RESEARCH PAPER
Trends of HIV testing among sexually active young females in Ethiopia: a multivariable decomposition analysis of 2005-2016 EDHS
1
Wollo University, Ethiopia
Submission date: 2022-01-24
Final revision date: 2022-03-18
Acceptance date: 2022-03-21
Publication date: 2023-01-28
HIV & AIDS Review 2023;22(1):53-61
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Even though HIV testing and care is highly targeted in different strategies in Ethiopia, most sexually active young females do not know their HIV status. Moreover, prior trend analysis has not been conducted among sexually active young females in Ethiopia. Therefore, this study aimed to assess the trend and determinants of HIV testing change among sexually active young females in Ethiopia.
Material and methods:
The current study utilized three consecutive Ethiopia Demographic and Health Survey (EDHS) datasets. A total of 1,201.9, 3,094, and 2,864.7 sexually active female youths were included in 2005, 2011, and 2016 EDHS surveys, respectively. Data were analyzed using Stata version 14.0. Logit-based decomposition analysis was performed to identify contributing factors for HIV testing change, and statistical significance was determined with p-value.
Results:
The trend of HIV testing increased from 7% in 2005 to 52.5% in 2016 EDHS. The analysis revealed that 19% of the overall change in HIV testing was due to the change in female youths composition. Changes in the composition of young females according to region, age, economic status, age of sexual initiation, and comprehensive HIV/ AIDS knowledge were the major sources of the change. Greater than 80% of the increase in HIV testing was due to differences in coefficient. The change in behaviors of married youths and early starting of sex life were the contributing factors to change of HIV testing over the last decade.
Conclusions:
Change of HIV testing among sexually active female youths increased in the last 10 years in Ethiopia. However, in order to achieve the HIV-related targets in the country, programmatic interventions targeting uneducated women is needed.
Even though HIV testing and care is highly targeted in different strategies in Ethiopia, most sexually active young females do not know their HIV status. Moreover, prior trend analysis has not been conducted among sexually active young females in Ethiopia. Therefore, this study aimed to assess the trend and determinants of HIV testing change among sexually active young females in Ethiopia.
Material and methods:
The current study utilized three consecutive Ethiopia Demographic and Health Survey (EDHS) datasets. A total of 1,201.9, 3,094, and 2,864.7 sexually active female youths were included in 2005, 2011, and 2016 EDHS surveys, respectively. Data were analyzed using Stata version 14.0. Logit-based decomposition analysis was performed to identify contributing factors for HIV testing change, and statistical significance was determined with p-value.
Results:
The trend of HIV testing increased from 7% in 2005 to 52.5% in 2016 EDHS. The analysis revealed that 19% of the overall change in HIV testing was due to the change in female youths composition. Changes in the composition of young females according to region, age, economic status, age of sexual initiation, and comprehensive HIV/ AIDS knowledge were the major sources of the change. Greater than 80% of the increase in HIV testing was due to differences in coefficient. The change in behaviors of married youths and early starting of sex life were the contributing factors to change of HIV testing over the last decade.
Conclusions:
Change of HIV testing among sexually active female youths increased in the last 10 years in Ethiopia. However, in order to achieve the HIV-related targets in the country, programmatic interventions targeting uneducated women is needed.
REFERENCES (59)
1.
Mahy M, Marsh K, Sabin K, Wanyeki I, Daher J, Ghys PD. HIV estimates through 2018: data for decision-making. AIDS 2019; 33 (Suppl 3): S203-S211.
2.
Marsh K, Eaton JW, Mahy M, et al. Global, regional and country-level 90-90-90 estimates for 2018: assessing progress towards the 2020 target. AIDS 2019; 33 (Suppl 3): S213-S226.
3.
Wall KM, Rogers E, Stephenson R. Meeting the mark by 2020: country progress toward FP2020 and UNAIDS HIV targets. BMJ Sex Reprod Health 2020; 46: 85-87.
4.
Fauci AS, Redfield RR, Sigounas G, Weahkee MD, Giroir BP. Ending the HIV epidemic: a plan for the United States. JAMA 2019; 321: 844-845.
5.
Chandra-Mouli V, Ferguson BJ, Plesons M, et al. The political, research, programmatic, and social responses to adolescent sexual and reproductive health and rights in the 25 years since the International Conference on Population and Development. J Adolesc Health 2019; 65 (6S): S16-S40.
6.
