Clients’ perceptions and satisfaction with HIV counselling and testing: A cross-sectional study in 56 HCT sites in South Africa

Abstract

Background: Client satisfaction serves as a predictor for acceptance of HIV counselling and testing (HCT) services. Therefore, the study of clients’ perception and satisfaction may offer insights on how to improve HCT programmes. Aim and setting: The aim of this study was to assess clients’ satisfaction with HCT as well as describe perceived barriers to and facilitators of HIV testing by HCT clients in South Africa.Methods: A cross-sectional survey was conducted through interviews with 498 clients purposefully selected at the end of an HCT visit at 56 HCT sites throughout the country. Results: All the 498 study participants had tested for HIV with 98.8% receiving their results. Most (88.2%) reported testing for HIV before. The vast majority (75.5%) of clients reported that they had decided to be tested for HIV by themselves. High levels of satisfaction with HCT service (89.8%), low levels (27.7%) of difficulty in making the decision to have an HIV test and high levels of perceived confidentiality (94.6%) of the HIV test results were reported in this study. The most cited perceived barrier to HIV testing was lack of awareness about the HCT service (98%), while staff attitudes (37%), confidentiality (29.6%) and privacy (23.6%) were perceived facilitators. In multivariate logistic regression, staff attitude was significantly associated with client satisfaction (p < 0.05).Conclusion: High levels of client satisfaction with HCT services were observed. Various barriers to and facilitators of – including staff attitude – HCT were identified which can help guide the improvement of HCT services in South Africa.