Low coverage of HIV testing among adolescents and young adults in Nigeria: Implication for achieving the UNAIDS first 95
Low coverage of HIV testing among adolescents and young adults in Nigeria: Implication for achieving the UNAIDS first 95
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DOI：
10.1371/journal.pone.0233368
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发表时间：
2020-05-19
期刊：
影响因子：
3.7
通讯作者：
Ushie, Boniface Ayanbekongshie
中科院分区：
文献类型：
--
作者：
Ajayi, Anthony Idowu;Awopegba, Oluwafemi Emmanuel;Ushie, Boniface Ayanbekongshie
背景大多数关于尼日利亚年轻人艾滋病毒检测的研究并不具有全国代表性。因此，最近具有全国代表性的数据，如多指标类集调查(MICS)，可帮助评估该国艾滋病毒预防的关键目标人群--青年中艾滋病毒检测的当前水平。在这项研究中，我们检查了青少年和青壮年(Aya)中HIV检测的覆盖率和相关因素。方法我们使用了14,312个AYA的数据，这些数据检查了2017年MCIS中最近和终身的HIV检测。我们感兴趣的结果曾经进行过艾滋病毒检测，最近也进行了艾滋病毒检测。我们使用调整和未调整的Logistic回归模型分析了社会人口因素(如年龄、婚姻状况、教育程度、财富状况)、耻辱信念、接触媒体和艾滋病毒知识与艾滋病毒检测的接受之间的关系。结果不到四分之一的Aya(23.7%)曾进行过HIV检测，在调查前一年进行过检测的比例更低(12.4%)。女性(25.4%)比男性(20.8%)更多的人曾检测过艾滋病毒。20-24岁(AOR 1.52，95%CI 1.34-1.72)、已婚(AOR 2.42，95%CI 1.98-2.97)、受教育程度较高(AOR 5.85，95%CI 4.39-7.81)、属于最富有的五分之一(AOR 1.99，95%CI 1.53-2.60)的年轻人，与15-19岁、未婚、未受过正规教育和属于最贫穷的五分之一的年轻人相比，进行过艾滋病毒检测的几率更高。对HIV感染者有正面污名信念的人(AOR 2.93，95%CI 2.47~3.49)，HIV知识较高(AOR 1.62，95%CI 1.24~2.11)，媒体暴露程度高(AOR 1.64，95%CI 1.36~1.97)，与有较多负面污名信念的人相比，进行过检测的几率更高。结论尼日利亚艾滋病检测覆盖率远低于国家艾滋病战略框架(2017-2021年)中95%的国家目标。此外，在这项研究中发现的低艾滋病毒检测率意味着实现联合国艾滋病规划署第一批95将需要针对Aya的干预。这些干预措施应侧重于提高年轻人对艾滋病毒的认识，通过媒体宣传活动减少负面污名观念，并通过以家庭为基础的检测和护理地点的“选择退出”战略增加艾滋病毒检测的机会。
BackgroundMost studies on HIV testing among young people in Nigeria are not nationally representative. As such, recent nationally representative data, such as the Multiple Indicator Cluster Survey (MICS), could help assess the current level of HIV testing among young people, a key target population for HIV prevention in the country. In this study, we examined the coverage and factors associated with HIV testing among adolescents and young adults (AYA).MethodsWe used the data for 14,312 AYA that examined recent and lifetime HIV testing from the 2017 MCIS. Our outcomes of interest were ever tested for HIV and recently tested for HIV. We examined the association between socio-demographic factors (e.g., age, marital status, education attainment, wealth status), stigma belief, exposure to media and HIV knowledge, and uptake of HIV testing using adjusted and unadjusted logistic regression models.ResultsLess than a quarter of the AYA (23.7%) had ever tested for HIV, and an even lower proportion (12.4%) tested in the year preceding the survey. More females (25.4%) compared to males (20.8%) had ever tested for HIV. Young people who were aged 20-24 years (AOR 1.52, 95% CI 1.34-1.72), married (AOR 2.42, 95% CI 1.98-2.97), had higher educational attainment (AOR 5.85, 95% CI 4.39-7.81), and belonged to the wealthiest quintile (AOR 1.99, 95% CI 1.53-2.60), had higher odds of having ever tested for HIV compared to those aged 15-19 years, never married, had no formal education and belonged to the poorest wealth quintile. Also, those who had positive stigma belief towards people living with HIV (AOR 2.93, 95% CI 2.47-3.49), had higher HIV knowledge (AOR 1.62, 95% CI 1.24-2.11), and higher media exposure (AOR 1.64, 95% CI 1.36-1.97), had higher odds of having ever tested compared to those who had more negative stigma belief, had low knowledge of HIV and low media exposure.ConclusionThe HIV testing coverage among AYA in Nigeria is well below the national target of 95% indicated in the national HIV/AIDS strategic framework (2017-2021). Also, the low rate of HIV testing found in this study means realising the UNAIDS first 95 will require interventions targeting AYA. These interventions should focus on improving young people's knowledge of HIV, reducing negative stigma belief through media campaigns and increasing access to HIV testing through home-based testing and "opt-out" strategy at the point of care.