Uptake of facility-based HIV testing among adolescents and young adults in Nigeria

Kadija M. Tahlil, Department of Epidemiology, Gillings School of Global Public Health.
Audrey E. Pettifor, Department of Epidemiology, Gillings School of Global Public Health.
Jessie K. Edwards, Department of Epidemiology, Gillings School of Global Public Health.
Weiming Tang, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Daniel Westreich, Department of Epidemiology, Gillings School of Global Public Health.
Titi Gbajabiamila, Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria.
Hong Xian, Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, St. Louis University, St. Louis, Missouri.
Ucheoma Nwaozuru, Department of Implementation Science, Wake Forest School of Medicine, Winston-Salem.
Suzanne Day, Department of Medicine, Division of Infectious Diseases.
Sonam J. Shah, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Nora E. Rosenberg, Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
David Oladele, Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria.
Adesola Z. Musa, Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria.
Lateef A. Blessing, Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria.
Ponmile Ogunjemite, Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria.
Donaldson F. Conserve, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia.
Temitope Ojo, Division of Infectious Diseases, John T. Milliken Department of Internal Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri.
Gbenga Ogedegbe, Institute for Excellence in Health Equity, New York University Grossman School of Medicine, New York, New York, USA.
Oliver Ezechi, Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria.
Juliet Iwelunmor, Division of Infectious Diseases, John T. Milliken Department of Internal Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri.
Joseph D. Tucker, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

Document Type

Journal Article

Publication Date

11-12-2025

Journal

AIDS (London, England)

DOI

10.1097/QAD.0000000000004393

Keywords

HIV; HIV testing; Nigeria; adolescent; young adult

Abstract

OBJECTIVE: In Nigeria, adolescents and young adults (AYA) who engage in multiple sexual partnerships, transactional sex, and needle-sharing are eligible for preexposure prophylaxis (PrEP) and are prioritized for HIV testing. AYA with PrEP-eligible behaviors should be using facility-based HIV testing services. We examined associations between these behaviors and facility-based HIV testing among AYA aged 14-24 years. DESIGN: A longitudinal analysis of a stepped-wedge trial. METHODS: Using Innovative Tools to Expand Youth-friendly HIV Self-Testing (I-TEST) data, we fit generalized linear models using generalized estimating equations. We used a two-stage weighted approach to generalize I-TEST estimates to all AYA in Nigeria. RESULTS: Of 1429 trial participants, the median age was 20 years (IQR: 18-22), 50.3% were female, and 69.4% reported secondary education as highest level of education completed. Recent facility-based HIV testing uptake was higher among AYA with one [unadjusted risk difference: 11.7%, 95% confidence interval (95% CI): 8.1-15.2], two [11% (5.3, 16.8)], and three or more sexual partners in the past 3 months [17.3% (10.5, 24)], compared to AYA with no recent sexual partners. AYA who engaged in transactional sex had higher facility-based testing uptake [14.7% (9.8, 19.5)] than AYA who never engaged in transactional sex. AYA who shared needles had lower facility-based testing uptake [-3.3% (-6.7, 0.2)] than AYA with no needle-sharing history. The trial and generalized estimates were in the same direction. CONCLUSION: While facility-based testing may reach AYA who engaged in multiple sexual partnerships or transactional sex, AYA who shared needles may require more tailored HIV testing approaches.

Department

Prevention and Community Health

Link to Full Text

Share

COinS