleni district, Gauteng Province with males and females aged between 15–24 years. Twenty-five youth with unknown HIV status participated in in-depth interviews (IDIs); while four focus group discussions (FGDs) were conducted with those that previously tested for HIV. Probes used in the guides included types of incentives that youth would value when testing for HIV or receiving treatment; barriers and motivators to HIV testing; enablers and challenges to using cellphone technology and preferences on type of social media that could be used to create awareness about HIV testing services. IDIs and FGDs were audio-recorded, transcribed, and translated. QSR NVIVO 10 was used for the analysis. The majority of the youth perceived that their risk of HIV infection was low due to factors such as being young, lacking physical signs of HIV, being sexually inactive and parents not being HIV positive. However, youth identified high risk behaviours such as unprotected sex, multiple sexual partners, excessive drinking of alcohol, being victims of sexual abuse, road accidents and violent behaviour as increasing their vulnerability to HIV. Most youth highlighted cues to action that would motivate them to test for HIV such as support of parents, receiving incentives, improved confidentiality during HIV testing and receiving information about HIV via social media (Facebook, Twitter and Whatsapp). Despite perceptions of low risk to HIV, youth remain vulnerable to HIV. Disseminating HIV information via digital platforms; giving youth options to choose between testing locations that they consider to be private; providing incentives and equipping parents/guardians to encourage youth to test could optimise HIV testing.

Highlights

Human Immunodeficiency Virus (HIV) infection among the youth remains a global health burden
It was mostly those with unknown HIV status who felt that they were at low risk to HIV
The prominent findings of our study were that majority of the youth perceived that they were at low risk to HIV, despite the high background HIV prevalence of 6.5% among youth in the Gauteng province [3]

Summary

Introduction

Human Immunodeficiency Virus (HIV) infection among the youth remains a global health burden. Youth often engage in sexual activities without using a condom [3, 4], have multiple sexual partners [5], and early sexual debut [3, 6] that place them at high risk for HIV. Despite their high risk behaviour, youth often perceive low vulnerability to HIV [6]. For this reason, utilisation of HIV testing remains low among this population and a high proportion of youth are not aware of their HIV status [5, 7, 8]

Methods

Results

Conclusion