Prevalence of and factors associated with HIV testing among adolescent girls and young women in South Africa: Evidence from the South Africa Demographic and Health Survey 2016
DOI:
https://doi.org/10.7196/Keywords:
HIV, HIV testing, AGYW, SADHS, associated factors, South AfricaAbstract
Background. Adolescent girls and young women (AGYW) remain vulnerable to HIV, with a higher incidence rate than their male counterparts.
Objectives. To determine the prevalence of and factors associated with HIV testing among AGYW in South Africa (SA).
Methods. A cross-sectional design was used to analyse the South Africa Demographic and Health Survey 2016. Only sexually active AGYW aged 15 - 24 years residing in SA at the time of the survey were included. Descriptive statistics were used to analyse baseline sociodemographic characteristics. Univariate and multivariate logistic regression models were used to determine factors associated with HIV testing. Statistical significance was set at p<0.05, and all analyses were adjusted using survey weights to account for unequal selection probabilities.
Results. The overall prevalence of HIV testing among sexually active AGYW was 85.2% (95% confidence interval (CI) 83.0 - 87.1). The AGYW who had a history of pregnancy (adjusted odds ratio (aOR) 4.47; 95% CI 2.90 - 6.89), were employed (aOR 3.29; 95% CI 1.75 - 6.21), belonged to a middle wealth index (aOR 1.80; 95% CI 1.04 - 3.10), had knowledge about mother-to-child transmission of HIV (aOR 3.29; 95% CI 2.26 - 4.79), had visited a health facility during the past 12 months (aOR 2.93; 95% CI 2.09 - 4.10), or had secondary/tertiary education (aOR 2.04; 95% CI 1.04 - 3.99) had higher odds of HIV testing.
Conclusion. The study identified an unmet need for HIV testing among sexually active AGYW in SA, especially adolescent girls aged 15 - 19 years. Increasing knowledge about HIV testing, adolescent-friendly services and other offsite strategies are therefore important for this particular key population.
References
HIV.gov. HIV basics: A timeline of HIV and AIDS. Updated June 2022. https://www.hiv.gov/hiv- basics/overview/history/hiv-and-aids-timeline (accessed 5 October 2022).
Joint United Nations Programme on HIV/AIDS (UNAIDS). Country factsheets: South Africa. 2021.
https://www.unaids.org/en/regionscountries/countries/southafrica (accessed 5 October 2022).
Avert. At a glance: HIV in South Africa. Updated 17 March 2022. https://www.beintheknow.org/
understanding-hiv-epidemic/data/glance-hiv-south-africa (accessed 5 October 2022).
South African National AIDS Council. The National Strategic Plan. 2022. https://sanac.org.za/about-
sanac/the-national-strategic-plan/ (accessed 5 October 2022).
Joint United Nations Programme on HIV/AIDS (UNAIDS). Understanding fast-track: Accelerating
action to end the AIDS epidemic by 2030. Updated June 2015. https://www.unaids.org/sites/default/
files/media_asset/201506_JC2743_Understanding_FastTrfack_en.pdf (accessed 5 October 2022).
Joint United Nations Programme on HIV/AIDS (UNAIDS). Young people and HIV. 2021. https://www. unaids.org/sites/default/files/media_asset/young-people-and-hiv_en.pdf (accessed 5 October 2022).
Jia KM, Eilerts H, Edun O, et al. Risk scores for predicting HIV incidence among adult heterosexual
populations in sub‐Saharan Africa: A systematic review and meta‐analysis. J Int AIDS Soc
;25(1):e25861. https://doi.org/10.1002/jia2.25861
Joint United Nations Programme on HIV/AIDS (UNAIDS). Women and HIV. 2019. https://www.
unaids.org/sites/default/files/media_asset/2019_women-and-hiv_en.pdf (accessed 5 October 2022).
