Prevalence and associated factors of HIV testing among reproductive-age women in eastern Africa: multilevel analysis of demographic and health surveys

Abstract

Abstract Background Despite efforts made to reduce the spread of the human immune-deficiency virus (HIV), its testing coverage remains low in low and middle-income countries (LMIC). Besides, information on factors associated with HIV counseling and testing among reproductive-age women is not sufficiently available. Therefore, this study was aimed to determine the pooled prevalence and factors associated with HIV testing among reproductive-age women in eastern Africa. Methods Secondary data analysis was conducted based on the Demographic and Health Surveys (DHS) data conducted in East African countries. We pooled the most recent DHS surveys done in 11 East African countries. A total weighted sample of 183,411 reproductive-age women was included for this study. Both bivariable and multivariable multilevel logistic regression models were fitted. Variables with a p-value ≤0.2 in the bivariable analysis were selected for multivariable analysis. Finally, in the multivariable analysis, variables with a p-value ≤0.05 were considered as significant factors affecting HIV testing. Results The pooled prevalence of HIV testing in eastern Africa was 66.92% (95%CI: 66.70, 67.13%). In the multivariable multilevel analysis factors such as the age of respondent, marital status, educational level, HIV knowledge, HIV stigma indicator, risky sexual behavior and women who visit a health facility were positively associated with HIV testing coverage among reproductive-age women. While women from rich and richest households, having multiple sexual partners, being from rural dwellers, late initiation of sex and higher community illiteracy level had a lower chance of being tested for HIV. Conclusion The pooled prevalence of HIV testing in eastern Africa was higher than most previous studies. Age of respondent, residence, wealth index, marital status, educational level, HIV knowledge, stigma indicator, risky sexual behavior, women who visit a health facility, multiple sexual partnerships, early initiation of sex and community illiteracy level were significantly associated with HIV testing. There should be an integrated strategic plan to give education about methods of HIV transmission and the implication of HIV testing and counseling. So all the stakeholders should have an integrated approach by giving special attention to the factors that hinder HIV testing to increase awareness regarding the benefit of HIV testing and counseling to control the spread of HIV/AIDS.

Keywords

• Multi-level analysis
• HIV/AIDS
• HIV testing
• Eastern Africa