"If you talk about a window period of two weeks, it is worse": HIV testing among men who have sex with men (MSM) in Johannesburg and Durban, South Africa

Abstract

Background: The Johannesburg/eThekwini Men's Study (JEMS) was conducted to provide information on HIV among men who have sex with men (MSM) in Johannesburg and Durban, South Africa, in response to reports that MSM in South Africa are disproportionately at risk of HIV infection. The study also assessed the availability and use of health services for MSM. HIV testing services are widely available in South Africa but are under-utilised. Increasing HIV testing uptake is integral to achieving the goals of the South African National Strategic Plan on HIV & AIDS and STIs, 2007-2011. Methods: HIV testing practices and attitudes towards HIV testing were assessed using 32 key informant interviews (KIIs) and 18 focus group discussions (FGDs). 282 sexually-active MSM were recruited into a survey using respondent-driven sampling. Survey participants completed a questionnaire which included a section on HIV testing, and provided finger-prick blood specimens for anonymous HIV testing. All survey participants were also offered free on-site voluntary counselling and testing (VCT). Results: HIV prevalence among survey participants was 44% (38% adjusted). KIIs and FGDs revealed a widespread reluctance to be tested for HIV. Although 98% of survey participants knew where they could be tested for HIV, only 74% had ever been tested, and 48% had been tested in the past year and given the result. Only 57% 'knew' their HIV status (self-reported). Of those who knew their status, 69% had disclosed their status to a sexual partner in the past year. Only 25 participants (9%) chose to have VCT, of whom 6 were HIV positive. Conclusions: Knowledge and disclosure of HIV status among MSM in the 2 survey cities was suboptimal. Interventions are needed to promote HIV testing and disclosure of HIV status among South African MSM. VCT services need to become more MSM-friendly in order to facilitate HIV testing.