Mabaso M, Makola L, Naidoo I, et al. HIV prevalence in South Africa through gender and racial lenses: Results from the 2012 population-based national household survey. Int J Equity Health 2019;18(1):167.
https://doi.org/10.1186/s12939-019-1055-6
Ante-Testard PA, Benmarhnia T, Bekelynck A, et al. Temporal trends in socioeconomic inequalities in HIV testing: An analysis of cross-sectional surveys from 16 sub-Saharan African countries. Lancet Glob Health 2020;8(6):e808-e818. https://doi.org/10.1016/S2214-109X(20)30108-X
Ajayi AI, Awopegba OE, Adeagbo OA, Ushie BA. Low coverage of HIV testing among adolescents and young adults in Nigeria: Implication for achieving the UNAIDS first 95. PLoS ONE 2020;15(5):e0233368. https://doi.org/10.1371/journal.pone.0233368
Kidman R, Waidler J, Palermo T. Uptake of HIV testing among adolescents and associated adolescent- friendly services. BMC Health Serv Res 2020;20:881. https://doi.org/10.1186/s12913-020-05731-3
National Department of Health, Statistics South Africa, South African Medical Research Council, and
ICF. South Africa Demographic and Health Survey 2016: Key findings. Pretoria, South Africa, and Rockville, Md, USA: NDoH, Stats SA, SAMRC, and ICF, 2018. https://www.dhsprogram.com/pubs/ pdf/SR248/SR248.pdf (accessed 10 April 2022).
Musekiwa A, Bamogo A, Shisana O, et al. Prevalence of self-reported HIV testing and associated factors among adolescent girls and young women in South Africa: Results from a 2017 nationally representative population-based HIV survey. Public Health Pract (Oxf) 2021;2:100093. https://doi. org/10.1016/j.puhip.2021.100093
Sonny ON, Musekiwa A. Trends and factors associated with HIV testing among adolescent girls and young women in Lesotho: Results from 2004 to 2014. Lesotho Demographic and Health Surveys. Venereology 2022;1(3):262-271. https://doi.org/10.3390/venereology1030019
Pachena A, Musekiwa A. Trends in HIV testing and associated factors among adolescent girls and young women in Zimbabwe: Cross-sectional analysis of demographic and health survey data from 2005 to 2015. Int J Environ Res Public Health 2022;19(9):5165. https://doi.org/10.3390/ijerph19095165
MusekiwaA,SilindaP,BamogoA,etal.Prevalenceandfactorsassociatedwithself-reportedHIVtesting among adolescent girls and young women in Rwanda: Evidence from 2019/20 Rwanda Demographic and Health Survey. BMC Public Health 2022;22(1):1281. https://doi.org/10.1186/s12889-022-13679-8
Elsheikh IE, Crutzen R, Adam I, Abdelraheem SI, van den Borne HW. Determinants of HIV testing during pregnancy among pregnant Sudanese women: A cross-sectional study. Behav Sci (Basel) 2022;12(5):150. https://doi.org/10.3390/bs12050150
Bekele YA, Fekadu GA. Factors associated with HIV testing among young females: Further analysis of the 2016 Ethiopian demographic and health survey data. PLoS ONE 2020;15(2):e0228783. https://doi. org/10.1371/journal.pone.0228783
Sonko I, Chung MH, Hou WH, Chen WT, Chang PC. Predictors of HIV testing among youth aged 15-24 years in The Gambia. PLoS ONE 2022;17(2):e0263720. https://doi.org/10.1371/journal. pone.0263720
Phillips G, McCuskey DJ, Felt D, et al. Association of HIV education with HIV testing and sexual risk behaviours among US youth, 2009-2017: Disparities between sexual minority and sexual majority youth. Prev Sci 2020;21(7):898-907. https://doi.org/10.1007/s11121-020-01153-z
Benyumiza D, Amongin JF, Ochaba I, et al. Factors associated with utilisation of HIV testing services among adolescents aged 10-19 years in Lira District, Northern Uganda: A cross-sectional study. Biomed Res Int 2021;2021:9568148. https://doi.org/10.1155/2021/9568148
Department of Labour, South Africa. Code of good practice: Key aspects of HIV/AIDS and employment. Government Gazette No. 21815:R1298, 1 December 2000. https://www.gov.za/sites/ default/files/gcis_document/201409/21815.pdf (accessed 5 March 2024).
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