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Background  Transmission of HIV in South Africa continues to be high due to a large proportion of individuals living with undiagnosed HIV. Uptake of HIV testing is influenced by a multitude of factors including the patient’s knowledge and beliefs about HIV.    Methods  This study sought to quantify the impact of knowledge and attitudes on HIV testing acceptance in an emergency department by co-administering a validated HIV knowledge and attitudes survey to patients who were subsequently offered HIV testing.    Results  During the study period 223 patients were interviewed and offered HIV testing. Individuals reporting more negative overall attitudes ( p  = 0.006), higher levels of stigma to HIV testing ( p  < 0.001), and individuals who believed their test was confidential ( p  < 0.001) were more likely to accept an HIV test.    Conclusions  Interventions focused on improving patient perceptions around testing confidentiality will likely have the greatest impact on testing acceptance in the emergency department.

The impact of HIV knowledge and attitudes on HIV testing acceptance among patients in an emergency department in the Eastern Cape, South Africa