The Association Between HIV Testing Modality and Antiretroviral Therapy Initiation Among Men Who Have Sex with Men in Selected Provinces of South Africa

Despite South Africa being the epicentre of HIV, some progress was made in the fight against HIV, i.e., the implementation of HIV programmes, provision of antiretroviral therapy (ART), etc. However, little is known about the association between HIV testing modalities and ART initiation. This study aimed to determine the association between HIV testing modalities and ART initiation among men who have sex with men (MSM) in selected provinces of South Africa. Following a retrospective cohort design, this study analysed programme data on 3345 MSM aged 16 years and older who were living with HIV and eligible for ART initiation. Logistic regression assessed the association between HIV testing modalities and ART initiation, controlling for age group, location, and the COVID-19 period. All analyses were done using SPSS version 30. Significance was set at p < 0.05. Participants who tested for HIV using the social network strategy (SNS) (98.6%) or index testing (96.3%) showed the highest proportions of ART initiation. Logistic regression showed that MSM who tested for HIV using the SNS had over 12 times higher odds of initiating ART (aOR = 12.166; 95% CI: 7.617–19.430; p < 0.001), compared to those who used a rapid test. A significant association was observed between HIV testing modalities and ART initiation, with SNS and index testing demonstrating higher odds of ART initiation.