World Health Organization. Maternal, newborn, child and adolescent health: HIV and youth. 2019. Available from: https://www who int/maternal_child_adolescent/topics/adolescence/hiv/en/ (Accessed: November 2020).
7.
Gona PN, Gona CM, Ballout S, et al. Burden and changes in HIV/AIDS morbidity and mortality in Southern Africa Development Community Countries, 1990-2017. BMC Public Health 2020; 20: 867. doi: 10.1186/s12889-020-08988-9.
8.
Abuogi LL, Humphrey JM, Mpody C, et al. Achieving UNAIDS 90-90-90 targets for pregnant and postpartum women in sub-Saharan Africa: progress, gaps and research needs. J Virus Erad 2018; 4 (Suppl 2): 33-39.
9.
Brown K, Williams DB, Kinchen S, et al. Status of HIV epidemic control among adolescent girls and young women aged 15-24 years – seven African countries, 2015-2017. MMWR Morb Mort Wkly Rep 2018; 67: 29-32.
10.
Penazzato M, Irvine C, Vicari M, et al. A global research agenda for pediatric HIV. J Acquir Immune Def Syndr (1999) 2018; 78 Suppl 1: S10-S15.
11.
Govender K, Masebo WG, Nyamaruze P, Cowden RG, Schunter BT, Bains A. HIV prevention in adolescents and young people in the Eastern and Southern African region: a review of key challenges impeding actions for an effective response. Open AIDS J 2018; 12: 53-67.
12.
Kahana SY, Jenkins RA, Bruce D, et al. Structural determinants of antiretroviral therapy use, HIV care attendance, and viral suppression among adolescents and young adults living with HIV. PLoS One 2016; 11: e0151106. doi: 10.1371/journal.pone.0151106.
13.
Wong VJ, Murray KR, Phelps BR, Vermund SH, McCarraher DR. Adolescents, young people, and the 90-90-90 goals: a call to improve HIV testing and linkage to treatment. AIDS 2017; 31 (Suppl 3): S191-S194.
14.
Ebrahim NB, Atteraya MS. Understanding structural determinants of HIV testing in a resource-limited setting: the case of Ethiopian women. Social Inquiry: Journal of Social Science Research 2020; 2: 216-233.
15.
Ethiopia Population-Based HIV Impact Assessment (EPHIA) 2017-2018. Summary Sheet: Preliminary Findings; 2018.
16.
Abebe A. The key challenges of youth in Ethiopia. Journal of Agricultural Economics and Rural Development 2020; 6: 684-688.
17.
Central Statistical Agency/CSA/Ethiopia and ICF. Ethiopia demographic and health survey 2016. Addis Ababa, Ethiopia and Calverton, Maryland: CSA and ICF; 2016.
18.
Girum T, Wasie A, Lentiro K, et al. Gender disparity in epidemiological trend of HIV/AIDS infection and treatment in Ethiopia. Arch Public Health 2018; 76: 51. doi: 10.1186/s13690-018-0299-8.
19.
Lancaster KE, Hetrick A, Jaquet A, et al. Substance use and universal access to HIV testing and treatment in sub-Saharan Africa: implications and research priorities. J Virus Erad 2018; 4 (Suppl 2): 26-32.
20.
Gebrezgabher BB, Kebede Y, Kindie M, Tetemke D, Abay M, Gelaw YA. Determinants to antiretroviral treatment non-adherence among adult HIV/AIDS patients in northern Ethiopia. AIDS Res Ther 2017; 14: 16. doi: 10.1186/s12981-017-0143-1.
21.
Abdissa D, Tazebew M, Gerbi A. Prevalence of voluntary counseling and testing utilization and its associated factors among Merawi Preparatory School students in Merawi Town, West Gojjam, Ethiopia. HIV/AIDS (Auckl) 2020; 12: 923-930.
22.
Diress G, Ahmed M, Adane S, Linger M, Alemnew B. Barriers and facilitators for HIV testing practice among Ethiopian women aged 15-24 years: analysis of the 2016 Ethiopian demographic and health survey. HIV/AIDS (Auckl) 2020; 12: 963-970.
23.
Tesfaye G, Dessie Y, Berhane Y, et al. HIV/AIDS awareness and testing practices among adolescents in eastern Ethiopia. Trop Med Int Health 2020; 25: 111-118.
24.
