Validity of self-report for ascertaining HIV status among circular migrants and permanent residents in South Africa: a cross-sectional, population-based analysis
| dc.contributor.author | Rachel R Yorlets | |
| dc.contributor.author | Mark N Lurie | |
| dc.contributor.author | Carren Ginsburg | |
| dc.contributor.author | Joseph W Hogan | |
| dc.contributor.author | Nina R Joyce | |
| dc.contributor.author | Sadson Harawa | |
| dc.contributor.author | Mark A Collinson | |
| dc.contributor.author | F Xavier Gómez-Olivé | |
| dc.contributor.author | Michael J White | |
| dc.date.accessioned | 2024-03-06T08:40:05Z | |
| dc.date.available | 2024-03-06T08:40:05Z | |
| dc.date.issued | 2023-03 | |
| dc.description.abstract | While expanded HIV testing is needed in South Africa, increasing accurate self-report of HIV status is an essential parallel goal in this highly mobile population. If self-report can ascertain true HIV-positive status, persons with HIV (PWH) could be linked to life-saving care without the existing delays required by producing medical records or undergoing confirmatory testing, which are especially burdensome for the country’s high prevalence of circular migrants. We used Wave 1 data from The Migration and Health Follow-Up Study, a representative adult cohort, including circular migrants and permanent residents, randomly sampled from the Agincourt Health and Demographic Surveillance System in a rural area of Mpumalanga Province. Within the analytic sample (n=1,918), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of self-report were calculated with dried blood spot (DBS) HIV test results as the standard. Among in-person participants (n=2,468), 88.8% consented to DBS-HIV testing. HIV prevalence was 25.3%. Sensitivity of self-report was 43.9% (95% CI: 39.5–48.5), PPV was 93.4% (95% CI: 89.5–96.0); specificity was 99.0% (95% CI: 98.3–99.4) and NPV was 83.9% (95% CI: 82.8–84.9). Self-report of an HIV-positive status was predictive of true status for both migrants and permanent residents in this high-prevalence setting. Persons who self-reported as living with HIV were almost always truly positive, supporting a change to clinical protocol to immediately connect persons who say they are HIV-positive to ART and counselling. However, 56% of PWH did not report as HIV-positive, highlighting the imperative to address barriers to disclosure. | |
| dc.description.librarian | PM2023 | |
| dc.faculty | Faculty of Health Sciences | |
| dc.identifier.uri | https://hdl.handle.net/10539/37757 | |
| dc.language.iso | en | |
| dc.school | Public Health | |
| dc.subject | HIV status; internal migration; sociodemographic factors; South Africa | |
| dc.title | Validity of self-report for ascertaining HIV status among circular migrants and permanent residents in South Africa: a cross-sectional, population-based analysis | |
| dc.type | Article |