Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia.
Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa.
PLoS One. 2023 Oct 5;18(10):e0292182. doi: 10.1371/journal.pone.0292182. eCollection 2023.
BACKGROUND: In sub-Saharan Africa, HIV and AIDS remain a major public health concern among adolescents and young men. HIV testing is the first critical step for linking infected individuals to HIV treatment and prevention. However, HIV-testing uptake among sexually active young men remains low in the region. This study was conducted to assess the HIV testing rates among unmarried young men in sub-Saharan Africa. METHODS: Using data from the most recent country Demographic and Health Surveys (DHS) conducted between January 1, 2015, and December 31, 2020, in 18 sub-Saharan African countries, an Inverse Heterogeneity model (IVhet) using MetaXL software was used to estimate country, regional and sub-regional pooled estimates of HIV testing uptake among sexually active unmarried young men in sub-Saharan Africa. Furthermore, multivariable binary logistic regression was conducted to examine the factors associated with HIV testing uptake among unmarried young men. RESULTS: The overall pooled prevalence estimate of HIV testing uptake among sexually active unmarried young men in sub-Saharan Africa was 33.0% (95% CI: 21-45, I2 = 99%, p <0.001). There was variation in the prevalence across countries ranging from 7% (95% CI: 5-9) in Guinea to 77% (95% CI: 74-80) in Cameroon. Central Africa had the highest prevalence of HIV testing among unmarried young men, at 47% (95% CI:0-100) while West Africa had the lowest prevalence at 11% (95% CI:2-23). Results further show that young men aged 15-19 (aOR = 0.59, 95% CI 0.52-0.66) were less likely to test for HIV. Young men who spent 8 to 12 years in school (aOR = 3.26 95% CI 2.21-4.79) or 13 years and above (aOR = 3.56 95% CI 2.35-5.37) had increased odds of undertaking an HIV test. CONCLUSION: The prevalence of HIV testing among sexually active unmarried young men remains low in sub-Saharan Africa. Therefore, the results suggest that health policymakers should consider re-evaluating the current HIV prevention policies and programmes with the view of redesigning the present HIV testing campaigns to enhance the uptake among young people.
背景：在撒哈拉以南非洲地区，艾滋病毒和艾滋病仍然是青少年和年轻男性面临的主要公共卫生问题。艾滋病毒检测是将感染者与艾滋病毒治疗和预防联系起来的第一步。然而，该地区性活跃的年轻男性接受艾滋病毒检测的比例仍然很低。本研究旨在评估撒哈拉以南非洲未婚年轻男性的艾滋病毒检测率。
方法：利用 2015 年 1 月 1 日至 2020 年 12 月 31 日期间进行的最新的国家人口与健康调查（DHS）数据，使用 MetaXL 软件中的逆异质性模型（IVhet），估计撒哈拉以南非洲地区性活跃未婚年轻男性中艾滋病毒检测率的国家、区域和次区域汇总估计值。此外，还进行了多变量二项逻辑回归，以检验与未婚年轻男性艾滋病毒检测率相关的因素。
结果：撒哈拉以南非洲地区性活跃未婚年轻男性的总体艾滋病毒检测率为 33.0%（95%CI：21-45，I2=99%，p<0.001）。各国之间的流行率存在差异，从几内亚的 7%（95%CI：5-9）到喀麦隆的 77%（95%CI：74-80）不等。中非地区未婚年轻男性艾滋病毒检测率最高，为 47%（95%CI：0-100），而西非地区最低，为 11%（95%CI：2-23）。结果进一步表明，年龄在 15-19 岁的年轻男性（aOR=0.59，95%CI0.52-0.66）进行艾滋病毒检测的可能性较低。在校 8 至 12 年（aOR=3.26，95%CI2.21-4.79）或 13 年及以上（aOR=3.56，95%CI2.35-5.37）的年轻男性进行艾滋病毒检测的可能性增加。
结论：撒哈拉以南非洲地区性活跃的未婚年轻男性中艾滋病毒检测的比例仍然很低。因此，结果表明，卫生政策制定者应考虑重新评估当前的艾滋病毒预防政策和方案，以重新设计当前的艾滋病毒检测运动，提高年轻人的参与度。
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