Department of Nursing, College of Health Sciences, Samara University, Afar, 132, Ethiopia.
Department of Public Health, College of Health Sciences, Samara University, Afar, Ethiopia.
BMC Infect Dis. 2024 Aug 13;24(1):821. doi: 10.1186/s12879-024-09695-1.
Human Immunodeficiency Virus (HIV) is a global health concern, causing over 35 million deaths, with 97% occurring in developing nations, particularly impacting Sub-Saharan Africa. While HIV testing is crucial for early treatment and prevention, existing research often focuses on specific groups, neglecting general adult testing rates. This study aims to identify predictors of HIV testing uptake among adults in Sub-Saharan Africa.
Data were obtained from the official Demographic and Health Survey program database, which used a multistage cluster sampling technique to collect the survey data. In this study, a weighted sample of 283,936 adults was included from thirteen Sub-Saharan African countries. Multilevel multivariable logistic regression analysis was employed to identify predictors of HIV testing uptake. Akaike's information criteria guided model selection. Adjusted odds ratios and corresponding 95% confidence intervals determined significant predictor variables.
Among adults in Sub-Saharan African countries, the prevalence of HIV testing uptake was 65.01% [95% CI (64.84%, 65.17%)]. Influential factors included male sex [AOR: 0.51, 95% CI (0.49,0.53)], varying odds ratios across age groups (20-24 [AOR: 3.3, 95% CI (3.21, 3.46) ], 25-29 [AOR: 4.4, 95% CI (4.23, 4.65)], 30-34 [AOR: 4.6, 95%CI (4.40, 4.87)], 35-39 [AOR: 4.0, 95%CI (3.82, 4.24)], 40-44 [AOR: 3.7, 95%CI (3.50, 3.91)], 45-49 [AOR: 2.7, 95%CI (2.55, 2.87)], 50+ [AOR: 2.7, 95%CI (2.50, 2.92)]), marital status (married [AOR: 3.3, 95%CI (3.16, 3.46)], cohabiting [AOR: 3.1, 95% CI (2.91, 3.28)], widowed/separated/divorced [AOR: 3.4, 95%CI (3.22, 3.63)]), female household headship (AOR: 1.28, 95%CI (1.24, 1.33)), education levels (primary [AOR: 3.9, 95%CI (3.72, 4.07)], secondary [AOR: 5.4, 95%CI (5.16, 5.74)], higher [AOR: 8.0, 95%CI (7.27, 8.71)]), media exposure (AOR: 1.4, 95%CI (1.32, 1.43)), wealth index (middle [AOR: 1.20, 95%CI (1.17, 1.27)], richer [AOR: 1.50, 95%CI (1.45, 1.62)]), Having discriminatory attitudes towards PLWHIV [AOR: 0.4; 95% CI (0.33, 0.37)], had multiple sexual partners [AOR: 1.2; 95% CI (1.11, 1.28)], had comprehensive knowledge about HIV [AOR: 1.6; 95% CI (1.55, 1.67)], rural residence (AOR: 1.4, 95%CI (1.28, 1.45)), and lower community illiteracy (AOR: 1.4, 95%CI (1.31, 1.50)) significantly influenced HIV testing uptake in the region.
This study highlights the need for tailored interventions to address disparities in HIV testing uptake among adults in Sub-Saharan Africa and progress towards the achievement of 95-95-95 targets by 2030. Thus, tailored interventions addressing key factors are crucial for enhancing testing accessibility and emphasizing awareness campaigns, easy service access, and targeted education efforts to improve early diagnosis, treatment, and HIV prevention in the region.
人类免疫缺陷病毒（HIV）是一个全球性的健康问题，已导致超过 3500 万人死亡，其中 97%发生在发展中国家，特别是撒哈拉以南非洲地区。HIV 检测对于早期治疗和预防至关重要，但现有研究往往集中在特定群体，而忽略了一般成年人的检测率。本研究旨在确定撒哈拉以南非洲成年人接受 HIV 检测的预测因素。
数据来自官方人口与健康调查计划数据库，该数据库采用多阶段聚类抽样技术收集调查数据。在这项研究中，从撒哈拉以南非洲的 13 个国家中抽取了一个加权样本，共包括 283936 名成年人。采用多水平多变量逻辑回归分析来确定 HIV 检测率的预测因素。Akaike 信息准则指导模型选择。调整后的优势比和相应的 95%置信区间确定了显著的预测变量。
在撒哈拉以南非洲国家的成年人中，HIV 检测率为 65.01%[95%CI（64.84%，65.17%）]。有影响力的因素包括男性（AOR：0.51，95%CI（0.49，0.53））、年龄组（20-24 岁 [AOR：3.3，95%CI（3.21，3.46）]、25-29 岁 [AOR：4.4，95%CI（4.23，4.65）]、30-34 岁 [AOR：4.6，95%CI（4.40，4.87）]、35-39 岁 [AOR：4.0，95%CI（3.82，4.24）]、40-44 岁 [AOR：3.7，95%CI（3.50，3.91）]、45-49 岁 [AOR：2.7，95%CI（2.55，2.87）]、50 岁以上 [AOR：2.7，95%CI（2.50，2.92）]）、婚姻状况（已婚 [AOR：3.3，95%CI（3.16，3.46）]、同居 [AOR：3.1，95%CI（2.91，3.28）]、丧偶/分居/离婚 [AOR：3.4，95%CI（3.22，3.63）]）、女性户主（AOR：1.28，95%CI（1.24，1.33））、教育水平（小学 [AOR：3.9，95%CI（3.72，4.07）]、中学 [AOR：5.4，95%CI（5.16，5.74）]、高等教育 [AOR：8.0，95%CI（7.27，8.71）]）、媒体接触（AOR：1.4，95%CI（1.32，1.43））、财富指数（中等 [AOR：1.20，95%CI（1.17，1.27）]、更富裕 [AOR：1.50，95%CI（1.45，1.62）]）、对 PLWHIV 有歧视态度（AOR：0.4；95%CI（0.33，0.37）]、有多个性伴侣（AOR：1.2；95%CI（1.11，1.28）]）、对 HIV 有全面的了解（AOR：1.6；95%CI（1.55，1.67））、农村居住（AOR：1.4，95%CI（1.28，1.45））和较低的社区文盲率（AOR：1.4，95%CI（1.31，1.50））对该地区的 HIV 检测率有显著影响。
本研究强调需要针对撒哈拉以南非洲成年人接受 HIV 检测的差异制定有针对性的干预措施，以实现到 2030 年 95-95-95 目标。因此，针对关键因素制定有针对性的干预措施对于提高检测的可及性和强调宣传活动、方便服务获取以及针对目标的教育工作至关重要，以改善该地区的早期诊断、治疗和 HIV 预防。
