Predictors of uptake of human immunodeficiency virus testing by tuberculosis patients in Free State Province, South Africa

Abstract

Setting: Two districts of the Free State Province in South Africa.

Objective: To determine the predictors of human immunodeficiency virus (HIV) test uptake by tuberculosis (TB) patients.

Design: A cross-sectional survey was conducted among 600 TB patients in 61 primary health care facilities. Probability proportional-to-size sampling was used to determine the number of patients recruited at each facility. Structured exit interviews were conducted with convenience samples of patients at these facilities. Descriptive and logistic regression analyses were performed on the data.

Results: The average age of the recruited TB patients was 38.4 years. The majority were female (n = 310, 51.7%), unmarried (n = 439, 73.3%), unemployed (n = 513, 85.5%) and had undertaken HIV testing (n = 405, 67.5%). In multivariate analysis, having received information on the relationship between TB and HIV (OR 5.4, 95%CI 3.1-9.5) was the strongest predictor of HIV test uptake among unmarried patients. Other associated factors included knowing/having lost someone ill with HIV/AIDS (acquired immune-deficiency syndrome; OR 3.6, 95%CI 2.2-5.8), female sex (OR 2.3, 95%CI 1.4-3.7), unemployment (OR 2.2, 95%CI 1.2-4.1) and undergoing retreatment for TB (OR 2.0, 95%CI 1.2-3.2).

Conclusion: HIV test scale-up efforts should aim to increase TB patients' awareness of the relationship between TB and HIV/AIDS and consider the impact of socio-demographic factors.