Determinants of gender disparities in scaling up the first 90 towards the UNAIDS 90-90-90 targets in South Africa: findings from the 2017 household-based national cross-sectional survey
OUTPUT TYPE: Journal Article
PUBLICATION YEAR: 2021
TITLE AUTHOR(S): S.Jooste, M.Mabaso, M.Taylor, A.North, Y.L.Shean, L.C.Simbayi
KEYWORDS: GENDER EQUALITY, HIV/AIDS, HIV/AIDS PREVENTION, HOUSEHOLDS
DEPARTMENT: Public Health, Societies and Belonging (HSC), Deputy CEO: Research (DCEO_R), Deputy CEO: Research (ERKC), Deputy CEO: Research (CGI)
Print: HSRC Library: shelf number 12035
HANDLE: 20.500.11910/16073
URI: http://hdl.handle.net/20.500.11910/16073
If you would like to obtain a copy of this Research Output, please contact Hanlie Baudin at researchoutputs@hsrc.ac.za.
Abstract
The first 90 of UNAIDS 90-90-90 targets to have 90% of the people living with HIV know their status is an important entry point to the HIV treatment cascade and care continuum, but evidence shows that there is a large gap between males and females in this regard. It is therefore important to understand barriers and facilitators of achieving the first 90 target. This study examined determinants of the first 90 target among females and males in order to inform strategies aimed at improving the HIV cascade in South Africa. The data used in the analysis were obtained from a 2017 household-based cross-sectional nationally representative survey conducted using a multi-stage stratified cluster random sampling design. A series of hierarchical multiple logistic regression models were fitted to identify the determinants of the first 90 target by gender. Overall, 84.8% of HIV-positive individuals aged 15 years and older were aware of their HIV status. Females were significantly more aware of their HIV status compared to males (88.7% vs 78.2%, p < 0.001). Both females aged 25 to 49 years [aOR = 3.20 (95% CI 1.35-7.57), p = 0.008], and 50 years and older [aOR = 3.19 (95% CI 1.04-9.76), p = 0.042] and males aged 25 to 49 years [aOR = 3.00 (95% CI 1.13-7.97), p = 0.028], and 50 years and older [aOR = 7.25 (95% CI 2.07-25.36), p = 0.002] were significantly more likely to know their HIV status compared to those aged 15 to 19 years. Males with tertiary education level were significantly more likely to be aware of their HIV positive status [aOR = 75.24 (95% CI 9.07-624.26), p < 0.001] compared to those with no education or with primary level education. Females with secondary [aOR = 3.28 (95% CI 1.20-8.99), p = 0.021] and matric [aOR = 4.35 (95% CI 1.54-12.37), p = 0.006] educational levels were significantly more likely to be aware of their HIV positive status, compared to those with no education or with primary level education. Significant progress has been made with regards to reaching the UNAIDS first 90 target. In this context achieving the first 90 target is feasible but there is a need for additional interventions to reach the males especially youth including those with no education or low levels of education.-
Related Research Outputs:
- National HIV incidence measures - new insights into the South African epidemic
- South African national HIV prevalence, incidence, behaviour and communication survey, 2008: the health of our children
- Lipstick & HIV/AIDS prevention
- New insights into HIV epidemic in South Africa: key findings from the National HIV Prevalence, Incidence and Behaviour Survey, 2012
- The psychology of "cure": unique challenges to consent processes in HIV cure research in South Africa
- Adolescent barriers to HIV prevention research: are parental consent requirements the biggest obstacle?
- Closing the gap in programming for adolescents living with HIV in eastern and southern Africa: the role of social protection in positive prevention
- Community-derived interventions can improve responsiveness to the HIV prevention needs of transgender women in South Africa
- The impact of HIV prevention interventions targeted at adolescent girls and young women (AGYW) on HIV incidence and other biomedical, behavioural, and structural outcomes in sub-Saharan Africa: a systematic review
- Methodological issues relating to household and migration surveys
- Whose right it is anyway? equality, culture and conflicts of rights in South Africa
- Review of the HIV/AIDS policy, legislation, financing & implementation of programmes in Mozambique
- Gender inequality persists in artisan employment in South Africa
- Social impact assessment of development projects
- Book review: Bradby, H. & Hundt, G.L. (eds). 2010. Global perspectives on war, gender and health: the sociology and anthropology of suffering. Surrey: Ashgate Publishing. 157 p. ISBN 9780754675235
- Safe water, access to health care and other factors affecting infant and child survival under African and coloured populations in South Africa
- Gender equality and Curriculum 2005
- A review of HIV/AIDS policy, financing, legislation and programmes: South African case study: Draft
- The impact of HIV/AIDS on the health sector: national survey of health personnel, ambulatory and hospitalised patients and health facilities, 2002
- Prevention of mother to child transmission: a report of an assessment of a pilot programme in fifteen health facilities in Gauteng province