Abstract:

The HIV prevalence in the Zimbabwean population aged 15-49 years remains high at 15.2%. Most adolescents do not know their HIV status. This is despite knowing a place to get tested. We determined the prevalence and correlates of HIV testing and counseling (HCT) among sexually active adolescents and young adults in Harare City.

We conducted a cross-sectional study among sexually active adolescents and young adults. Data were collected using a pretested self-administered questionnaire. Epi-Info 7 was used to capture and analyze data for frequencies, odds ratios and their corresponding 95% confidence intervals. Chi-square tests and logistic regression models were used to assess independent correlates of HIV testing. Statistical significance was set at p< 0.01.

A total of 427 adolescents and young adults were recruited. The majority (56.9%) were female. The overall prevalence of HIV testing among participants was 56.4%. On multivariate analysis, knowing a facility that offers HIV testing [aOR=5.05; 95%CI (2.55-10.00)], reporting being involved in a sexual relationship with one’s partner [aOR=3.24; 95%CI (1.67-6.30)], being afraid of a positive result [aOR=0.07;95%CI(0.01-0.30)]and being male [aOR=0.43;95%CI(0.23-0.80)]were independent correlates of HCT among adolescents and young adults in Harare City.

Although comparable to other settings in Sub-Saharan Africa, HIV testing among adolescents and young adults in Harare City is still considered very low. Interventions should therefore aim at raising awareness on the importance of HIV testing. In addition city authorities should consider addressing barriers for HCT observed in this study including fear of living with a positive result.

Keywords: Adolescents, HIV Testing, Correlates, Prevalence, Harare City.

References:

[1]. Addis, Z., Yalew, A., Shiferaw, Y., Alemu, A., Birhan, W., Mathewose, B., & Tachebele, B. (2013). Knowledge, attitude and practice towards voluntary counseling and testing among university students in North West Ethiopia: a cross sectional study. BMC Public Health, 13, 714. https://doi.org/10.1186/1471-2458-13-714.

[2]. Baltazar, G. M et al. (2001) AIDS in Kenya: Background, Projections, Impact, Interventions and Policy, eds. 6th Ed, Nairobi, AIDS Control Unit of Ministry Of Health and National AIDS Control Council.

[3]. Bekker, L.-G., & Hosek, S. (2015). HIV and adolescents: focus on young key populations. Journal of the International AIDS Society, 18(2Suppl 1). https://doi.org/10.7448/IAS.18.2.20076.

[4]. CDC. Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings. (2006). Retrieved February 7, 2018, from https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5514a1.htm

[5]. Dirar, A., Mengiste, B., Kedir, H., & Godana, W. (2014). Factors Contributing to Voluntary Counseling and Testing Uptake among Youth in Colleges of Harar, Ethiopia. Science Journal of Public Health, 1(2), 91. https://doi.org/10.11648/j.sjph.20130102.17.

[6]. Fact sheet on adolescent health. Geneva: WHO (2014). Retrieved May 18, 2016, from

http://www.unaids.org/en/media/unaids/contentass

[7]. Glynn, J. R., Caraël, M., Auvert, B., Kahindo, M., Chege, J., Musonda, R. … Study Group on the Heterogeneity of HIV Epidemics in African Cities. (2001). Why do young women have a much higher prevalence of HIV than young men? A study in Kisumu, Kenya and Ndola, Zambia. AIDS (London, England), 15 Suppl 4, S51-60.

[8]. Inungu, J., Lewis, A., Younis, M. Z., Wood, J., O’Brien, S., & Verdun, D. (2011). HIV Testing among Adolescents and Youth in the United States: Update from the 2009 Behavioral Risk Factor Surveillance System. The Open AIDS Journal, 5, 80–85. http://doi.org/10.2174/1874613601105010080.

[9]. Joint United Nations Programme on HIV/AIDS (UNAIDS). Global AIDS Response Progress. Reporting 2014: Construction of Core Indicators for Monitoring the 2011 UN Political Declaration on HIV and AIDS. Geneva, Switzerland: UNAIDS; 2014.

[10].  Kabiru, C. W., Beguy, D., Crichton, J., & Zulu, E. M. (2011). HIV/AIDS among youth in urban informal (slum) settlements in Kenya: what are the correlates of and motivations for HIV testing? BMC Public Health, 11, 685. https://doi.org/10.1186/1471-2458-11-685.

[11].  Leta, T. H., Sandøy, I. F., & Fylkesnes, K. (2012). Factors affecting voluntary HIV counselling and testing among men in Ethiopia: a cross-sectional survey. BMC Public Health, 12, 438. https://doi.org/10.1186/1471-2458-12-438.

