Staveteig, Sarah, Shanxiao Wang, Sara K. Head, Sarah E.K. Bradley, and Erica Nybro. 2013. Demographic Patterns of HIV Testing Uptake in Sub-Saharan Africa. DHS Comparative Reports No. 30. Calverton, Maryland, USA: ICF International.
HIV testing is an integral component of HIV prevention strategies and provides a gateway to treatment and care. This report uses nationally representative data on HIV testing uptake from 47 DHS and AIS surveys in 29 sub-Saharan African countries conducted between 2003 and 2011. We examine four aspects of HIV testing uptake: (1) uptake by individual and household characteristics; (2) increases in uptake over time; (3) the role of HIV testing during ANC in overall uptake; and (4) uptake by HIV serostatus. While uptake of HIV testing has increased in every country studied, the gains have been uneven. Regardless of any male-female testing differential in the earliest survey in a country, the most recent survey in every country indicates that women are more likely than men to have ever been tested for HIV. This disparity appears to reflect the relative success of increased testing uptake during antenatal care (ANC). Even so, in the median country, the majority of adults have never been tested for HIV. While seropositive individuals are more likely to have ever been tested for HIV, in 16 of 25 countries studied with respect to serostatus the majority of HIV-positive men and women have no way of knowing their HIV status because they have never been tested. Scaling up access and outreach to testing among underserved populations in particular, including men in rural areas, remains an important frontier to achieving universal access to treatment and support in most countries.