Prevalence and determinants of HIV testing among adolescent girls and young women in 28 sub-Saharan African countries

Abstract

Background: HIV and AIDS remain a major global public health issue with the largest burden in sub-Saharan African (SSA) (SSA) countries. Adolescent girls and young women (AGYW) in the sub-Saharan African region experience intersecting vulnerabilities that may increase their exposure to HIV, while also constraining their engagement with treatment and care. HIV testing is crucial in the AIDS response for both prevention and treatment, therefore, necessitating understanding of HIV testing practices, especially among priority populations. We examined HIV testing and associated factors among AGYW (15–24 years) in 28 SSA countries. Methods: We analysed Demographic and Health Survey datasets from 28 SSA countries from 2010–2022 focusing on data collected from AGYW aged 15–24 (n=58,263) who had screened for HIV in the last survey conducted in each country. We merged all weighted datasets from 28 countries to generate the prevalence of HIV testing among AGYW in each country and to provide an overall prevalence in SSA. We then conducted bivariate and multivariable binary logistic regression analysis to examine factors associated with HIV testing and presented the results in crude odds ratio [cOR] and adjusted odds ratio [aOR] with corresponding confidence intervals (CIs). Results: Our results showed that the overall prevalence of HIV testing among AGYW across the 28 SSA countries was 63%, with Zambia and Mali having the highest and lowest prevalence at 76% 6.70% respectively. Being in the age bracket 20–24 [aOR=2.22, 95% CI=2.08–2.37], comprehensive HIV knowledge [aOR=3.76, 95% CI=2.60–5.43], higher formal education [aOR=2.23, 95% CI=2.02–2.46], and three and above lifetime sexual partners [aOR=1.41, 95% CI=1.29–1.55] were all associated with HIV testing. Also, past year experience of STI [aOR=1.25, 95% CI=1.11–1.41], being employed [aOR=1.08, 95% CI=1.02–1.16], pregnancy history [aOR=1.09, 95% CI=1.03–1.14], high household wealth index [aOR=2.26, 95% CI=1.97–2.59] and being in a union [aOR=3.23, 95% CI=2.97–3.51] were associated with HIV testing. Conclusion: Concerningly, 21 countries, representing 75% of the countries included in the current study, have HIV testing coverage below 50% for AGYW. Collaborative efforts are needed to fast-track HIV screening/testing for AGYW considering their disproportionate vulnerability to HIV exposure.