背景:人类免疫缺陷病毒(HIV)是全球健康问题,造成三千五百多万人死亡,97%发生在发展中国家,特别影响撒哈拉以南非洲。虽然艾滋病毒检测对于早期治疗和预防至关重要,现有的研究往往集中在特定的群体,忽视一般成人检测率。这项研究旨在确定撒哈拉以南非洲成年人接受艾滋病毒检测的预测因素。
方法:数据来自官方人口与健康调查项目数据库,采用多级整群抽样技术收集调查数据。在这项研究中,纳入来自13个撒哈拉以南非洲国家的283,936名成年人的加权样本.采用多水平多变量逻辑回归分析来确定HIV检测吸收的预测因素。Akaike的信息标准指导模型选择。调整后的比值比和相应的95%置信区间确定了显著的预测变量。
结果:在撒哈拉以南非洲国家的成年人中,艾滋病毒检测的患病率为65.01%[95%CI(64.84%,65.17%)]。影响因素包括男性[AOR:0.51,95%CI(0.49,0.53)],不同年龄段的赔率比不同(20-24[AOR:3.3,95%CI(3.21,3.46)],25-29[AOR:4.4,95%CI(4.23,4.65)],30-34[AOR:4.6,95CI(4.40,4.87)],35-39[AOR:4.0,95CI(3.82,4.24)],40-44[AOR:3.7,95CI(3.50,3.91)],45-49[AOR:2.7,95CI(2.55,2.87)],50+[AOR:2.7,95CI(2.50,2.92)]),婚姻状况(已婚[AOR:3.3,95CI(3.16,3.46)],同居[AOR:3.1,95%CI(2.91,3.28)],丧偶/分居/离婚[AOR:3.4,95CI(3.22,3.63)]),女性家庭负责人(AOR:1.28,95CI(1.24,1.33)),教育水平(小学[AOR:3.9,95CI(3.72,4.07)],次要[AOR:5.4,95CI(5.16,5.74)],更高的[AOR:8.0,95CI(7.27,8.71)]),媒体曝光(AOR:1.4,95CI(1.32,1.43)),财富指数(中间[AOR:1.20,95CI(1.17,1.27)],更丰富的[AOR:1.50,95CI(1.45,1.62)]),对PLWHIV有歧视态度[AOR:0.4;95%CI(0.33,0.37)],有多个性伴侣[AOR:1.2;95%CI(1.11,1.28)],对艾滋病毒有全面的了解[AOR:1.6;95%CI(1.55,1.67)],农村住宅(AOR:1.4,95CI(1.28,1.45)),和较低的社区文盲率(AOR:1.4,95CI(1.31,1.50))显着影响了该地区的HIV检测吸收。
结论:本研究强调需要有针对性的干预措施,以解决撒哈拉以南非洲成年人在艾滋病毒检测方面的差异,并在2030年前实现95-95-95目标方面取得进展。因此,针对关键因素的量身定制的干预措施对于增强测试的可及性和强调提高认识运动至关重要,方便的服务访问,有针对性的教育工作,以改善早期诊断,治疗,以及该地区的艾滋病毒预防。
BACKGROUND: Human Immunodeficiency Virus (HIV) is a global health concern, causing over 35 million deaths, with 97% occurring in developing nations, particularly impacting Sub-Saharan Africa. While HIV testing is crucial for early treatment and prevention, existing research often focuses on specific groups, neglecting general adult testing rates. This study aims to identify predictors of HIV testing uptake among adults in Sub-Saharan Africa.
METHODS: Data were obtained from the official Demographic and Health Survey program database, which used a multistage cluster sampling technique to collect the survey data. In this study, a weighted sample of 283,936 adults was included from thirteen Sub-Saharan African countries. Multilevel multivariable logistic regression analysis was employed to identify predictors of HIV testing uptake. Akaike\'s information criteria guided model selection. Adjusted odds ratios and corresponding 95% confidence intervals determined significant predictor variables.
RESULTS: Among adults in Sub-Saharan African countries, the prevalence of HIV testing uptake was 65.01% [95% CI (64.84%, 65.17%)]. Influential factors included male sex [AOR: 0.51, 95% CI (0.49,0.53)], varying odds ratios across age groups (20-24 [AOR: 3.3, 95% CI (3.21, 3.46) ], 25-29 [AOR: 4.4, 95% CI (4.23, 4.65)], 30-34 [AOR: 4.6, 95%CI (4.40, 4.87)], 35-39 [AOR: 4.0, 95%CI (3.82, 4.24)], 40-44 [AOR: 3.7, 95%CI (3.50, 3.91)], 45-49 [AOR: 2.7, 95%CI (2.55, 2.87)], 50+ [AOR: 2.7, 95%CI (2.50, 2.92)]), marital status (married [AOR: 3.3, 95%CI (3.16, 3.46)], cohabiting [AOR: 3.1, 95% CI (2.91, 3.28)], widowed/separated/divorced [AOR: 3.4, 95%CI (3.22, 3.63)]), female household headship (AOR: 1.28, 95%CI (1.24, 1.33)), education levels (primary [AOR: 3.9, 95%CI (3.72, 4.07)], secondary [AOR: 5.4, 95%CI (5.16, 5.74)], higher [AOR: 8.0, 95%CI (7.27, 8.71)]), media exposure (AOR: 1.4, 95%CI (1.32, 1.43)), wealth index (middle [AOR: 1.20, 95%CI (1.17, 1.27)], richer [AOR: 1.50, 95%CI (1.45, 1.62)]), Having discriminatory attitudes towards PLWHIV [AOR: 0.4; 95% CI (0.33, 0.37)], had multiple sexual partners [AOR: 1.2; 95% CI (1.11, 1.28)], had comprehensive knowledge about HIV [AOR: 1.6; 95% CI (1.55, 1.67)], rural residence (AOR: 1.4, 95%CI (1.28, 1.45)), and lower community illiteracy (AOR: 1.4, 95%CI (1.31, 1.50)) significantly influenced HIV testing uptake in the region.
CONCLUSIONS: This study highlights the need for tailored interventions to address disparities in HIV testing uptake among adults in Sub-Saharan Africa and progress towards the achievement of 95-95-95 targets by 2030. Thus, tailored interventions addressing key factors are crucial for enhancing testing accessibility and emphasizing awareness campaigns, easy service access, and targeted education efforts to improve early diagnosis, treatment, and HIV prevention in the region.