{
  "abstract": "Background: Adolescent girls and young women (AGYW) in Sub-Saharan Africa (SSA) face a disproportionate HIV risk. Achieving UNAIDS 95-95-95 targets requires high diagnostic coverage, yet critical gaps persist. This multi-country study evaluated individual- and community-level factors associated with HIV testing across 21 SSA nations.\n\nMethods: Secondary data analysis was performed on a pooled sample of 92,935 young women (ages 15–24) from recent Demographic and Health Surveys (DHS) across 1,678 primary sampling units (clusters). Multi-level mixed-effects logistic regression was utilized to assess individual (Level-1) and contextual community-level (Level-2) factors associated with lifetime HIV testing practices.\n\nResults: Lifetime HIV testing prevalence was 44.74% (n = 41,576), exposing a 55.26% testing gap. In the fully adjusted model (Model III), age (20–24 vs. 15–19 years: Adjusted Odds Ratio (AOR) = 2.342, 95% Confidence Interval (CI: 2.262, 2.424) and higher formal education (AOR) = 4.975, 95% (CI: 4.548, 5.443) were strongly associated with testing. Marital status showed significant associations, peaking among widowed, divorced, or separated women (AOR) = 5.160, 95% (CI: 4.665, 5.706). Comprehensive HIV knowledge doubled the odds of testing (AOR) = 2.024, 95% (CI: 1.958, 2.093). Contextually, high community media saturation was positively associated with testing (AOR) = 2.803, 95% (CI: 2.295, 3.422), whereas high community-level education demonstrated an inverse association (AOR) = 0.314, 95% (CI: 0.261, 0.378). The residual Median Odds Ratio (MOR = 1.30) indicated moderate cluster-level variation.\n\nConclusion: HIV testing practices among SSA young women are associated with nested sociodemographic, cognitive, and community-level factors. Strategies targeting expanded community media engagement, youth-friendly out-of-clinic screening, and discreet HIV self-testing options may help improve diagnostic coverage.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Emergency and Critical Care Nursing, College of Health Sciences, Debark University, Debark, Ethiopia",
    "Department of Pediatric and Child Health Nursing, College of Health Sciences, Debark University, Debark, Ethiopia",
    "Department of Nursing, College of Health Sciences, Debark University, Debark, Ethiopia",
    "College of Health Sciences, Debark University, Debark, Ethiopia",
    "Department of Public Health, College of Health Sciences, Debark University, Debark, Ethiopia",
    "Department of Nursing, Debark University, Debark, Ethiopia",
    "Debre Berhan University, Asrat Woldeyes Health Science Collage, School of Nursing and Midwifery, Department of Pediatric and Child Health Nursing, Debre Berhan, Ethiopia"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Tsegaamlak Kumelachew Derse",
      "orcid": "0009-0006-0840-8707"
    },
    {
      "affs": [
        1
      ],
      "name": "Desalegn Mitiku Kide",
      "orcid": "0009-0006-8087-9845"
    },
    {
      "affs": [
        2
      ],
      "name": "Addisu Simachew Asgai",
      "orcid": "0000-0002-5438-8237"
    },
    {
      "affs": [
        3
      ],
      "name": "Tadios lidetu",
      "orcid": "0000-0002-5489-3559"
    },
    {
      "affs": [
        4
      ],
      "name": "Jenberu Mekurianew Kelkay"
    },
    {
      "affs": [
        5
      ],
      "name": "Zemenu Addis"
    },
    {
      "affs": [
        6
      ],
      "name": "Asaye Worku Agegn"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/dnajhqfqm36k3.bib",
  "cited_by": 0,
  "doi": "10.1177/23259582261494706",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13735082/",
  "id": "dnajhqfqm36k3",
  "issns": [
    "2325-9574",
    "2325-9582"
  ],
  "landing_url": "https://doi.org/10.1177/23259582261494706",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research Article"
    ],
    [
      "openalex",
      "2725|HIV/AIDS Research and Interventions"
    ]
  ],
  "openalex": "W7215074473",
  "pdf_url": null,
  "pmcid": "PMC13735082",
  "pmid": "42820944",
  "published": "2026-10-01",
  "publisher": "SAGE Publications",
  "ris": "https://research.draconitic.com/paper/dnajhqfqm36k3.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:20:51Z",
      "native_id": "PMC13735082",
      "source": "pmc",
      "url": "https://doi.org/10.1177/23259582261494706"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2725|HIV/AIDS Research and Interventions",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Individual and Contextual Determinants of HIV Testing Practices Among Adolescent Girls and Young Women in Sub-Saharan Africa: A Multi-Level Mixed-Effects Analysis",
  "title_text": "Individual and Contextual Determinants of HIV Testing Practices Among Adolescent Girls and Young Women in Sub-Saharan Africa: A Multi-Level Mixed-Effects Analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:20:51Z",
  "url": "https://research.draconitic.com/paper/dnajhqfqm36k3",
  "venue": "Journal of the International Association of Providers of AIDS Care",
  "versions": []
}