Spatial distribution and factors associated with HIV testing among adolescent girls and young women in Sierra Leone

Abstract Background Sierra Leone faces a significant challenge in addressing HIV/AIDS, particularly among adolescent girls and young women. This age group is considered highly vulnerable due to biological factors and social inequalities. Understanding the prevalence of HIV testing in this demographi...

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Main Authors: Augustus Osborne, Camilla Bangura, Samuel Maxwell Tom Williams, Alusine H. Koroma, Lovel Fornah, Regina M. Yillah, Bright Opoku Ahinkorah
Format: Article
Language:English
Published: BMC 2024-10-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-024-10031-w
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author Augustus Osborne
Camilla Bangura
Samuel Maxwell Tom Williams
Alusine H. Koroma
Lovel Fornah
Regina M. Yillah
Bright Opoku Ahinkorah
author_facet Augustus Osborne
Camilla Bangura
Samuel Maxwell Tom Williams
Alusine H. Koroma
Lovel Fornah
Regina M. Yillah
Bright Opoku Ahinkorah
author_sort Augustus Osborne
collection DOAJ
description Abstract Background Sierra Leone faces a significant challenge in addressing HIV/AIDS, particularly among adolescent girls and young women. This age group is considered highly vulnerable due to biological factors and social inequalities. Understanding the prevalence of HIV testing in this demographic is crucial for designing effective prevention and treatment strategies. This study investigated the spatial distribution of HIV testing and its associated factors among adolescent girls and young women in Sierra Leone. Methods Data from the 2019 Sierra Leone Demographic and Health Survey was used for the study. The sample comprised 6,062 adolescent girls and young women between the ages of 15 and 24. Spatial autocorrelation and Moran’s I statistic were employed to analyze the spatial distribution of HIV testing. An analysis utilising mixed-effect multilevel binary logistic regression was performed to determine the factors associated with HIV testing. The findings were presented as adjusted odds ratios (aOR) and a 95% confidence interval (CI). Results The national prevalence of HIV testing among adolescents and young women in Sierra Leone was 42.1% [40.3,43.9]. Kailahun, Kambia, Tonkolil, some parts of the Western rural area, and Bonthe districts were found to be statistically significant hotspot for HIV testing. Whereas, Karene, Falaba, Bo, kenema, and some parts of Pujuhun were statistically cold spot districts. Adolescent girls and young women aged 20–24 [aOR = 1.63, 95% CI = 1.29, 2.07] had higher odds of HIV testing than those aged 15–19. Those with secondary/higher education [aOR = 1.87, 95% CI = 1.40, 2.51] had higher odds of HIV testing than those with no education. The odds of HIV testing was higher among adolescent girls and young women who use the Internet [aOR = 1.75, 95% CI = 1.32, 2.33] than those who did not use internet. Adolescent girls and young women with one [aOR = 16.56, 95% CI = 12.31, 22.29] and two or more parity [aOR = 16.37, 95% CI = 10.86, 24.68] had higher odds of HIV testing than those with no parity. The likelihood of HIV testing was higher among adolescent girls and young women who had sex below 18 [aOR = 4.54, 95% CI = 3.25, 6.34] and those who had sex at 18+ [aOR = 5.70, 95% CI = 3.84, 8.45] compared to those who had never had sex. Adolescent girls and young women who visited health facilities in the past 12 months [aOR = 1.82, 95% CI = 1.46, 2.26] had higher odds of HIV testing than those who did not. Conclusion Despite some positive trends, HIV testing rates among adolescent girls and young women in Sierra Leone remain moderate. Spatial autocorrelation analysis consistently revealed hotspots and cold spots for HIV testing, with Kailahun, Kambia, Tonkolil, some parts of the Western rural area, and Bonthe districts remaining persistent hotspots. Age, education, internet use, sexual history, parity, and healthcare access are significant factors influencing testing behaviour. To improve testing rates, the government and policymakers should prioritize educational campaigns, expand internet access, integrate HIV testing into routine healthcare, and address stigma associated with HIV.
