BACKGROUND:
Timely clinic presentation for testing is vital for effective tuberculosis (TB) prevention and treatment. Social support is acknowledged as a crucial factor affecting health-seeking behaviours among individuals with TB. To investigate whether perceived social support influences the likelihood of household contacts presenting to the clinic on time and explore any gender differences in this relationship.

METHODS:
A cohort study was conducted among household contacts of TB patients in the Eastern Cape, South Africa. Perceived social support was assessed using a validated social support scale. Timely clinic presentation was defined as attending a clinic within 30 days of referral. Logistic regression analysis assessed the association between social support and timely clinic presentation, incorporating covariates such as gender, employment status, TB stigma, income, HIV status, prior TB, TB symptoms, level of education and residential type (urban/rural).

RESULTS:
We enrolled 437 household contacts, of whom 22.88% presented for testing in a timely manner. We found that perceived social support was not significantly associated with timely clinic presentation (OR: 1.01; 95% CI: 0.76–1.36; p = 0.93). No significant interaction between gender and social support was found (p = 0.505), indicating no gender differences in the association. However, clinic presentation was significantly associated with rural residence (OR: 2.66; 95% CI: 1.52–4.66; p < 0.01), positive HIV status (OR: 2.49; 95% CI: 1.32–4.70; p < 0.01), TB symptoms (OR: 1.77; 95% CI: 1.04–3.01; p = 0.03) and age (OR: 1.02; 95% CI: 1.00–1.04; p = 0.01).

CONCLUSIONS:
Findings suggest that interventions to improve linkage to testing should consider messaging tailored to different age groups, integrated TB and HIV services, and enhance outreach efforts, particularly targeting urban populations and asymptomatic individuals. To inform these interventions, future research should investigate additional social and system-level barriers to care-seeking.