Predictors of HIV Testing among Orphaned Youths in Three East African Countries
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ORIGINAL PAPER
Predictors of HIV Testing among Orphaned Youths in Three East African Countries Allison Pack1,8 · Suzanne Maman1 · Heathe Luz McNaughton Reyes1 · Laura Nyblade2 · Kathryn Whetten3,4,5 · Catherine Zimmer6 · Christine L. Gray3,4 · Carol Golin1,7 Accepted: 11 November 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract In parts of sub-Saharan Africa, where HIV prevalence is high, HIV is a leading cause of death among youths. Orphaned and separated youths are an especially vulnerable group, yet we know little about what influences their testing behavior. We conducted multiple logistical regression to examine theory-based predictors of past-year HIV testing among 423 orphaned and separated youths in Ethiopia, Kenya and Tanzania. We also conducted moderation, assessing whether predictors varied by sex. Over one-third of our sample reported past-year HIV testing. Those with greater perceived social support and those who reported sexual HIV risk behavior were more likely to report past-year testing. Furthermore, boys who reported ever previously testing for HIV were more likely, a year later, to report past-year HIV testing. In conclusion, our findings have important implications for intervention development, including the potential for enhanced perceived social support to positively influence HIV testing among orphaned and separated youths. Keywords HIV testing · Orphans · Youths · Sub-saharan africa
Introduction * Allison Pack [email protected] 1
Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
2
Global Health Division, RTI International, Washington, D.C, USA
3
Duke Global Health Institute, Duke University, Durham, NC, USA
4
Duke Global Health Institute, Center for Health Policy and Inequalities Research, Duke University, Durham, NC, USA
5
Sanford School of Public Policy, Duke University, Durham, NC, USA
6
Odum Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
7
Division of General Medicine and Epidemiology, Department of Medicine, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
8
Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, 302 Rosenau Hall, CB #7440, Chapel Hill, NC 27599‑7440, USA
HIV is a leading cause of death among youths, particularly in parts of sub-Saharan Africa (SSA) where the prevalence of HIV is high [1, 2]. To combat the virus, global efforts are focused on achieving 90-90-90 targets for the HIV treatment cascade, such that, in 2020: 90% of individuals living with HIV will know their status; 90% of those who know their status will receive antiretroviral treatment (ART); and 90% of those receiving ART will achieve viral suppression [3]. HIV testing is the critical first step in this treatment cascade. It is also a key strategy for HIV prevention, with evidence demonstrating that HIV testing leads to risk
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