Skip to content
DraconiticResearch
Search Sources API
203,234 studies31 sourcesUpdated 49 min ago
Peer-reviewedCC BY-NC 4.0Journal of the International Association of Providers of AIDS Care

Individual and Contextual Determinants of HIV Testing Practices Among Adolescent Girls and Young Women in Sub-Saharan Africa: A Multi-Level Mixed-Effects Analysis

  • Tsegaamlak Kumelachew Derse1
  • Desalegn Mitiku Kide2
  • Addisu Simachew Asgai3
  • Tadios lidetu4
  • Jenberu Mekurianew Kelkay5
  • Zemenu Addis6
  • Asaye Worku Agegn7
7 affiliations
  1. 1Department of Emergency and Critical Care Nursing, College of Health Sciences, Debark University, Debark, Ethiopia
  2. 2Department of Pediatric and Child Health Nursing, College of Health Sciences, Debark University, Debark, Ethiopia
  3. 3Department of Nursing, College of Health Sciences, Debark University, Debark, Ethiopia
  4. 4College of Health Sciences, Debark University, Debark, Ethiopia
  5. 5Department of Public Health, College of Health Sciences, Debark University, Debark, Ethiopia
  6. 6Department of Nursing, Debark University, Debark, Ethiopia
  7. 7Debre Berhan University, Asrat Woldeyes Health Science Collage, School of Nursing and Midwifery, Department of Pediatric and Child Health Nursing, Debre Berhan, Ethiopia
Read full textDOICite

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.

Methods: 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.

Results: 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.

Conclusion: 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.

Related

  1. Sociodemographic, psychosocial, and contextual factors associated with HIV testing uptake among adults across five districts in Ghana: a cross-sectional study
    Awolu Adam, Barnabas Kyinpuo, Isaac Yeboah Donyina +5
    BMC Public HealthPeer-reviewedCC BY-NC-ND 4.0Epidemiology & public healthCrossref
  2. Exploring contextual factors associated with adolescent sexual violence in Tasikmalaya Regency, Indonesia: a qualitative study informing an ecological empowerment framework
    Fanni Hanifa, Nita Arisanti, Tetti Solehati +3
    BMC Public HealthPeer-reviewedCC BY 4.0Epidemiology & public healthCrossref
  3. Testing the solitary drinking component of the social-contextual framework for AUD risk among young adults using Directed Acyclic Graphs
    Connor J. Smith, Jonas Dora, Mikela Ritter +2
    PsyArXivPreprintCC BY 4.0Full textPsychiatry & mental healthOSF
  4. Family Mealtimes in Hispanic Households: Associations of General Parenting Styles and Food Parenting Practices with Adolescent Food Group Intake
    Lillie Monroe-Lord, Azam Ardakani, Elmira Asongwed +4
    NutrientsPeer-reviewedCC BYFull textNutritionEurope PMC
  5. Contextual mechanisms linking physical activity types to adolescent mental health: Swiss insights
    L Lenze, L Glauser, L Zurfluh +1
    The European Journal of Public HealthPeer-reviewedCC BY-NC 4.0Full textPhysiologyPMCEurope PMC

Cite

BibTeXRIS
BibTeX
@article{derse2026individual,
  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}},
  author = {Tsegaamlak Kumelachew Derse and Desalegn Mitiku Kide and Addisu Simachew Asgai and Tadios lidetu and Jenberu Mekurianew Kelkay and Zemenu Addis and Asaye Worku Agegn},
  journal = {Journal of the International Association of Providers of AIDS Care},
  year = {2026},
  month = oct,
  doi = {10.1177/23259582261494706},
  url = {https://doi.org/10.1177/23259582261494706},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Individual and Contextual Determinants of HIV Testing Practices Among Adolescent Girls and Young Women in Sub-Saharan Africa: A Multi-Level Mixed-Effects Analysis
AU  - Tsegaamlak Kumelachew Derse
AU  - Desalegn Mitiku Kide
AU  - Addisu Simachew Asgai
AU  - Tadios lidetu
AU  - Jenberu Mekurianew Kelkay
AU  - Zemenu Addis
AU  - Asaye Worku Agegn
PY  - 2026
DA  - 2026/10/01
JO  - Journal of the International Association of Providers of AIDS Care
DO  - 10.1177/23259582261494706
UR  - https://doi.org/10.1177/23259582261494706
AB  - 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.  Methods: 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.  Results: 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.  Conclusion: 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.
SN  - 2325-9574
SN  - 2325-9582
ER  -