School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
Ministry of Health and Social Welfare, Banjul, The Gambia.
PLoS One. 2022 Feb 18;17(2):e0263720. doi: 10.1371/journal.pone.0263720. eCollection 2022.
Worldwide, an estimated 38.0 million people lived with the human immunodeficiency virus in 2019, and 3.4 million young people aged 1524 years were living with HIV. Sub-Saharan Africa carries a significant HIV burden with West and Central Africa most affected with HIV. Among the young people living with HIV in West and Central Africa, an estimated 810,000 were aged 1524 years. This study aimed to assess predictors that influence the uptake of HIV testing among youth aged 15~24 years in The Gambia.
The 2013 Gambia Demographic and Health Survey data for youth aged 15~24 years was used. The Andersen behavioral model of health service use guided this study. A cross-sectional study design was used on 6194 subjects, among which 4730 were female. The analysis employed Chi-squared tests and hierarchical logistic regression.
Less than one-quarter of the youth 1404 (22.6%) had ever been tested for HIV. Young people aged 20~24 years (adjusted odds ratio (aOR): 1.98), who were females (aOR: 1.13), married youth (aOR: 3.89), with a primary (aOR: 1.23), secondary or higher education (aOR: 1.46), and who were from the Jola/Karoninka ethnic group (aOR: 1.81), had higher odds of having been tested for HIV. Those with adequate HIV knowledge and those who were sexually active and had aged at first sex ≥15 years (aOR: 3.99) and those <15 years (aOR: 3.96) were more likely to have been tested for HIV compared to those who never had sex.
This study underscores the low level of model testing on HIV testing among youth (15~24 years) in The Gambia. Using Anderson's Model of Health Service Utilization, the predisposing factors (socio-demographic and HIV knowledge) and the need-for-care factors (sexual risk behaviors) predict healthcare utilization services (HIV testing) in our study; however, only socio-demographic model explained most of the variance in HIV testing. The low effect of model testing could be related to the limited number of major variables selected for HIV knowledge and sexual risk behavior models. Thus, consideration for more variables is required for future studies.
据估计，2019 年全球有 3800 万人感染了人类免疫缺陷病毒，有 340 万 15 至 24 岁的年轻人携带艾滋病毒。撒哈拉以南非洲地区艾滋病毒负担沉重，其中西非和中非受影响最为严重。在西非和中非携带艾滋病毒的年轻人中，估计有 81 万人年龄在 15 至 24 岁之间。本研究旨在评估影响冈比亚 15 至 24 岁年轻人接受艾滋病毒检测的因素。
本研究使用了 2013 年冈比亚人口与健康调查中 15 至 24 岁青年的数据。安德森健康服务使用行为模型指导了这项研究。对 6194 名受试者进行了横断面研究设计，其中 4730 名为女性。采用卡方检验和分层逻辑回归进行分析。
只有不到四分之一的年轻人（22.6%）曾接受过艾滋病毒检测。20 至 24 岁的年轻人（调整后的优势比（aOR）：1.98）、女性（aOR：1.13）、已婚青年（aOR：3.89）、接受过小学（aOR：1.23）、中学或更高教育（aOR：1.46）以及来自乔拉/卡洛因卡族裔（aOR：1.81）的年轻人，接受艾滋病毒检测的可能性更高。那些具备充分艾滋病毒知识、有过性行为、首次性行为年龄≥15 岁（aOR：3.99）和<15 岁（aOR：3.96）的年轻人，比从未有过性行为的年轻人更有可能接受艾滋病毒检测。
本研究强调了在冈比亚，青少年（15 至 24 岁）接受艾滋病毒检测的模型测试水平较低。本研究利用安德森健康服务利用模型，将倾向因素（社会人口学和艾滋病毒知识）和需要关怀因素（性风险行为）预测我们研究中的医疗保健利用服务（艾滋病毒检测）；然而，只有社会人口学模型解释了艾滋病毒检测的大部分差异。模型测试效果不佳可能与艾滋病毒知识和性风险行为模型选择的主要变量数量有限有关。因此，未来的研究需要考虑更多的变量。
