School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
Aurum Institute, Johannesburg, South Africa.
BMC Public Health. 2022 Jul 1;22(1):1281. doi: 10.1186/s12889-022-13679-8.
BACKGROUND: HIV/AIDS remains a major public health problem globally. The majority of people living with HIV are from Sub-Saharan Africa, particularly adolescent girls and young women (AGYW) aged 15-24 years. HIV testing is crucial as it is the gateway to HIV prevention, treatment, and care; therefore this study determined the prevalence and factors associated with self-reported HIV testing among AGYW in Rwanda. METHODS: We conducted secondary data analysis on the AGYW using data extracted from the nationally representative population-based 2019/2020 cross-sectional Rwanda Demographic and Health Survey (DHS). We described the characteristics of study participants and determined the prevalence of HIV testing and associated factors using the multivariable logistic regression model. We adjusted all our analyses for unequal sampling probabilities using survey weights. RESULTS: There were a total of 5,732 AGYW, with the majority (57%) aged 15-19 years, 83% were not living with a man, 80% were from rural areas, 29% were from the East region, and 20% had a history of pregnancy. Self-reported HIV testing prevalence was 55.4% (95%CI: 53.7 to 57.0%). The odds of ever having an HIV test were significantly higher for those aged 20-24 years (aOR 2.87, 95%CI: 2.44 to 3.37); with higher education (aOR 2.41, 95%CI:1.48 to 3.93); who were rich (aOR 2.06, 95%CI:1.57 to 2.70); with access to at least one media (aOR 1.64, 95%CI: 1.14 to 2.37); who had ever been pregnant (aOR 16.12, 95%CI: 9.60 to 27.07); who ever had sex (aOR 2.40, 95%CI: 1.96 to 2.95); and those who had comprehensive HIV knowledge (aOR 1.34, 95%CI: 1.17 to 1.54). CONCLUSIONS: We report an unmet need for HIV testing among AGYW in Rwanda. We recommend a combination of strategies to optimize access to HIV testing services, especially among the 15-19 years adolescent girls, including facility-based testing, school and community outreach, awareness campaigns on HIV testing, and home-based testing through HIV self-testing.
背景:艾滋病毒/艾滋病仍然是全球的一个主要公共卫生问题。大多数艾滋病毒感染者来自撒哈拉以南非洲地区,特别是年龄在 15 至 24 岁的青少年女孩和年轻妇女。艾滋病毒检测至关重要,因为它是预防、治疗和护理艾滋病毒的途径;因此,本研究旨在确定卢旺达青少年女孩和年轻妇女自我报告的艾滋病毒检测流行率和相关因素。
方法:我们利用 2019/2020 年全国代表性人口为基础的横断面卢旺达人口与健康调查(DHS)中提取的数据,对青少年女孩和年轻妇女进行二次数据分析。我们描述了研究参与者的特征,并使用多变量逻辑回归模型确定了艾滋病毒检测的流行率和相关因素。我们使用调查权重对所有分析进行了调整,以考虑到不等抽样概率。
结果:共有 5732 名青少年女孩和年轻妇女,其中大多数(57%)年龄在 15-19 岁之间,83%的人没有与男性同居,80%的人来自农村地区,29%的人来自东部地区,20%的人有过怀孕经历。自我报告的艾滋病毒检测流行率为 55.4%(95%置信区间:53.7 至 57.0%)。与 15-19 岁的青少年女孩相比,20-24 岁的青少年女孩(比值比 2.87,95%置信区间:2.44 至 3.37);接受过高等教育(比值比 2.41,95%置信区间:1.48 至 3.93);富裕(比值比 2.06,95%置信区间:1.57 至 2.70);至少接触过一种媒体(比值比 1.64,95%置信区间:1.14 至 2.37);曾经怀孕(比值比 16.12,95%置信区间:9.60 至 27.07);曾经有过性行为(比值比 2.40,95%置信区间:1.96 至 2.95);以及对艾滋病毒有全面了解(比值比 1.34,95%置信区间:1.17 至 1.54)。
结论:我们报告了卢旺达青少年女孩对艾滋病毒检测的需求未得到满足。我们建议采取综合策略,优化艾滋病毒检测服务的获取,特别是针对 15-19 岁的青少年女孩,包括基于设施的检测、学校和社区外联、艾滋病毒检测宣传活动以及通过艾滋病毒自我检测进行家庭检测。
BMC Infect Dis. 2024-4-19