title: Predictors of HIV Testing among Youth in Sub-Saharan Africa: A Cross-Sectional Study.
abstract: BACKGROUND
  In spite of a high prevalence of HIV infection among adolescents and young adults in sub-Saharan Africa, uptake of HIV testing and counseling among youth in the region remains sub-optimal. The objective of this study was to assess factors that influence uptake of HIV testing and counseling among youth aged 15-24 years in sub-Saharan Africa.
  
  
  METHODS
  This study used the Demographic and Health Survey (DHS) data from countries that represent four geographic regions of sub-Saharan Africa: Congo (Brazzaville), representing central Africa (DHS 2011-2012); Mozambique, representing southern Africa (DHS 2011); Nigeria, representing western Africa (DHS 2013); and Uganda, representing eastern Africa (DHS 2011). Analyses were restricted to 23,367 male and female respondents aged 15-24 years with complete data on the variables of interest. Chi-square tests and logistic regression models were used to assess predictors of HIV testing. Statistical significance was set at p< 0.01.
  
  
  RESULTS
  The analysis revealed that a majority of the respondents were female (78.1%) and aged 20-24-years (60.7%). Only a limited proportion of respondents (36.5%) had ever tested for HIV and even fewer (25.7%) demonstrated comprehensive knowledge of HIV/AIDS. There was a significant association between HIV testing and respondents' gender, age, age at sexual debut, and comprehensive knowledge of HIV in the pooled sample. Older youth (adjusted OR (aOR) = 2.19; 99% CI = 1.99-2.40) and those with comprehensive knowledge of HIV (aOR = 1.98; 1.76-2.22) had significantly higher odds of ever being tested for HIV than younger respondents and those with limited HIV/AIDS knowledge respectively. Furthermore, men had lower odds of HIV testing than women (aOR = 0.32; 0.28-0.37).
  
  
  CONCLUSIONS
  Reaching youth in sub-Saharan Africa for HIV testing continues to be a challenge. Public health programs that seek to increase HIV counseling and testing among youth should pay particular attention to efforts that target high-risk subpopulations of youth. The results further suggest that these initiatives would be strengthened by including strategies to increase HIV comprehensive knowledge.
authors.affiliation: Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Avenue, Tucson, Arizona, 85724, United States of America.
authors.forename: Ibitola O
authors.initials: IO
authors.lastname: Asaolu
authors.affiliation: Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Avenue, Tucson, Arizona, 85724, United States of America.
authors.forename: Jayleen K
authors.initials: JK
authors.lastname: Gunn
authors.affiliation: Department of Obstetrics and Gynecology, University of Arizona, 1501 N Campbell Ave, Tucson, Arizona, 85724, United States of America.
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Center
authors.affiliation: Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Avenue, Tucson, Arizona, 85724, United States of America.
authors.forename: Mary P
authors.initials: MP
authors.lastname: Koss
authors.affiliation: Department of Kinesiology and Community Health, University of Illinois at Urbana Champaign, 1206 S. 4th Street, Champaign, Illinois, 61820, United States of America.
authors.forename: Juliet I
authors.initials: JI
authors.lastname: Iwelunmor
authors.affiliation: Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Avenue, Tucson, Arizona, 85724, United States of America.
authors.forename: John E
authors.initials: JE
authors.lastname: Ehiri
mesh_terms: D000293:Adolescent; D017954:Africa South of the Sahara / Q000453:epidemiology; D003376:Counseling / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D055815:Young Adult