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

Exposure to comprehensive sexuality education in schools in South Africa: the implications on the uptake of HIV testing services among HIV positive adolescent girls

Comprehensive sexuality education (CSE) is seen as a key instrument through which to affect behaviour and improve sexual and reproductive health (SRH) outcomes amongst adolescents. However, few studies have to date evaluated key SRH outcomes following exposure to CSE within a school setting. This study estimates the association between CSE and HIV testing and HIV testing self-efficacy amongst HIV positive adolescent girls. Data were collected from a cross-sectional survey administered in four high HIV prevalence districts . Independent variables included exposure to CSE, with outcome variables measuring uptake of HIV testing in the 12 months preceding the survey, and HIV testing self-efficacy. The sample comprised 505 HIV positive adolescent girls aged 12-19. . Attending CSE was associated with both; being more confident to get an HIV test (AOR: 2.44, 95% CI: 1.47-4.06, p < 0.001) and having ever tested for HIV (AOR: 2.15, 95% CI: 1.39-3.33, p < 0.001) while controlling for numerous variables. Results suggest CSE can play an important role in not only affecting HIV-related behaviours themselves, but also critical factors that affect HIV behaviours, including self-efficacy.

Sexual Behaviour and Attitudes towards Safe Sex of Youth Receiving Antiretroviral Care at Public Health Facilities in Palapye District, Botswana

BACKGROUND

Sexual behaviour of HIV-infected youths is very important in determining the direction of the HIV epidemic, as these youths are reservoirs of HIV and can propagate its transmission if they engage in risky sexual behaviours. However, support structures for secondary prevention are weak even in healthcare settings. There is a need to understand the sexual behaviour of these youths and, in turn, tailor appropriate secondary prevention strategies, hence the current study was designed to assess sexual behaviour and attitudes towards safe sex of youth receiving antiretroviral care at public health facilities in Palapye district, Botswana.

METHOD

This quantitative, descriptive cross-sectional survey was used to describe the sexual behaviour and attitudes towards safe sex and identify factors associated with risky sexual behaviours among HIV-infected youths aged between 15 and 19 years receiving antiretroviral therapy (ART) care from public healthcare facilities in Palapye District, Botswana.

RESULTS

A total of 188 youths participated in this study, 56% being females while 44% were males. We reported that 15.4% had ever had sex. At their last sexual encounter, more than half of the youths (51.7%) had not used condoms. More than a third of the participants were under the influence of alcohol during their last sexual experience. Generally, the youths had good attitudes towards safe sex, as most youths said they would prioritise protecting their sexual partners and themselves from HIV and STIs. Alcohol use, substance use and not considering religion as important were strongly associated with having ever had sex.

CONCLUSIONS

A significant proportion of HIV-infected youths are sexually active, whereas their preventive practices such as condom use are poor despite good attitudes towards safe sex. Alcohol use, substance use and not perceiving religion as important were associated with risky sexual behaviours.

A qualitative exploration of the salience of MTV-Shuga, an edutainment programme, and adolescents' engagement with sexual and reproductive health information in rural KwaZulu-Natal, South Africa

Young people, particularly adolescent girls and young women, represent a growing proportion of those living with HIV. Edutainment programmes have been widely used throughout the world to "educate" and "entertain" audiences and tackle serious social issues in bold and engaging ways. This paper examines the extent to which an edutainment programme, MTV-Shuga, was reported to influence young people's engagement with sexual and reproductive health (SRH) information in rural KwaZulu-Natal, South Africa. In 2019 we conducted eight community-based screenings of MTV-Shuga episodes followed by 25 individual in-depth interviews and 13 focus group discussions with young people aged between 15 and 30. Interviews were audio recorded and transcribed verbatim. Data analysis was thematic and complemented by constant comparison and deviant case analysis techniques. In this rural and poor setting with a high burden of HIV, young people exhibited high levels of awareness of SRH and HIV but had constrained access to services, and limited ability to engage with parents or guardians on SRH matters. MTV Shuga provided an entertaining guide of ways to navigate the risks that they faced in a way that resonated with them. The findings highlight the importance of enabling young people in rural areas to watch MTV Shuga with peers in a safe space in which discussion of the content is facilitated. There is also value in encouraging parents to watch MTV Shuga as a means of enabling discussions between children and adults in their lives about SRH matters.