Woldeyohannes D, Asmamaw Y, Sisay S, Hailesselassie W, Birmeta K, Tekeste Z. Risky HIV sexual behavior and utilization of voluntary counseling and HIV testing and associated factors among undergraduate students in Addis Ababa, Ethiopia. BMC Public Health 2017; 17: 121. doi: 10.1186/s12889-017-4060-y.
25.
Bekele YA, Fekadu GA. Factors associated with HIV testing among young females; further analysis of the 2016 Ethiopian demographic and health survey data. PLoS One 2020; 15: e0228783. doi: 10.1371/journal.pone.0228783.
26.
Tegegne ET, Tessema MK, Tegegne KT. Magnitude of HIV testing and socio demographic factors associated with it among adults age 15-49 years in Ethiopia. Int J Sxi Rep 2021; 7; doi: https://doi.org/10.18203/issn.....
27.
Nigussie T, Legesse T, Abebe L, Getachew S, Alemayehu D. Magnitude of risky sexual behaviors, determinants, and consequences among high school and preparatory school students in Mizan Aman Town, Ethiopia. Journal of Midwifery and Reproductive Health 2020; 8: 2096-2104.
28.
Arefaynie M, Yalew M, Damtie Y, Kefale B. Determinants of early sexual initiation among female youth in Ethiopia: a multilevel analysis of 2016 Ethiopian Demographic and Health Survey. BMC Womens Health 2020; 20: 205. doi: 10.1186/s12905-020-01069-4.
29.
Geremew AB, Gelagay AA, Yeshita HY, et al. Youth risky sexual behavior: prevalence and socio-demographic factors in North-West Ethiopia: a community-based cross-sectional study. Community Health Equity Res Policy 2022; 42: 145-154.
30.
Turi E, Merga BT, Fekadu G, Abajobir AA. Why too soon? Early initiation of sexual intercourse among adolescent females in Ethiopia: evidence from 2016 Ethiopian Demographic and Health Survey. Int J Womens Health 2020; 12: 269-275.
31.
Dovel K, Shaba F, Offorjebe OA, et al. Effect of facility-based HIV self-testing on uptake of testing among outpatients in Malawi: a cluster-randomised trial. Lancet Glob Health 2020; 8: e276-e287.
32.
World Health Organization. 2020. Consolidated guidelines on HIV testing services, 2019. Available from: https://apps.who.int/iris/hand....
33.
Salisu AK, Batsari LM. Assessment of The Millennium Development Goals (MGDs). KIU Journal of Social Sciences 2020; 6: 25-31.
34.
Fikadu A, Teferi E, Mekuria M, Birhanu A, Benti T. Youth friendly reproductive health service utilization and associated factors among school youths in Ambo Town, Oromia Regional State, Ethiopia, 2018. Am J Health Res 2020; 8: 60-68.
35.
Geza G. Evaluation of the effect of adolescent and youth friendly services implementation on HIV testing uptake among youth (aged 15-24 years) in health facilities of Amathole district, Eastern Cape; 2020.
36.
Motshegwa GD, Palamuleni ME. Determinants of HIV testing among young people in South Africa. Gender Behav 2020; 18.
37.
Sullivan MC, Rosen AO, Allen A, et al. Falling short of the first 90: HIV stigma and HIV testing research in the 90-90-90 era. AIDS Behav 2020; 24: 357-362.
38.
Ante-Testard PA, Benmarhnia T, Bekelynck A, et al. Temporal trends in socioeconomic inequalities in HIV testing: an analysis of cross-sectional surveys from 16 sub-Saharan African countries. Lancet Glob Health 2020; 8: e808-e818. doi: 10.1016/S2214-109X(20)30108-X.
39.
Mwaba K, Mannell J, Burgess R, Sherr L. Uptake of HIV testing among 15-19-year-old adolescents in Zambia. AIDS Care 2020; 32 (Suppl 2): 183-192.
40.
Marinda E, Simbayi L, Zuma K, et al. Towards achieving the 90-90-90 HIV targets: results from the south African 2017 national HIV survey. BMC Public Health 2020; 20: 1375. doi: 10.1186/s12889-020-09457-z.
41.
Ending AIDS: progress towards the 90-90-90 targets. Geneva: Joint United Nations Programme on HIV/AIDS; 2017.
42.
Shisana O, Rehle T, Simbayi LC, et al. South African National HIV Prevalence, Incidence and Behaviour Survey, 2012. Cape Town: HSRC Press; 2014.
43.
Simbayi L, Zuma K, Zungu N, et al. South African National HIV Prevalence, Incidence, Behaviour and Communication Survey, 2017: towards achieving the UNAIDS 90-90-90 targets. Cape Town: HSRC Press; 2019.