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spelling doaj-art-1446a3ca0d24423d8903ea8ea838d5fe2025-08-20T02:11:24ZengBMCBMC Infectious Diseases1471-23342024-10-0124111410.1186/s12879-024-10031-wSpatial distribution and factors associated with HIV testing among adolescent girls and young women in Sierra LeoneAugustus Osborne0Camilla Bangura1Samuel Maxwell Tom Williams2Alusine H. Koroma3Lovel Fornah4Regina M. Yillah5Bright Opoku Ahinkorah6Department of Biological Sciences, School of Basic Sciences, Njala UniversityDepartment of Biological Sciences, School of Basic Sciences, Njala UniversityDepartment of Biological Sciences, School of Basic Sciences, Njala UniversityDepartment of Biological Sciences, School of Basic Sciences, Njala UniversityDepartment of Public Health, Ernest Bai Koroma University of Science and TechnologyInstitute for DevelopmentREMS Consultancy Services LimitedAbstract Background Sierra Leone faces a significant challenge in addressing HIV/AIDS, particularly among adolescent girls and young women. This age group is considered highly vulnerable due to biological factors and social inequalities. Understanding the prevalence of HIV testing in this demographic is crucial for designing effective prevention and treatment strategies. This study investigated the spatial distribution of HIV testing and its associated factors among adolescent girls and young women in Sierra Leone. Methods Data from the 2019 Sierra Leone Demographic and Health Survey was used for the study. The sample comprised 6,062 adolescent girls and young women between the ages of 15 and 24. Spatial autocorrelation and Moran’s I statistic were employed to analyze the spatial distribution of HIV testing. An analysis utilising mixed-effect multilevel binary logistic regression was performed to determine the factors associated with HIV testing. The findings were presented as adjusted odds ratios (aOR) and a 95% confidence interval (CI). Results The national prevalence of HIV testing among adolescents and young women in Sierra Leone was 42.1% [40.3,43.9]. Kailahun, Kambia, Tonkolil, some parts of the Western rural area, and Bonthe districts were found to be statistically significant hotspot for HIV testing. Whereas, Karene, Falaba, Bo, kenema, and some parts of Pujuhun were statistically cold spot districts. Adolescent girls and young women aged 20–24 [aOR = 1.63, 95% CI = 1.29, 2.07] had higher odds of HIV testing than those aged 15–19. Those with secondary/higher education [aOR = 1.87, 95% CI = 1.40, 2.51] had higher odds of HIV testing than those with no education. The odds of HIV testing was higher among adolescent girls and young women who use the Internet [aOR = 1.75, 95% CI = 1.32, 2.33] than those who did not use internet. Adolescent girls and young women with one [aOR = 16.56, 95% CI = 12.31, 22.29] and two or more parity [aOR = 16.37, 95% CI = 10.86, 24.68] had higher odds of HIV testing than those with no parity. The likelihood of HIV testing was higher among adolescent girls and young women who had sex below 18 [aOR = 4.54, 95% CI = 3.25, 6.34] and those who had sex at 18+ [aOR = 5.70, 95% CI = 3.84, 8.45] compared to those who had never had sex. Adolescent girls and young women who visited health facilities in the past 12 months [aOR = 1.82, 95% CI = 1.46, 2.26] had higher odds of HIV testing than those who did not. Conclusion Despite some positive trends, HIV testing rates among adolescent girls and young women in Sierra Leone remain moderate. Spatial autocorrelation analysis consistently revealed hotspots and cold spots for HIV testing, with Kailahun, Kambia, Tonkolil, some parts of the Western rural area, and Bonthe districts remaining persistent hotspots. Age, education, internet use, sexual history, parity, and healthcare access are significant factors influencing testing behaviour. To improve testing rates, the government and policymakers should prioritize educational campaigns, expand internet access, integrate HIV testing into routine healthcare, and address stigma associated with HIV.https://doi.org/10.1186/s12879-024-10031-wHIVTestingAGYWSierra LeonePublic Health
spellingShingle Augustus Osborne
Camilla Bangura
Samuel Maxwell Tom Williams
Alusine H. Koroma
Lovel Fornah
Regina M. Yillah
Bright Opoku Ahinkorah
Spatial distribution and factors associated with HIV testing among adolescent girls and young women in Sierra Leone
BMC Infectious Diseases
HIV
Testing
AGYW
Sierra Leone
Public Health
title Spatial distribution and factors associated with HIV testing among adolescent girls and young women in Sierra Leone
title_full Spatial distribution and factors associated with HIV testing among adolescent girls and young women in Sierra Leone
title_fullStr Spatial distribution and factors associated with HIV testing among adolescent girls and young women in Sierra Leone
title_full_unstemmed Spatial distribution and factors associated with HIV testing among adolescent girls and young women in Sierra Leone
title_short Spatial distribution and factors associated with HIV testing among adolescent girls and young women in Sierra Leone
title_sort spatial distribution and factors associated with hiv testing among adolescent girls and young women in sierra leone
topic HIV
Testing
AGYW
Sierra Leone
Public Health
url https://doi.org/10.1186/s12879-024-10031-w
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