Low rates of prior HIV testing among HIV-positive adults accessing outpatient services in Eswatini

Harriet Nuwagaba-Biribonwoha,Zandile Mnisi,Neena Philip,Averie Baird Gachuhi,Sikhathele Mazibuko,Ruben Sahabo,Mathew Lamb,Wafaa M El Sadr,Sean Burke,Yingfeng Wu,Veli Madau,Margaret L Mcnairy

doi:10.1186/s12981-019-0254-y

Abstract

Prior HIV testing and awareness of HIV-positive status were assessed among HIV-positive adults at 20 clinics in Eswatini. Of 2196 HIV-positive adults, 1183 (53.8%) reported no prior HIV testing, and 1948 (88.7%) were unaware of their HIV-positive status. Males [adjusted odds ratio, AOR, (95% confidence interval): 0.7 (0.5–0.9)], youth 18–25 years [AOR 0.6 (0.4–0.95)], adults ≥ 50 years [AOR 0.5 (0.3–0.9)], those needing family support [AOR 0.6 (0.5–0.8)], and those living ≥ 45 min from clinic [AOR 0.5 (0.4–0.8)] were less likely to know their HIV-positive status. More HIV testing is needed to achieve 95-95-95 targets, with targeted strategies for those less likely to test for HIV.

Highlights

HIV testing is the gateway to HIV prevention and treatment services
In order to achieve HIV epidemic control, Eswatini, like other sub-Saharan African countries, has committed to the UNAIDS 95:95:95 targets: by 2030, 95% of people living with HIV (PLHIV) should be diagnosed, 95% of those diagnosed should be on treatment and 95% of those on treatment should be virally suppressed [2]
The odds of no prior HIV testing were higher among males compared to females [AOR 1.7, 1.4–2.0]

Summary

Introduction

HIV testing is the gateway to HIV prevention and treatment services. Universal access to HIV testing services (HTS) is a high priority in the Kingdom of Eswatini (formerly Swaziland), a country with a severe generalised HIV epidemic [1]. In order to achieve HIV epidemic control, Eswatini, like other sub-Saharan African countries, has committed to the UNAIDS 95:95:95 targets: by 2030, 95% of people living with HIV (PLHIV) should be diagnosed, 95% of those diagnosed should be on treatment and 95% of those on treatment should be virally suppressed [2]. There has been significant investment in HTS in Eswatini in order to achieve 95-95-95 targets. National program data indicate that over 400,000 HIV tests are conducted annually in this country which has a population of 1.1 million people [3].

Methods

Results

Discussion

Conclusion