"Factors associated with HIV self-testing and PrEP use among Nigerian y" by Juliet Iwelunmor, Ebenezer Adeoti et al.
 

Factors associated with HIV self-testing and PrEP use among Nigerian youth: Baseline outcomes of a pragmatic, stepped-wedge, cluster-randomized controlled trial

Juliet Iwelunmor, Division of Infectious Diseases, Washington University School of Medicine, Saint Louis, MO, USA. Electronic address: ijuliet@wustl.edu.
Ebenezer Adeoti, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, USA.
Titilola Gbaja-Biamila, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, USA; Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria.
Ucheoma Nwaozuru, Department of Implementation Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Chisom Obiezu-Umeh, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, USA.
Adesola Z. Musa, Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria.
Hong Xian, Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria.
Weiming Tang, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
David Oladele, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, USA; Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria.
Collins O. Airhihenbuwa, Heath Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA.
Nora Rosenberg, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Donaldson F. Conserve, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
Franklin Yates, Maternal and Pediatric Infectious Diseases Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
Temitope Ojo, Division of Infectious Diseases, Washington University School of Medicine, Saint Louis, MO, USA.
Oliver Ezechi, Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria.
Joseph D. Tucker, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.

Document Type

Journal Article

Publication Date

11-13-2024

Journal

Contemporary clinical trials

DOI

10.1016/j.cct.2024.107733

Keywords

Adolescent and young adult; HIV prevention; Nigeria; Sexually transmitted infections

Abstract

INTRODUCTION: Adolescents and young adults (AYA, 14-24 years) bear a disproportionate burden of new HIV infections in Nigeria and are more likely to have worse HIV outcomes compared to other age groups. However, little is known about their access to recommended sexual health care services, including HIV self-testing (HIVST), sexually transmitted infections (STI) testing, sexual behavior patterns, awareness and or access to pre-exposure prophylaxis (PrEP), and overall risk for HIV. METHODS: We present a baseline analysis of the 4 Youth by Youth randomized controlled trial aimed to evaluate the uptake and sustainability of crowdsourced HIVST strategies led by and for young people across 14 states in Nigeria. None of the participants had received intervention at the time of completing this self-reported behavioral survey. We conducted a descriptive analysis to summarize participants' characteristics, sexual behavior, HIV testing, STI testing, and knowledge of PrEP and use across the study sample of the AYAs. We conducted a chi-square test, and the level of significance was set at ≤0.05. RESULTS: A total of 1551 participants completed the baseline survey comprising males (777, 50.1 %) and females (774, 49.9 %). The majority (77 %) of the participants were students at enrollment. Very few of the participants had ever tested for syphilis, 47 (3.1 %), gonorrhea, 49 (3.2 %), chlamydia, 31 (2.0 %), and hepatitis B, 106 (6.9 %). 678 (43.8 %) of the participants reported to be sexually active at the time of enrolment into the study, of which about 38 % of them engaged in condomless sex. Paying for sex, alcohol use, and drug use are all significant sexual behaviors (p < 0.01). Only 14 (1 %) have ever used PrEP. 481 (31.4 %) have ever tested for HIV, and 104 (6.8 %) have ever used an HIV self-testing kit at baseline. 457 (38.6 %) were eligible for PrEP. CONCLUSIONS: HIVST and STI uptake were low at baseline among the AYA in this study. Most AYAs also do not receive recommended sexual health care services, including STI testing services. This underlines the need for interventions to increase the uptake of HIV/STI prevention services among Nigerian AYA.

Department

Prevention and Community Health

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