Tested or Not?—A Categorical Examination of HIV/AIDS Testing among Workers in the South African Construction Industry

Abstract

HIV/AIDS voluntary counseling and antibody testing (VCT) is the cornerstone of HIV/AIDS prevention. Prevalence rates for the infection in the South African construction industry exceed those of most other sectors. Little is known about the testing status of different categories of construction workers. A field-administered questionnaire survey gathered data from 512 site-based construction employees in the Western Cape, South Africa. Bivariate tests of association and bivariate and multivariate binary logistic regression were used to explore demographic determinants of testing. The results indicate that (1) age, gender, employment type, and firm predict testing status, with older workers, females, permanent workers, and workers employed by firms with proactive intervention management more likely to have been tested than their counterparts; (2) education and race are not determinants of testing status; (3) workers aged 30 years and younger are the least likely to have been tested, particularly those 20 years and younger; (4) female construction workers are five times more likely to have been tested than males; (5) permanent employees are twice as likely to have been tested than temporary workers; and (6) workers employed by firms with comparatively more proactive HIV/AIDS intervention management are more likely to have been tested. This research identifies key variables that increase or decrease the probability of construction workers being tested at sites where VCT services are offered. Consequently, it confirms that the provision of VCT services is not in itself sufficient to address worker HIV incidence and prevalence rates. Rather, constructions firms need to be much more focused on the design of these services to ensure better targeting of subpopulations that are least likely to test. The identification of these key demographic variables highlights the value of shifting away from relatively standardized VCT services in the industry to those that are company- and perhaps even site-specific. This requires a degree of innovation in VCT services that not only is grounded in the construction sector but learns and adapts knowledge and practice from other sectors of society.