Prevalence and factors associated with self-reported HIV testing among adolescent girls and young women in Rwanda: evidence from 2019/20 Rwanda Demographic and Health Survey

Abstract

Background HIV/AIDS remains a major public health problem globally. The majority of people living with HIV are from Sub-Saharan Africa, particularly adolescent girls and young women (AGYW) aged 15-24 years. HIV testing is crucial as it is the gateway to HIV prevention, treatment, and care; therefore this study determined the prevalence and factors associated with self-reported HIV testing among AGYW in Rwanda. Methods We conducted secondary data analysis on the AGYW using data extracted from the nationally representative population-based 2019/2020 cross-sectional Rwanda Demographic and Health Survey (DHS). We described the characteristics of study participants and determined the prevalence of HIV testing and associated factors using the multivariable logistic regression model. We adjusted all our analyses for unequal sampling probabilities using survey weights. Results There were a total of 5,732 AGYW, with the majority (57%) aged 15-19 years, 83% were not living with a man, 80% were from rural areas, 29% were from the East region, and 20% had a history of pregnancy. Self-reported HIV testing prevalence was 55.4% (95%CI: 53.7 to 57.0%). The odds of ever having an HIV test were significantly higher for those aged 20-24 years (aOR 2.87, 95%CI: 2.44 to 3.37); with higher education (aOR 2.41, 95%CI:1.48 to 3.93); who were rich (aOR 2.06, 95%CI:1.57 to 2.70); with access to at least one media (aOR 1.64, 95%CI: 1.14 to 2.37); who had ever been pregnant (aOR 16.12, 95%CI: 9.60 to 27.07); who ever had sex (aOR 2.40, 95%CI: 1.96 to 2.95); and those who had comprehensive HIV knowledge (aOR 1.34, 95%CI: 1.17 to 1.54). Conclusions We report an unmet need for HIV testing among AGYW in Rwanda. We recommend a combination of strategies to optimize access to HIV testing services, especially among the 15-19 years adolescent girls, including facility-based testing, school and community outreach, awareness campaigns on HIV testing, and home-based testing through HIV self-testing.

Prevalence of risk factors for human immunodeficiency virus among sexually active women in Rwanda: a nationwide survey

“…Moreover, region was also found to be associated with risk factors for HIV, where the western region compared to Kigali had lower odds of facing HIV risk factors. The western province is a rural area with less activity and entertainment places like bars where women are less likely to participate in risky sexual behaviours [19]. The study nds are consistent with studies in Eswatini [42] which reported that women in rural areas are likely to have a limited number of lifetime sexual partners hence reducing the risk for HIV.…”

“…The ndings are similar to other studies in Swaziland [32], Sierra Leone [1], Zambia [20] and China [33]. This may be because older women 25-34 and 34-44 years were probably more informed about sexual matters and more knowledgeable about HIV [19] whereas younger women are generally explorative and easily fall victim to peer pressure hence easily indulging in risky sexual behaviours [1,33].…”

“…This may be because the HIV/AIDS organizations and the Ministry of Health, Rwanda disseminate HIV information via newspapers, radio, and TV [19]. Therefore, media should be explored further with more innovative strategies to continue providing adequate knowledge about HIV prevention and control which enables adopting appropriate attitudes and practices to an even wider audience [19,43].…”

“…Previous studies have focused on HIV prevalence, testing and associated factors [8,14], or other aspects of HIV [13]. Other studies mainly focused on the risk factors for HIV acquisition either among the general population [7], or adolescents [19] but not sexually active women and none had gone ahead to explore the prevalence of key risk factors for HIV. Considering women being a vulnerable group to HIV/AIDS, we, therefore aimed to determine the prevalence of risk factors of HIV and associated demographic factors among sexually active women in Rwanda using the 2020 Rwanda Demographic Health Survey.…”

Determinants of comprehensive knowledge on mother-to-child transmission of HIV and its prevention among childbearing women in Rwanda: insights from the 2020 Rwandan Demographic and Health Survey

“…In Rwanda, some studies have been conducted around HIV and its prevalence amongst others [ 5 , 13 ] [ 21 – 24 ]. The focus of these studies has largely been identifying HIV incidence and prevalence at the district level [ 5 ], risk factors and characteristics of mothers living with HIV [ 13 ] and rates of MTCT of HIV at 6–10 weeks postpartum [ 21 ] amongst others.…”