Estimating the Prevalence of over- and Under-Reporting in HIV Testing, Status and Treatment in Rural Northeast South Africa: A Comparison of a Survey and Clinic Records
| dc.contributor.author | Hannah H Leslie | |
| dc.contributor.author | Chodziwadziwa W Kabudula | |
| dc.contributor.author | Rebecca L West | |
| dc.contributor.author | Mi-Suk Kang Dufour | |
| dc.contributor.author | Aimée Julien | |
| dc.contributor.author | Nkosinathi G Masilela | |
| dc.contributor.author | Stephen M Tollman | |
| dc.contributor.author | Audrey Pettifor | |
| dc.contributor.author | Kathleen Kahn | |
| dc.contributor.author | Sheri A Lippman | |
| dc.date.accessioned | 2024-02-22T13:31:23Z | |
| dc.date.available | 2024-02-22T13:31:23Z | |
| dc.date.issued | 2023-10-27 | |
| dc.description.abstract | We assess the accuracy of self-reported testing, HIV status, and treatment responses compared to clinical records in Ehlanzeni District, South Africa. We linked a 2018 population-based survey of adults 18-49 years old with clinical data at local primary healthcare facilities from 2014 to 2018. We calculated self-reported testing, HIV status, and treatment, and triangulated findings with clinic record data. We adjusted testing estimates for known gaps in HIV test documentation. Of 2089 survey participants, 1657 used a study facility and were eligible for analysis. Half of men and 84% of women reported an HIV test in the past year. One third of reported tests could be confirmed in clinic data within 1 year and an additional 13% within 2 years; these fractions increased to 57% and 22% respectively limiting to participants with a verified clinic file. After accounting for gaps in clinic documentation, we found that prevalence of recent HIV testing was closer to 15% among men and 51% in women. Estimated prevalence of known HIV was 16.2% based on self-report vs. 27.6% with clinic documentation. Relative to clinical records among confirmed clinic users, self report of HIV testing and of current treatment were highly sensitive but non-specific (sensitivity 95.5% and 98.8%, specificity 24.2% and 16.1% respectively), while self report of HIV status was highly specific but not sensitive (sensitivity 53.0%, specificity 99.3%). While clinical records are imperfect, survey-based measures should be interpreted with caution in this rural South African setting. | |
| dc.description.librarian | PM2023 | |
| dc.faculty | Faculty of Health Sciences | |
| dc.identifier.uri | https://hdl.handle.net/10539/37712 | |
| dc.language.iso | en | |
| dc.school | Public Health | |
| dc.subject | HIV testing; South Africa; self-reported measures; survey research. | |
| dc.title | Estimating the Prevalence of over- and Under-Reporting in HIV Testing, Status and Treatment in Rural Northeast South Africa: A Comparison of a Survey and Clinic Records | |
| dc.type | Article |