Abebe Mesfin, Asgedom Yordanos Sisay, Gebrekidan Amanuel Yosef, Wondimagegne Yohannes Addisu, Hareru Habtamu Endashaw, Tebeje Tsion Mulat
Department of Midwifery, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia.
Department of Epidemiology and Biostatistics, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
Front Public Health. 2025 Jan 8;12:1518314. doi: 10.3389/fpubh.2024.1518314. eCollection 2024.
HIV continues to be a significant global health issue, particularly affecting sub-Saharan Africa, including Tanzania. Knowing one's HIV status is a crucial first step in combating HIV/AIDS and achieving the targets set for the Sustainable Development Goals (SDGs) by 2030. However, despite ongoing efforts, HIV testing coverage remains low in developing countries, including Tanzania, where testing among young people poses particular challenges. Therefore, this study, based on the 2022 Tanzanian Demographic and Health Survey, aims to identify the factors influencing HIV testing among young women through the lens of Anderson's Behavioral Model.
In this study, we analyzed a weighted sample of 5,810 young women from the 2022 Tanzania Demographic and Health Survey (TDHS). Given the hierarchical structure of the DHS data and the binary nature of the outcome variable 'ever tested for HIV,' we employed a multilevel mixed-effect logistic regression model. The best-fitting model was identified using the deviance value. In the multivariable analysis, we calculated adjusted odds ratios (AORs) along with their 95% confidence intervals (CIs) to assess the strength of associations between various predictors and HIV testing. Statistical significance was determined at a -value of less than 0.05.
In our study, the prevalence of HIV testing among young women was 60.18% (95% CI: 58.91 to 61.43%). Significant factors associated with HIV testing included age (AOR = 4.33, 95% CI [3.43, 5.45]), marital status (AOR = 2.31, 95% CI [1.76, 3.04]), knowledge of HIV prevention (AOR = 1.59, 95% CI [1.23, 2.04]), discriminatory attitudes towards HIV (AOR = 0.74, 95% CI [0.58, 0.95]), visiting healthcare facilities (AOR = 4.80, 95% CI [3.75, 6.14]), media exposure (AOR = 1.44, 95% CI [1.09, 1.90]), internet use (AOR = 1.56, 95% CI [1.02, 2.38]), and ever heard of STIs (AOR = 2.12, 95% CI [1.63, 2.77]).
Our study found that 60.18% of young women in Tanzania have been tested for HIV. Addressing barriers like stigma and improving access to healthcare and information through media and the internet can significantly boost HIV testing rates among young women, aiding the global effort to end the AIDS epidemic by 2030.The Anderson Behavioral Model emphasizes the importance of predisposing, enabling, and need factors in healthcare utilization, which aligns with our findings and underscores the necessity of a multifaceted approach to improve HIV testing rates.
艾滋病毒仍然是一个重大的全球卫生问题，尤其对撒哈拉以南非洲地区产生影响，包括坦桑尼亚。了解个人的艾滋病毒感染状况是抗击艾滋病毒/艾滋病以及实现2030年可持续发展目标（SDGs）所设定目标的关键第一步。然而，尽管一直在努力，但在包括坦桑尼亚在内的发展中国家，艾滋病毒检测覆盖率仍然很低，在年轻人中进行检测面临特殊挑战。因此，本研究基于2022年坦桑尼亚人口与健康调查，旨在通过安德森行为模型的视角确定影响年轻女性艾滋病毒检测的因素。
在本研究中，我们分析了来自2022年坦桑尼亚人口与健康调查（TDHS）的5810名年轻女性的加权样本。鉴于人口与健康调查数据的分层结构以及结果变量“是否曾接受艾滋病毒检测”的二元性质，我们采用了多层次混合效应逻辑回归模型。使用偏差值确定最佳拟合模型。在多变量分析中，我们计算了调整后的优势比（AORs）及其95%置信区间（CIs），以评估各种预测因素与艾滋病毒检测之间关联的强度。统计学显著性以p值小于0.05确定。
在我们的研究中，年轻女性中艾滋病毒检测的患病率为60.18%（95%CI：58.91至61.43%）。与艾滋病毒检测相关的显著因素包括年龄（AOR = 4.33，95%CI [3.43，5.45]）、婚姻状况（AOR = 2.31，95%CI [1.76，3.04]）、艾滋病毒预防知识（AOR = 1.59，95%CI [1.23，2.04]）、对艾滋病毒的歧视态度（AOR = 0.74，95%CI [0.58，0.95]）、前往医疗机构就诊（AOR = 4.80，95%CI [3.75，6.14]）、媒体曝光（AOR = 1.44，95%CI [1.09，1.90]）、互联网使用（AOR = 1.56，95%CI [1.02，2.38]）以及是否听说过性传播感染（AOR = 2.12，95%CI [1.63，2.77]）。
我们的研究发现，坦桑尼亚60.18%的年轻女性接受过艾滋病毒检测。解决诸如耻辱感等障碍，并通过媒体和互联网改善获得医疗保健和信息的机会，可以显著提高年轻女性的艾滋病毒检测率，有助于全球在2030年结束艾滋病流行的努力。安德森行为模型强调了在医疗保健利用中诱发因素、促成因素和需求因素的重要性，这与我们的研究结果一致，并强调了采取多方面方法提高艾滋病毒检测率的必要性。
