Exploring perceptions of low risk behaviour and drivers to test for HIV among South African youth

Abstract

Human Immunodeficiency Virus (HIV) prevalence among South African youth is high, yet HIV testing remains suboptimal. We explored how perceptions of HIV risk and behaviours informed decisions to test for HIV. This study was conducted from April 2018 to March 2019 in Ekurhuleni district, Gauteng Province with males and females aged between 15–24 years. Twenty-five youth with unknown HIV status participated in in-depth interviews (IDIs); while four focus group discussions (FGDs) were conducted with those that previously tested for HIV. Probes used in the guides included types of incentives that youth would value when testing for HIV or receiving treatment; barriers and motivators to HIV testing; enablers and challenges to using cellphone technology and preferences on type of social media that could be used to create awareness about HIV testing services. IDIs and FGDs were audio-recorded, transcribed, and translated. QSR NVIVO 10 was used for the analysis. The majority of the youth perceived that their risk of HIV infection was low due to factors such as being young, lacking physical signs of HIV, being sexually inactive and parents not being HIV positive. However, youth identified high risk behaviours such as unprotected sex, multiple sexual partners, excessive drinking of alcohol, being victims of sexual abuse, road accidents and violent behaviour as increasing their vulnerability to HIV. Most youth highlighted cues to action that would motivate them to test for HIV such as support of parents, receiving incentives, improved confidentiality during HIV testing and receiving information about HIV via social media (Facebook, Twitter and Whatsapp). Despite perceptions of low risk to HIV, youth remain vulnerable to HIV. Disseminating HIV information via digital platforms; giving youth options to choose between testing locations that they consider to be private; providing incentives and equipping parents/guardians to encourage youth to test could optimise HIV testing.

Prevalence and predictors of HIV testing among young men in Papua New Guinea: a cross-sectional analysis of a nationally representative sample

“…Another plausible reason for this could be the low-risk perception of being young and active and lacking physical signs of HIV. Young men who perceive their risk of HIV as low and do not have access to HIV testing services are less likely to have received an HIV test in their lifetime [46,47].…”

“…Another plausible reason could be that young men have a low-risk perception and are unaware of the physical signs of HIV and its adverse consequences [53]. Evidence has shown that young men with low-risk perceptions who do not have access to HIV testing services are less likely to have received an HIV test in their lifetime [54,55]. Youth-friendly health services can help close the HIV testing gap among young men by addressing access barriers, providing a more accessible, equitable, and effective social environment, and linking to HIV treatment and care.…”

Factors affecting HIV prevention communication between professional nurses and high school learners in eThekwini

“…One of the reasons for the low uptake of HIV testing services is a low HIV risk perception among adolescents (Muravha et al 2021). These low-risk perceptions among high school learners and the overall high incidence of HIV infection among AGYW underscore the importance of increasing usage and access to HIV prevention services provided in schools.…”

“…Despite the existence of HIV prevention services for learners in high schools in South Africa, the uptake of HIV testing services among adolescents remains low (Lebina et al 2019 ). One of the reasons for the low uptake of HIV testing services is a low HIV risk perception among adolescents (Muravha et al 2021 ). These low-risk perceptions among high school learners and the overall high incidence of HIV infection among AGYW underscore the importance of increasing usage and access to HIV prevention services provided in schools.…”

Women for science and science for women: Gaps, challenges and opportunities towards optimizing pre-exposure prophylaxis for HIV-1 prevention

“…Self-assessment of risk is challenging when reflecting on intimate relationships and in settings of intimate partner violence for instance, women might feel uncomfortable to discuss or acknowledge their own risk. The impact of these barriers is strongest in high-HIV prevalence settings, predominantly in eastern and southern Africa ( 7 , 8 ).…”