HIV testing among women of reproductive age in 28 sub-Saharan African countries: a multilevel modelling

Zegeye, Betregiorgis, Adjei, Nicholas Kofi, Ahinkorah, Bright Opoku, Tesema, Getayeneh Antehunegn, Ameyaw, Edward Kwabena, Budu, Eugene, Seidu, Abdul-Aziz, and Yaya, Sanni (2023) HIV testing among women of reproductive age in 28 sub-Saharan African countries: a multilevel modelling. International Health, 15 (5). pp. 573-584.

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Abstract

Background: Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) remains one of the most significant public health challenges globally, particularly in sub-Saharan Africa (SSA). Although HIV testing is a vital step for both prevention and treatment, its uptake is still low in SSA. We therefore examined HIV testing in SSA and its individual/household and community factors among women of reproductive age groups (15-49 y).

Methods: Demographic and Health Survey data collected between 2010 and 2020 from 28 SSA countries were used for this analysis. We analysed the coverage of HIV testing and individual/household and community factors on 384 416 women in the reproductive age groups (15-49 y). Bivariate and multivariable multilevel binary logistic regression analysis were conducted to select candidate variables and to identify significant explanatory variables associated with HIV testing and the results were presented using adjusted odd ratios (AORs) at 95% confidence intervals (CIs).

Results: The pooled prevalence of HIV testing among women of reproductive age in SSA was 56.1% (95% CI 53.7 to 58.4), with the highest coverage found in Zambia (86.9%) and the lowest in Chad (6.1%). Age (45-49 y; AOR 0.30 [95% CI 0.15 to 0.62]), women's education level (secondary; AOR 1.97 [95% CI 1.36 to 2.84]) and economic status (richest; AOR 2.78 [95% CI 1.40 to 5.51]) were some of the individual/household factors associated with HIV testing. Similarly, religion (no religion; AOR 0.58 [95% CI 0.34 to 0.97]), marital status (married; AOR 0.69 [95% CI 0.50 to 0.95]) and comprehensive knowledge of HIV (yes; AOR 2.01 [95% CI 1.53 to 2.64]) were significantly associated individual/household factors for HIV testing. Meanwhile, place of residence (rural; AOR 0.65 [95% CI 0.45 to 0.94]) was found to be a significant community-level factor.

Conclusion: More than half of married women in SSA have been tested for HIV, with between-country variations. Both individual/household factors were associated with HIV testing. Stakeholders should therefore consider all above-mentioned factors to plan an integrated approach to enhancing HIV testing through health education, sensitization, counselling and empowering older and married women, those with no formal education, those who do not have comprehensive HIV/AIDS knowledge and those in rural areas.

Item ID: 80524
Item Type: Article (Research - C1)
ISSN: 1876-3405
Keywords: AIDS, DHS, global health, HIV test, sub-Saharan Africa, women’s health
Copyright Information: © The Author(s) 2023. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com.
Research Data: http://dhsprogram.com/data/available-datasets.cfm
Date Deposited: 12 Feb 2024 22:33
FoR Codes: 42 HEALTH SCIENCES > 4202 Epidemiology > 420202 Disease surveillance @ 70%
42 HEALTH SCIENCES > 4202 Epidemiology > 420205 Epidemiological modelling @ 30%
SEO Codes: 20 HEALTH > 2005 Specific population health (excl. Indigenous health) > 200509 Women's and maternal health @ 100%
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