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

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.