Private healthcare sector doctors and HIV testing practices in the eThekwini Metro of KwaZulu-Natal

Abstract

Background: Human immunodeficiency virus (HIV) testing has many logistic and ethical challenges. The UNAIDS/WHO policy statement states that the testing of individuals must be confidential, be accompanied by counselling, and be conducted with informed consent. HIV testing is integral to the management of the epidemic, and since KwaZulu-Natal (KZN) has the highest prevalence of AIDS in South Africa, it is vital that doctors in this province are knowledgeable about HIV testing practices. This study was undertaken in view of the lack of data on private sector doctors’ HIV testing practices in KwaZulu-Natal. Method: A descriptive cross-sectional study was conducted among private sector doctors who manage HIV and AIDS patients in the eThekwini Metro of KZN. One hundred private practitioners were randomly selected from a sample of 175 consenting private sector doctors. These doctors were asked to fill in an anonymous questionnaire. The questionnaires were collected and analysed using SPSS^® version 15. Results: A response rate of 60% was obtained, with 57 (95%) indicating that they do HIV testing after obtaining patients’ consent. Over 96% of the doctors carried out pre-test counselling, while over 98% did post-test counselling. Eighty-one per cent did a confirmatory test if the patient tested positive, while 49% performed a confirmatory test if the patient tested negative; over 50% did the test after three months. Forty-seven per cent did not know or failed to indicate what confirmatory test they used. The majority did not disclose patient status or do counselling in the presence of others. However, if it was done, it was done with the consent of the patient or the parents in cases where the patient was a minor. The majority stated that they follow the guidelines when testing. Conclusion: The HIV testing practices of private sector doctors who participated in the study are compliant with the UNAIDS/WHO policy statement regarding confidentiality, informed consent and counselling. However, doctors’ knowledge of confirmatory test appears to be inadequate.