New Findings From South Africa Survey Show Great Progress: Nearly One Million Adults Each Month Are Tested for HIV

Strong political leadership and powerful media campaigns are credited

The 3rd South African National HIV Communication Survey (NCS) results released today at the XIX International AIDS Conference in Washington, D.C., revealed new data that show substantial increases in behaviors that reduce the risk of HIV: condom use, HIV counseling and testing, and voluntary medical male circumcision. The data also confirm that exposure to HIV communication programs have a direct impact on people practicing these behaviors.

The Third NCS was conducted jointly by Johns Hopkins Health and Education in South Africa (JHHESA), loveLife and Soul City, with data analysis by Health and Development Africa (HDA) and the Johns Hopkins Bloomberg School of Public Health and funding from the US President’s Emergency Plan for AIDS Relief (PEPFAR) through the US Agency for International Development (USAID).

From 1992 to 2012 condom use at first sex increased from 18% to 66%. This change was created by both communication programs that promoted condoms and the increased availability of condoms. People who report using condoms at first sex were less likely to say they are HIV positive (3.5% for males; 6.2% for females) compared to those that did not use a condom at first sex (13.6% for men and 18.5% for females).

The survey shows 17.4 million or 64.3% of South Africans have ever tested for HIV, of which 10.6 million tested in the past 12 months as part of the HIV counseling and testing campaign, led by President Jacob Zuma, Deputy President Kgalema Motlanthe and Health Minister Aaron Motsoaledi.

Survey respondents who knew that President Zuma had tested for HIV, as part of the “I am Responsible” campaign, were far more likely to discuss HIV testing with their sex partners (52%) than those who were not aware that the President had tested (39%). People who talked about testing with their sex partners, in turn, were more likely to test for HIV (63%) than those who did not talk about testing with their partners (33%).

Stigma associated with HIV has substantially declined, as the survey reveals that there is greater openness in HIV testing and disclosure. Among sexually active South Africans, 48% say that they have talked to their sex partner about HIV testing and getting tested and 32% said that they had an HIV test with their partner. Among those tested who know their results, 86% were willing to disclose their HIV status during the interview. Among those who reported their HIV status, 88% reported being negative and 12% were positive.

Over 50% of South African men are now circumcised and 90% of these are full circumcisions, which means they receive the HIV prevention benefits. There has been a sharp increase in the percentage of men who have been medically circumcised from 33% in 2009 to 48% in 2012. Over 350,000 circumcisions have taken place in the past year and just under 1 million men say they definitely intend to get circumcised in the next 12 months.

The NCS found that 82.5% of the population, or 23 out of 28 million South Africans aged 16–55 years, could correctly recall the content of one or more of the 19 creative communication programs being implemented in the country. The cumulative effect of these 19 communication programs increased the practice and maintenance of these prevention behaviors. People who were exposed to more HIV communication programs were more likely to use condoms at first sexual encounter, get tested for HIV and are more likely to intend to get circumcised in the next 12 months.

According to Lusanda Mahlasela, one of the NCS researchers: “Strong and visible political leadership from the President, the Deputy President and the Health Minister, as part of the bold and innovative communication campaigns, have brought about positive changes in condom use, HIV testing, male circumcision, and public attitudes towards the disease, and can only make prevention and treatment much easier over the next five years.”

The NCS was managed by Health and Development Africa (HDA). Field work was conducted by Freshly Ground Insights. Data analysis was jointly conducted by HDA and the Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs.

The NCS was conducted between February and May 2012. It comprised 10,034 respondents from 398 sub-places across all 9 provinces. The survey was designed to be representative of the South African population aged 16-55 years. The questionnaire included socio-demographic characteristics, exposure to HIV communication programs and indicators of HIV knowledge, attitudes, self-efficacy and behavior.

Media contact for Johns Hopkins Bloomberg School of Public Health: Natalie Wood-Wright at 410-614-6029 or nwoodwri@jhsph.edu.