Prevalence and factors associated with HIV testing among Young People in Wakiso District, Uganda

Abstract

Background HIV testing is the entry point for all HIV related care and treatment and reducing new infections but 30% of all new HIV infections occur among young people (15-24 years). HIV testing among young people in Uganda is low implying high level of unawareness of 30% despite recent progress in enhancing the accessibility of HIV-related health services. Opportunities to diagnose young people are often missed due to genuine barriers at different levels and little has been known about HIV testing among young people in an HIV prevalent and Uganda’s densely populated district of Wakiso. Objective: To determine the prevalence, factors associated, barriers and facilitators of HIV testing among young people in Wakiso district. Methods: We conducted a sequential mixed-methods study among 646 young people aged 15-24 years resident in two sub-counties of Wakiso district from March to May 2019. Data collected by questionnaires were entered into EPI-DATA manager version 4.4 and analyzed in STATA version 14. The main outcome was ever testing for HIV while its factors associated were analyzed using a modified Poisson regression model with a 5% significance level. Audio recordings from 16 purposively selected in-depth interviews were transcribed and analyzed using a content thematic approach to identify the barriers and facilitators. Results: A total of 650 young people participated in the qualitative and of which 16 participated in the quantitative part. The prevalence of ever testing for HIV was 80.2% (95%CI: 76.9-83.1%) while the prevalence of HIV testing in the last one year was 75.0% (95%CI: 71.1-78.6%). Female sex, older age, ever married, sexual encounter, short distances to the nearest testing site, willingness to test for HIV, having peers who encourage and youth-friendly HIV testing services were associated with testing for HIV among young people in Wakiso district with several individuals, community and health services barriers and facilitators of HIV testing. Conclusion: The prevalence of HIV testing (80%) among young people in Wakiso district is lower than 90% target although it was higher than the national average (70%). A big number had never tested for HIV which presents a significant challenge to the epidemic control of HIV. Unawareness is likely to be even higher than 20% because even among those who have ever tested, some were not sure about their current status therefore HIV community outreaches should specifically target young people.