[12].  Lindberg, C., Lewis-Spruill, C., & Crownover, R. (2006). Barriers to sexual and reproductive health care: urban male adolescents speak out. Issues in Comprehensive Pediatric Nursing, 29(2), 73–88. https://doi.org/10.1080/01460860600677577.

[13].  Lopez-Quintero, C., Shtarkshall, R., & Neumark, Y. D. (2005). Barriers to HIV-testing among Hispanics in the United States: analysis of the National Health Interview Survey, 2000. AIDS Patient Care and STDs, 19(10), 672–683. https://doi.org/10.1089/apc.2005.19.672.

[14].  MOHCC- Zimbabwe National Guidelines for HIV Testing and Counselling in Children and Adolescents (2014). Retrieved January 13, 2018, from https://aidsfree.usaid.gov/sites/default/files/hts_zimbabwe_2014.pdf.

[15]. Musumari, P. M., Tangmunkongvorakul, A., Srithanaviboonchai, K., Yungyuankul, S., Techasrivichien, T., Suguimoto, S. P., … Chariyalertsak, S. (2016). Prevalence and Correlates of HIV Testing among Young People Enrolled in Non-Formal Education Centers in Urban Chiang Mai, Thailand: A Cross-Sectional Study. PLOS ONE, 11(4), e0153452. https://doi.org/10.1371/journal.pone.0153452.

[16].  Njagi, F., & Maharaj, P. (2006). Access to voluntary counselling and testing services: Perspectives of young people. South African Review of Sociology, 37(2), 113–127. https://doi.org/10.1080/21528586.2006.10419150.

[17].  Peltzer, K., & Matseke, G. (2013). Determinants of HIV testing among young people aged 18 – 24 years in South Africa. African Health Sciences, 13(4), 1012–1020. https://doi.org/10.4314/ahs.v13i4.22.

[18].  Strauss, M., Rhodes, B., & George, G. (2015). A qualitative analysis of the barriers and facilitators of HIV counselling and testing perceived by adolescents in South Africa. BMC Health Services Research, 15(1), 250. https://doi.org/10.1186/s12913-015-0922-0.

[19]. Swenson, R. R., Rizzo, C. J., Brown, L. K., Payne, N., DiClemente, R. J., Salazar, L. F., … Hennessy, M. (2009). Prevalence and Correlates of HIV Testing among Sexually Active African American Adolescents in Four U.S. Cities. Sexually Transmitted Diseases, 36(9), 584–591. https://doi.org/10.1097/OLQ.0b013e3181b4704c.

[20].  Takarinda, K. C., Madyira, L. K., Mhangara, M., Makaza, V., Maphosa-Mutsaka, M., Rusakaniko, S., … Harries, A. D. (2016). Factors Associated with Ever Being HIV-Tested in Zimbabwe: An Extended Analysis of the Zimbabwe Demographic and Health Survey (2010–2011). PLOS ONE, 11(1), e0147828. https://doi.org/10.1371/journal.pone.0147828.

[21].  UNAIDS Fast track strategy to end AIDS epidemic by 2030, UNAIDS,(2014).Retrieved December 15, 2014, from http://www.unaids.org/en/resources/campaigns/World-AIDS-Day-Report-2014.

[22].  UNAIDS- The gap report (July 2014). Retrived January 13, 2018, from

http://files.unaids.org/en/media/unaids/contentassets/documents/unaidspublication/2014/UNAIDS_Gap_report_en.pdf.

[23].  UNGASS- Zimbabwe Global Aids Response Progress Report (2014). Retrieved January 13, 2018, from http://files.unaids.org/en/dataanalysis/knowyourresponse/countryprogressreports/2014countries/ZWE_narrative_report_2014.pdf.

[24].  UNICEF- Analysis of UNAIDS2012 HIV and AIDS Estimates (2013). Retrieved January 13, 2018, from United Nations. United Nations General Assembly (UNGASS) Report: Jan 2006-Dec 2007. United Nations, New York; 2008.

[25]. United Nations General Assembly: country report on the follow up to the declaration of commitment on HIV/AIDS. Reporting period 2006–2007. National Aids Control Program. Pakistan [Internet]. 2008 [cited 18/5/16].:http://aidsdatahub.org/dmdocuments/pakistanUNGASSReport2008.pdf.

[26]. Varga, C. A. (2001). The forgotten fifty per cent: a review of sexual and reproductive health research and programs focused on boys and young men in sub-Saharan Africa. African Journal of Reproductive Health, 5(3), 175–195.

[27].  WHO. HIV/AIDS fact sheet. (June, 21, 2015). Retrieved July, 21, 2015, from

http://www.who.int/mediacentre/factsheets/fs360/en/