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High Prevalance of Self-Reported Undiagnosed HIV despirte High Coverage of HIV Testing: a Cross-sectional Population Based Sero-Survey in South Africa



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Objectives: To measure HIV prevalence and uptake of HIV counseling and testing (HCT) in a peri-urban South African
community. To assess predictors for previous HIV testing and the association between the yield of previously undiagnosed
HIV and time of last negative HIV test
Methods: A random sample of 10% of the adult population ($15 years) were invited to attend a mobile HCT service. Study
procedures included a questionnaire, HIV testing and CD4 counts. Predictors for previous testing were determined using a
binominal model.
Results: 1,144 (88.0%) of 1,300 randomly selected individuals participated in the study. 71.0% (68.3–73.6) had previously had
an HIV test and 37.5% (34.6–40.5) had tested in the past 12 months. Men, migrants and older (.35 years) and younger (,20
years) individuals were less likely to have had a previous HIV test. Overall HIV prevalence was 22.7 (20.3–25.3) with peak
prevalence of 41.8% (35.8–47.8) in women aged 25.1–35 years and 37.5% (26.7–48.3) in men aged 25.1–45 years. Prevalence
of previously undiagnosed HIV was 10.3% (8.5–12.1) overall and 4.5% (2.3–6.6), 8.0% (CI 3.9–12.0) and 20.0% (13.2–26.8) in
individuals who had their most recent HIV test within 1, 1–2 and more than 2 years prior to the survey.
Conclusion: The high burden of undiagnosed HIV in individuals who had recently tested underscores the importance of
frequent repeat testing at least annually. The high prevalence of previously undiagnosed HIV in individuals reporting a
negative test in the 12 months preceding the survey indicates a very high incidence. Innovative prevention strategies are












Created at 9/30/2011 12:48 PM by Davis, Gregory P
Last modified at 9/30/2011 12:48 PM by Davis, Gregory P