Prevalence of non-testing for HIV and associated factors among young women in Sub-Saharan africa: a multilevel analysis of DHS 2020–2024

Abstract

BACKGROUND: HIV testing services are crucial in preventing the spread of the virus and providing care for those infected. Despite the decline in the number of newly infected people, HIV/AIDS remains a major public health problem in Africa. Being aware of one's HIV status is linked to reduced risk and changes in behavior. Individuals who are newly diagnosed with HIV can quickly be linked to antiretroviral therapy (ART), as well as care and support service. METHODS: Data from the recent Demographic and Health Surveys were used for analysis. The study used a total of 82,361 young women. The determinants of non-testing were examined using a multilevel mixed-effects logistic regression model. Significant factors associated with HIV non-testing were declared significant at p-values < 0.05. The adjusted odds ratio and confidence interval were used to interpret the results. A model with the lowest deviance and highest logliklihood ratio was selected as the best-fit model. RESULTS: HIV non-testing prevalence among women in 12 Sub-Saharan Africa was 53.96% (95% CI: 53.61%, 54.30%). Women age (AOR = 1.88, 95% CI: 1.02, 1.38), educational level (AOR = 0.711, 95% CI: 0.673,0.751), marital status (AOR = 1.61, 95% CI: 1.5,1.74), media exposure (AOR = 1.08, 95% CI: 1.04,1.12), wealth index (AOR = 0.86, 95% CI: 0.82, 0.899), visited health facility (AOR = 0.41, 95% CI: 0.396, 0.424), Age at first sexual intercourse (AOR = 1.12, 95% CI: 1.001,1.25), risky sexual behavior (AOR = 1.34, 95% CI: 1.26,1.42), knowledge (AOR = 0.71, 95% CI: 0.684, 0.731), residence (AOR = 0.567, 95% CI: 0.542,0.592), distance from the health facility (AOR = 0.927, 95% CI: 0.893, 0.962), had higher odds of HIV non testing prevalence. CONCLUSION: According to this study, the prevalence of HIV non-testing among young women in Sub-Saharan Africa is alarmingly high at 53.96%. This prevalence is determined by risky sexual activities, age, marital status and other factors. Targeted awareness campaigns, especially for those in disadvantaged circumstances, should be put into place to address this problem. Testing is promoted by stepping up community outreach and using media campaigns. Furthermore, expanding access to medical facilities and offering counseling services will motivate more young women to be checked, which will ultimately improve the region's health results. To achieve this, interventions such as mobile testing units, youth-friendly clinics, and school-based awareness campaigns should be prioritized to ensure effective engagement and support for young women.