Prevalence and factors associated with self-reported HIV testing among adolescent girls and young women in Rwanda: evidence from 2019/20 Rwanda Demographic and Health Survey

BACKGROUND

HIV/AIDS remains a major public health problem globally. The majority of people living with HIV are from Sub-Saharan Africa, particularly adolescent girls and young women (AGYW) aged 15-24 years. HIV testing is crucial as it is the gateway to HIV prevention, treatment, and care; therefore this study determined the prevalence and factors associated with self-reported HIV testing among AGYW in Rwanda.

METHODS

We conducted secondary data analysis on the AGYW using data extracted from the nationally representative population-based 2019/2020 cross-sectional Rwanda Demographic and Health Survey (DHS). We described the characteristics of study participants and determined the prevalence of HIV testing and associated factors using the multivariable logistic regression model. We adjusted all our analyses for unequal sampling probabilities using survey weights.

RESULTS

There were a total of 5,732 AGYW, with the majority (57%) aged 15-19 years, 83% were not living with a man, 80% were from rural areas, 29% were from the East region, and 20% had a history of pregnancy. Self-reported HIV testing prevalence was 55.4% (95%CI: 53.7 to 57.0%). The odds of ever having an HIV test were significantly higher for those aged 20-24 years (aOR 2.87, 95%CI: 2.44 to 3.37); with higher education (aOR 2.41, 95%CI:1.48 to 3.93); who were rich (aOR 2.06, 95%CI:1.57 to 2.70); with access to at least one media (aOR 1.64, 95%CI: 1.14 to 2.37); who had ever been pregnant (aOR 16.12, 95%CI: 9.60 to 27.07); who ever had sex (aOR 2.40, 95%CI: 1.96 to 2.95); and those who had comprehensive HIV knowledge (aOR 1.34, 95%CI: 1.17 to 1.54).

CONCLUSIONS

We report an unmet need for HIV testing among AGYW in Rwanda. We recommend a combination of strategies to optimize access to HIV testing services, especially among the 15-19 years adolescent girls, including facility-based testing, school and community outreach, awareness campaigns on HIV testing, and home-based testing through HIV self-testing.

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

Adolescent girls and young women (AGYW), aged 15−24 years, experience higher HIV incidence compared to their male counterparts, especially in sub-Saharan Africa (SSA), where the HIV burden is highest. This study determined trends in self-reported HIV testing and associated factors among AGYW in Zimbabwe using the Zimbabwe DHS datasets for 2005/6, 2010/11, and 2015. The proportion of adolescents aged 15−19 years who had ever tested for HIV increased from 14.7% in 2005/6 to 26.5% in 2010/11 and 47.9% in 2015. Among young women, aged 20−24 years, the proportion increased from 34.8% in 2005/6 to 68.7% in 2010/11 and 84.8% in 2015. The odds of ever having an HIV test were significantly higher for those with a higher education (adjusted odds ratio [aOR] 12.49, 95% CI: 2.69 to 57.92, p = 0.001), comprehensive HIV knowledge (aOR 1.91, 95% CI: 1.31 to 2.78, p = 0.001), knowledge about mother-to-child transmission (MTCT) (aOR 2.09, 95% CI: 1.55 to 2.82, p < 0.001), non-discriminatory attitudes (aOR 1.60, 95% CI: 1.12 to 2.28, p = 0.010), three or more lifetime sexual partners (aOR 2.0, 95% CI: 1.09 to 3.66, p = 0.025), and a history of pregnancy (aOR 6.08, 95% CI: 4.22 to 8.75, p < 0.001). There is need to scale-up programmes targeting AGYW.

Factors associated with HIV testing among youth in a generalised hyperendemic setting: findings from a national survey in Eswatini

Aim: Even though Eswatini was the first country in Africa to achieve the UNAIDS 95-95-95 targets among people living with HIV nationally, youth aged 15-24 years lag behind in HIV testing. This study determined the overall prevalence of HIV testing among the youth and the factors associated with HIV testing.Methods: Data were analysed for 1 834 young people from the 2016-2017 Swaziland HIV Incidence Measurement Survey (SHIMS2) using multivariable logistic regression.Results: Overall, 66% of the young people had tested for HIV in the past 12 months before SHIMS2. Lower odds of HIV testing were observed among males, among those aged 15-17 years, the never married/cohabited, those with primary and secondary education, and among those who had high perceived stigma towards people living with HIV and AIDS. Youth from households classified in the poor and middle quintiles had higher odds of testing for HIV compared to those from rich households.Conclusion: Efforts to increase HIV testing should consider the sociodemographic and behavioural factors identified as determinants of HIV non-testing in this age group.