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AIDS Behav. 2018 Jul;22(7):2368-2379. doi: 10.1007/s10461-018-2155-9.

Beyond Social Desirability Bias: Investigating Inconsistencies in Self-Reported HIV Testing and Treatment Behaviors Among HIV-Positive Adults in North West Province, South Africa.

Author information

1
Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA. Alyssa.Mooney@ucsf.edu.
2
Department of Epidemiology & Biostatistics, University of California San Francisco, Mission Hall, 2nd Floor, 550 16th Street, San Francisco, CA, 94158, USA. Alyssa.Mooney@ucsf.edu.
3
Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco, CA, USA.
4
International Training and Education Center for Health (I-TECH) South Africa, Pretoria, Republic of South Africa.
5
Department of Global Health, University of Washington, Seattle, WA, USA.
6
National Institute for Communicable Diseases/NHLS, Johannesburg, Republic of South Africa.
7
Division of Virology, School of Pathology, University of the Witwatersrand, Johannesburg, Republic of South Africa.
8
Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
9
Department of Medicine, University of California, San Francisco, CA, USA.

Abstract

This mixed-methods study used qualitative interviews to explore discrepancies between self-reported HIV care and treatment-related behaviors and the presence of antiretroviral medications (ARVs) in a population-based survey in South Africa. ARV analytes were identified among 18% of those reporting HIV-negative status and 18% of those reporting not being on ART. Among participants reporting diagnosis over a year prior, 19% reported multiple HIV tests in the past year. Qualitative results indicated that participant misunderstandings about their care and treatment played a substantial role in reporting inaccuracies. Participants conflated the term HIV test with CD4 and viral load testing, and confusion with terminology was compounded by recall difficulties. Data entry errors likely also played a role. Frequent discrepancies between biomarkers and self-reported data were more likely due to poor understanding of care and treatment and biomedical terminology than intentional misreporting. Results indicate a need for improving patient-provider communication, in addition to incorporating objective measures of treatment and care behaviors such as ARV analytes, to reduce inaccuracies.

KEYWORDS:

Adherence; Antiretroviral treatment; Bias; HIV; Measurement error; South Africa

PMID:
29779162
DOI:
10.1007/s10461-018-2155-9
[Indexed for MEDLINE]

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