HIV non-testing, perpetration of violence against women, and sexual risk-behaviour: A cross-sectional analysis of South African peri-urban township men

Glob Public Health. 2022 Apr;17(4):512-525. doi: 10.1080/17441692.2021.1876134. Epub 2021 Feb 7.


Despite HIV testing having improved globally, men remain disproportionately less likely to test for HIV. While violence against women (VAW) and HIV risk have a strong association among women, few studies explore men around VAW perpetration, risky-sexual behaviour, and HIV testing. Males aged 18-42 years were recruited from a peri-urban settlement near Johannesburg, South Africa. Data were from an endline of a trial. We used logistic regression to assess odds of non-HIV testing using STATA 13. At endline, 1508 men participated in the study. Of these nearly one-third (31.6%, n = 475) had not tested for HIV in the past year. HIV non-testing was significantly lower among men who were single, older, did not complete high school and were less food secure. VAW perpetration retained a significant association with HIV non-testing after controlling for socio-demographics (AOR = 0.73, 95%CI = 0.58-0.93). In multivariate models, HIV non-testing was also associated with inconsistent condom use (AOR = 0.64, 95%CI = 0.48-0.85), problem drinking (AOR = 0.72, 95%CI = 0.55-0.94) and reporting of all four risky sexual behaviours (AOR = 0.70, 95%CI = 0.49-1.01). Data suggests that one-third of men who never test for HIV in this setting may represent a high-risk group. Future campaigns could consider behaviour change around non-violence, relationship quality, and gender norms alongside HIV testing.

Keywords: HIV testing; South Africa; inequitable masculinities; men; sexual risk behaviour; violence against women.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cross-Sectional Studies
  • Female
  • HIV Infections* / diagnosis
  • HIV Infections* / epidemiology
  • HIV Infections* / prevention & control
  • HIV Testing*
  • Humans
  • Male
  • Sexual Behavior*
  • South Africa / epidemiology
  • Violence*
  • Young Adult