Comparing HIV Testing Patterns Among Adolescent Girls, Young Women, and Older Women in Nigeria: A Comparative Analysis and Socioecological Correlates
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Background
HIV testing is a key entry point for prevention and treatment in Nigeria, yet age-related disparities persist. Adolescent girls and young women (AGYW) are disproportionately affected by HIV but often demonstrate lower uptake of testing services. This study examined differences in HIV self-testing awareness, use, and antenatal HIV testing between AGYW and older women, the distribution of HIV testing service uptake, and identified multilevel factors associated with HIV self-test awareness and testing among AGYW.
Methods
This study analyzed cross-sectional data from the 2023-2024 Nigeria Demographic and Health Survey (NDHS), including women aged 15–49 years. Descriptive statistics were used to assess differences in HIV self-testing awareness, use, antenatal HIV testing, and place of HIV testing between Adolescent Girls and Young Women (AGYW) (15–24 years) and older women (25–49 years). Among AGYW, bivariate and multivariate logistic regression were conducted to identify socioecological factors associated with HIV self-testing, awareness and use.
Results
A total of 14,708 AGYW and 24,342 older women were included in the analysis. The median age of AGYW was 19 years (IQR: 17–22), compared to 35 years (IQR: 25–41) among older women. Older women reported significantly higher awareness of HIV self-testing (13.1%) compared to AGYW (8.8%). Use of the HIV self-testing kit was low overall but higher among older women (2.3%) than among AGYW (1.1%). Older women reported greater uptake of antenatal HIV testing (57.9%) than AGYW (48.4%). Education, wealth, and internet use were positively associated with awareness, while AGYW aged 15–19 had significantly lower odds of awareness than AGYW women aged 20-24. Regional disparities were also observed in the awareness and use of HIV self-test kits.
Conclusions
Findings support that targeted, AGYW-centred strategies are needed to improve equitable access to HIV testing and achieve national and global HIV prevention goals.