44.
Balaji AB, Eaton DK, Voetsch AC, Wiegand RE, Miller KS, Doshi SR. Association between HIV-related risk behaviors and HIV testing among high school students in the United States, 2009. Arch Pediatr Adolesc Med 2012; 166: 331-336.
45.
Kim YK, Small E, Okumu M. School-based HIV/AIDS education, risky sexual behaviors, and HIV testing among high school students in the United States. Soc Work Health Care 2019; 58: 258-273.
46.
Rosenberg MS, Gómez-Olivé FX, Rohr JK, et al. Sexual behaviors and HIV status: a population-based study among older adults in rural South Africa. J Acquir Immune Defic Syndr 2017; 74: e9-e17. doi: 10.1097/QAI.0000000000001173.
47.
Erena AN, Shen G, Lei P. Factors affecting HIV counselling and testing among Ethiopian women aged 15-49. BMC Infect Dis 2019; 19: 1076. doi: 10.1186/s12879-019-4701-0.
48.
Agegnehu CD, Tesema GA. Effect of mass media on comprehensive knowledge of HIV/AIDS and its spatial distribution among reproductive-age women in Ethiopia: a spatial and multilevel analysis. BMC Public Health 2020; 20: 1420. doi: 10.1186/s12889-020-09536-1.
49.
Edelstein Z, Kharfen M, Kim M, et al. Use of awareness raising campaigns to expand HIV testing: experiences in the Bronx, NY and Washington, DC (HPTN 065 study). Journal of Social Marketing 2020; 10: 339-356.
50.
Riddell J, Teal G, Flowers P, Boydell N, Coia N, McDaid L. Mass media and communication interventions to increase HIV testing among gay and other men who have sex with men: social marketing and visual design component analysis. Health (London) 2022; 26: 338-360.
51.
Kidman R, Waidler J, Palermo T; On Behalf of the Tanzania Adolescent Cash Plus Evaluation Team. Uptake of HIV testing among adolescents and associated adolescent-friendly services. BMC Health Serv Res 2020; 20: 881. doi: 10.1186/s12913-020-05731-3.
52.
Ajayi AI, Awopegba OE, Adeagbo OA, Ushie BA. Low coverage of HIV testing among adolescents and young adults in Nigeria: implication for achieving the UNAIDS first 95. PLoS One 2020; 15: e0233368. doi: 10.1371/journal.pone.0233368.
53.
Boyd D, Lea C 3rd, Quinn C. Learning about HIV: predicting the sources of knowledge that matter regarding HIV testing among a national sample of Black and Latinx adolescents and young adults in the United States. J Assoc Nurses AIDS Care 2020; 31: 417-427.
54.
Jooste S, Mabaso M, Taylor M, North A, Tadokera R, Simbayi L. Trends and determinants of ever having tested for HIV among youth and adults in South Africa from 2005-2017: results from four repeated cross-sectional nationally representative household-based HIV prevalence, incidence, and behaviour surveys. PLoS One 2020; 15: e0232883. doi: 10.1371/journal.pone.0232883.
55.
Fortenberry JD, Koenig LJ, Kapogiannis BG, Jeffries CL, Ellen JM, Wilson CM. Implementation of an integrated approach to the national HIV/AIDS strategy for improving human immunodeficiency virus care for youths. JAMA Pediatr 2017; 171: 687-693.
56.
Mathews C, Guttmacher SJ, Flisher AJ, et al. The quality of HIV testing services for adolescents in Cape Town, South Africa: do adolescent-friendly services make a difference? J Adolesc Health 2009; 44: 188-190.
57.
Mendelsohn AS, Gill K, Marcus R, et al. Sexual reproductive healthcare utilisation and HIV testing in an integrated adolescent youth centre clinic in Cape Town, South Africa. South Afr J HIV Med 2018; 19: 826. doi: 10.4102/sajhivmed.v19i1.826.
58.
Dessie DB. Investigating determinants of knowledge about HIV prevention among young in Ethiopia. World J Soc Sci 2020; 7: 46-55.
59.
Seid A, Ahmed M. What are the determinants of misconception about HIV transmission among ever-married women in Ethiopia? HIV/AIDS (Auckl) 2020; 12: 441-448.
Share
RELATED ARTICLE
| eISSN: | 1732-2707 |
| ISSN: | 1730-1270 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
