Factors Associated with Ever Having Tested for HIV among Adolescent Girls and Young Women in Zambia: 2016 Zambia Population-based HIV Impact Assessment Open Access

Truong, Ha (Spring 2019)

Permanent URL: https://etd.library.emory.edu/concern/etds/6108vc38w?locale=en


Adolescent girls and young women (AGYW) age 15-24 years are an important population to focus on in HIV testing efforts because AGYW accounted for a disproportionate number of new HIV infections compared to males of the same age. We aimed to identify factors associated with the outcome of ever having tested for HIV among AGYW using socio-demographic data and data from the reproduction, sexual activity, and gender norms modules of the 2016 ZAMPHIA survey. The ZAMPHIA survey was a nationally representative, cross-sectional, population-based survey used to measure Zambia’s national HIV burden and HIV services uptake. Our study population includes HIV-negative AGYW age 15-24 years who had been sexually active within 12 months before interview (n=2,112). We determined weighted descriptive frequencies, crude and adjusted weighted prevalence ratios (aPR) and 95% confidence intervals for exposures of interest using multivariable log-binomial regression models and jackknife replicate weights to account for the complex survey design. Having ever tested for HIV was associated with age 20-24 years compared to age 15-19 years (aPR=1.18 (1.12, 1.24)), being married or living with a partner compared to never being married (aPR=1.21 (1.15, 1.27)), urban residence compared to rural residence (aPR=1.05 (1.02, 1.09)), experiencing pregnancy compared to never experiencing pregnancy (aPR=1.49 (1.33, 1.67)), using a modern contraceptive method compared to not using a modern contraceptive method (aPR=1.12 (1.07, 1.16)), and having one sexual partner in the last 12 months compared to having two or more sexual partners (aPR=1.12 (1.01, 1.24)). Having ever tested for HIV was less common in AGYW in age-similar relationships compared to those in an age-disparate relationships, defined as an age difference of 5 or more years (aPR=0.92 (0.89, 0.96)). Our results are consistent with the the socio-behavioral risk factors associated with lower rates of HIV testing in adolescent populations in other Sub-Saharan African countries and encourages further research into the linkage of HIV testing services with family planning services to increase HIV testing among AGYW and relationship between age-disparate relationships, perceived HIV risk, and motivation to obtain HIV testing among AGYW.

Table of Contents

Abstract 1

Introduction 2

Methods 4

Study design and setting 4

Survey participants and study population 5

Variables 5

Statistical methods 7

Results 8

Sample characteristics 8

Multivariable analyses 9

Discussion 10

References 15

Tables 19

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