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      Socio-ecological predictors of HIV testing in women of childbearing age in Nigeria

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          Abstract

          Introduction

          HIV remains a public health problem in Nigeria. Women within the age of 15 to 49 years, the childbearing age, have a prevalence rate of 1.9%, higher than that of their male counterparts of the same age group. Women can transmit HIV to their partners and their children. Nigeria accounts for 30% of global transmission of HIV from mother to child. Therefore, the study seeks to identify the socio-ecological predictors of HIV testing because HIV testing is the gateway to HIV prevention to achieve the sustainable development goal of zero new infections by the year 2030.

          Methods

          the study was a cross-sectional study, analyzing the 2013 Nigeria demographic and health survey data using SPSS V27.

          Results

          the result of the study indicated a higher odds ratio for good comprehensive knowledge of HIV (p<0.001, OR=3.81), good attitude to HIV (p<0.001, OR=2.50), and high perceived risk of HIV (p<0.001, OR=2.03). A low odds ratio was observed for good cultural belief despite the significance of the association (p<0.001, OR=0.83).

          Conclusion

          socio-ecological factors of HIV knowledge, attitude to HIV, perceived risk, and cultural belief were significant predictors of HIV testing in women of childbearing age. Programs targeted at women aged 15-19 years will enhance HIV testing as the gateway to HIV prevention and achieve the 95-95-95 target and zero new infections by 2030.

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          Most cited references15

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          Predictors of HIV Testing among Youth in Sub-Saharan Africa: A Cross-Sectional Study

          Introduction 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.
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            Antenatal care and uptake of HIV testing among pregnant women in sub-Saharan Africa: a cross-sectional study

            Introduction Current guidelines recommend inclusion of HIV testing in routine screening tests for all pregnant women. For this reason, antenatal care (ANC) represents a vital component of efforts to prevent mother-to-child transmission (PMTCT) of HIV. To elucidate the relationship between ANC services and HIV testing among pregnant women in sub-Saharan Africa, we undertook an analysis of data from four countries. Methods Four countries (Congo, Mozambique, Nigeria and Uganda) were purposively selected to represent unique geographical regions of sub-Saharan Africa. Using Demographic and Health Survey datasets, weighted crude and adjusted logistic regression models were used to explore factors that influenced HIV testing as part of ANC services. The study was approved by the Institutional Review Board of the University of Arizona. Results Pooled results showed that 60.7% of women received HIV testing as part of ANC. Ugandan women had the highest rate of HIV testing as part of ANC (81.5%) compared with women in Mozambique (69.4%), Nigeria (54.4%) and Congo (45.4%). Difficulty reaching a health facility was a barrier in Congo and Mozambique but not Nigeria or Uganda. HIV testing rates were lower in rural areas, among the poorest women, the least educated and those with limited knowledge of HIV. In every country, crude regression analyses showed higher odds of being tested for HIV if women received their ANC services from a skilled attendant compared with an unskilled attendant. After adjusting for confounders, women in the total sample had 1.78 (99% CI: 1.45–2.18) times the odds of having an HIV test as part of their ANC if they went to a skilled attendant compared with an unskilled attendant. Conclusions There is a need for integration of HIV testing into routine ANC service to increase opportunities for PMTCT programmes to reach HIV-positive pregnant women. Attention should be paid to the expansion of outreach services for women in rural settings, and to the training, supervision and integration of unskilled attendants into formal maternal and child health programmes. Education of pregnant women and their communities is needed to increase HIV knowledge and reduce HIV stigma.
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              HIV epidemiology in Nigeria

              Nigeria realizes the devastating effects of HIV/AIDS on its people, health, economic, and social progress fairly recently. This paper analyses descriptively the HIV epidemiology in Nigeria based on the sentinel surveillance system in place. Recently, it is estimated that about 3, 229, 757 people live with HIV in Nigeria and about 220, 393 new HIV infections occurred in 2013 and 210,031 died from AIDS related cases. People practicing low-risk sex are the driving force of HIV epidemic in Nigeria while the high risk groups involving female sex workers, men who have sex with men and injecting drug users contribute substantially to new infections. In conclusion, HIV prevalence among adults in Nigeria is relatively low (3.2%), yet Nigeria is an enormous country where HIV infection remains an issue that demands a systematic and highly tailored intervention.
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                Author and article information

                Contributors
                https://orcid.org/0000-0003-3849-6358
                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                23 February 2022
                2022
                : 41
                : 162
                Affiliations
                [1 ]461 Nigerian Airforce Hospital, Kaduna, Nigeria,
                [2 ]Kaduna State University, Kaduna, Nigeria
                Author notes
                [& ] Corresponding author: Hassana Bashir Yakasai, 461 Nigerian Airforce Hospital, Kaduna, Nigeria. hbyakasai@ 123456yahoo.com
                Article
                PAMJ-41-162
                10.11604/pamj.2022.41.162.30345
                9120744
                cac38e53-4fbd-40a7-a324-25b9637d46ff
                Copyright: Hassana Bashir Yakasai et al.

                The Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 14 June 2021
                : 06 February 2022
                Categories
                Research

                Medicine
                hiv testing,childbearing,women,hiv prevention,nigeria
                Medicine
                hiv testing, childbearing, women, hiv prevention, nigeria

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