Factors associated with HIV testing among sexually active South African youth aged 15–24 years

Abstract

HIV infection is high among South African youth but most report being unaware of their HIV status. We explored the correlates of HIV testing using data from youth aged 15-24 years old who reported being sexually experienced during a national survey conducted in South Africa in 2003 (N=7665). Among sexually experienced youth, 32.7% of females and 17.7% of males reported having been tested for HIV. In multivariable analysis, ever being pregnant (OR = 2.97; 95% CI 2.36-3.73), ever starting a conversation about HIV/AIDS (OR = 1.29; 95% CI 1.0-1.65) and urban residence (OR = 2.0; 95% CI 1.58-2.52) were independent correlates of HIV testing among sexually experienced females. Among sexually experienced males, HIV-positive status (OR = 1.76; 95% CI 1.14-2.73), personally knowing someone that died of AIDS (OR = 1.68; 95% CI 1.14-2.47), being aged 20-24 years (OR = 1.56; 95% CI 1.10-2.22) and having completed high school (OR = 1.58; 95% CI 1.17-2.12) were independent correlates of HIV testing. The following factors were significantly associated with HIV testing among both men and women; ever talking to parents about HIV/AIDS, ever participating in a loveLife programme, a higher frequency of visits to a clinic in the past 12 months and non-black race (p<0.05). There is a need to better understand the correlates of HIV testing to ensure that adolescent HIV prevention programmes actively promote HIV testing among this group. Specific attention needs to be paid to young women who do not access antenatal care and young men who are less regular users of routine clinical care. Communication is a significant predictor of having tested for HIV and should be encouraged with parents and through intervention programmes for adolescents. Finally, specific attention must be paid to increasing access to HIV testing for at-risk adolescents in rural communities.

Determinants of HIV testing among young people aged 18 – 24 years in South Africa

“…In agreement with other studies, 5,7,8,11,12,15 this study found that older age, being female, HIV knowledge, having ever talked to the mother or female guardian about HIV and having ever been pregnant or made someone pregnant were found to be associated with HIV testing. This age disparity may be due to the likelihood that younger youths have had a shorter sexual experience and are less informed on sexual issues than older youth.…”

“…While all communication about HIV may be beneficial, the role of parental communication in reducing HIV risk among youth has been documented previously. 5,12 This supports the continued need to engage the mother or female guardian in discussions about HIV and sexuality with their children. 4 These factors identified to be associated with an HIV test should be used to inform current HIV testing uptake programmes.…”

“…In the last national population-based survey in 2008 the HIV prevalence was estimated at 10.5%, 17.4% for women and 3.3% for men among young people aged 18 -24 years in South Africa. 4 In previous national surveys among youth in South Africa it was found that in 2003 among sexually experienced youth (15-24 years old) 32.7% of females and 17.7% of males reported having been tested for HIV, 5 in 2006 among youth (15-24 years) 30% reported ever been tested for HIV and 41% among those who ever had sexual intercourse, 6 and in 2008 among youth (18-24 years) 47.8% reported ever having tested for HIV, 31.4% among men and 64.1% among women, and among those who ever had sexual intercourse 56.3% had ever been tested for HIV, 36.3% among men and 75.5% among women. 4 Studies among youth (15-24 years) from other low and middle income countries found HIV testing rates ranging from 2.6% in Nigeria, 7 17% in Haiti, 8 28.9% in Tanzania, 9 36.8% in Guayana, 8 48% in the Dominican Republic, 9 to 64% among females and 55% among males in Kisumu, Kenya.…”

“…4 Studies among youth (15-24 years) from other low and middle income countries found HIV testing rates ranging from 2.6% in Nigeria, 7 17% in Haiti, 8 28.9% in Tanzania, 9 36.8% in Guayana, 8 48% in the Dominican Republic, 9 to 64% among females and 55% among males in Kisumu, Kenya. 10 Factors associated with HIV testing among young people include demographic factors (age, sex, education, wealth), 7,8 HIV risk behaviour, 5,8,10 perceived HIV risk, 11 psychosocial variables related to HIV knowledge, stigma attitudes, 12,13 talked with parents about HIV/AIDS, 5 pregnancy, 5,11 and in general self-efficacy, 14 frequent conversations about HIV, 15 health systems factors, 16 programme exposure, 14 exposure to HIV media campaigns, exposure to HIV prevention programmes and general access to media. 17 A few recent studies of HIV testing in Southern Africa could be located and none could be found which examined testing among youth 18"24 years.…”

HIV Testing in Non-Injection Drug Users: Prevalence and Associated Factors

“…Studies have indicated factors associated with HIV testing, namely sociodemographic characteristics (24)(25)(26), sexual risk behaviors, history of sexually transmitted infections (STI) (25,27), self-perceived HIV risk (28), and knowing people living with HIV/AIDS (PLHA) and/or someone who had died from AIDS (24,29,30). These determinants must be taken into account when planning healthcare actions and broadening coverage of the testing for those most vulnerable, such as NIDU.…”