Unlocking Self-Testing: Predictors of HIV Self-Testing Kit Use Among Reproductive-Aged Women in Tanzania; A Multilevel Analysis of the 2022 Demographic and Health Survey

Background The introduction of HIV self-test (HIVST) kits offered a significant advancement in fighting HIV/AIDS, particularly for vulnerable populations. Despite its potential, self-testing uptake varies. In Tanzania, where HIV prevalence among women remains a concern, this study aimed to identify the socio-demographic and behavioural predictors of self-testing for effective prevention. Methods We conducted a cross-sectional analysis using data from the 2022 Tanzania Demographic and Health Survey. Data management and analysis were performed using Stata 18.5. Given the survey’s complex design, a multilevel mixed-effect logistic regression model was used to identify predictors of HIVST kit use, with results presented as adjusted odds ratios (AORs) and 95% confidence intervals (CIs). Statistical significance was set at p < 0.05. Results The prevalence of HIVST kit usage among women of reproductive age in Tanzania was 3.2% (95% CI: 2.8–3.7%). Individual-level factors associated with a higher likelihood of HIV self-test kit use included age, 25–34 (AOR = 1.93, 95%CI: 1.43–2.60) and 35–49 (AOR = 1.60, 95%CI:1.43–2.26), secondary/higher education (AOR = 2.77, 95%CI: 1.57–4.85), belonging to the rich wealth quintile (AOR = 2.69, 95%CI: 1.52–4.77), internet use (AOR = 3.04, 95%CI: 2.04–4.52), awareness of sexually transmitted infections (STIs) (AOR = 2.03, 95%CI: 1.21–3.42), and one or higher number of sexual partners. At the community level, geographical zone was associated with increased odds of use, while living in a high-poverty community (AOR = 0.52, 95%CI: 0.30–0.89) was associated with a lower likelihood of HIV self-test kit use. Conclusion This study reveals a low uptake of HIVST kits among women of reproductive age in Tanzania, highlighting the influence of both individual-level factors, such as age, education, wealth, internet access, STI awareness, and sexual behaviours, as well as community-level factors like geographical zone and community poverty. These findings underscore the importance of considering both individual characteristics and the broader community context when designing targeted interventions to promote HIVST kits.