Published in PLOS One on 2026-06-26, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Gabalape Arnold Sejie, Thato Lebang, Gosego Ngole, Onneile Dichabe, Merapelo Selwane, Oratile Marapo, Kefilwe Madikwe, Goratang Malgas, Tumelo Ikaneng
Source: PLOS One • DOI 10.1371/journal.pone.0352165
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
HIV represents a significant public health challenge, contributing to increased mortality and morbidity in developing countries, particularly Sub-Saharan Africa. While HIV testing is crucial for early treatment and prevention, the uptake of the HIV testing among the adolescent and young adults in Botswana remains low. This study aims to predict barriers to HIV testing uptake among adolescents and young adults.
A quantitative cross-sectional study was conducted. Data was obtained using a questionnaire employing a simple random sampling technique to collect the survey data. Statistical analysis involved descriptive statistics and multivariable logistic regression.
A total of 353 participants were recruited. The prevalence of HIV testing uptake in the preceding 12 months was (64.9%; n = 229). Determinants associated with non-uptake of HIV testing included participants in casual relationships (OR 1.776,95%CI 0.998–3.160, P < 0.049), transactional relationships (AOR 1.098, 95% CI 0.189–6.382) compared with single participants. Additional determinants included residence beyond 5 km from HIV testing centers (OR 1.825, 95% CI 1.074–3.103, P < 0.026), and cohabiting (AOR 3.45, 95% CI 0.271–43.979). Religious affiliation was also predictive, with Christians (AOR 2.347, 95% CI 0.188–29.295), Muslims (AOR 1.765, 95% CI 0.046–59.506), and adherents of African traditional religions (AOR 1.718, 95% CI 0.084–35.004) exhibiting higher odds of non-testing compared with non-believers. Participants with negative attitudes toward HIV testing were 69% less likely to forgo HIV testing (OR 0.310, 95% CI 0.1704–3.103, P = 0.026) than those with positive attitudes.
This study provides critical evidence on disparities in HIV testing among adolescents and young adults in Botswana, highlighting persistent gaps in access and utilization. These findings underscore the necessity for context-specific strategies that mitigate access barriers and address behavioral, structural, and socio-cultural determinants to optimize HIV testing uptake, advancing progress toward the UNAIDS 2030 target of zero new infections.
Introduction
Human Immunodeficiency Virus (HIV) remains a significant global public health concern with an estimated 40.8 million individuals reported living with HIV in 2024 [1]. The World Health Organization (WHO) African Region inhabited by 12% of the world’s population accounted for over two thirds of the global HIV burden [1]. In addition, approximately 630, 000 lives were lost due to HIV-related causes worldwide with 97% of these deaths occurring in developing nations, Sub-Saharan Africa being the primary region carrying a disproportionate burden [1]. As a result, the Joint United Nations Programme on HIV/AIDS (UNAIDS) has considered an acceleration of response aimed at eliminating HIV by the year 2030. To achieve this, the 95-95-95 targets was formulated [2]. This target aims to ensure that, by 2030, 95% of people living with HIV know their serostatus, 95% of people diagnosed as HIV-positive receive antiretroviral treatment, and 95% of people on antiretroviral treatment have their viral load sustainably suppressed. Thus, access to screening remains the main element to be taken into account to achieve this objective [2]. HIV testing is therefore a fundamental approach that serves as a crucial initial step in the continuum of HIV care enabling individuals to become aware of their HIV status and to seek treatment and/or preventive care [2,3]. In 2024, the global HIV response was closer than ever to reaching these testing and treatment targets. Globally, an estimated 87% (69– > 98%) of all people living with HIV knew their HIV status, 89% (71– > 98%) of people who knew their HIV-positive status were receiving antiretroviral therapy, and 94% (75– > 98%) of people on treatment had a suppressed viral load [1].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider public health desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Gabalape Arnold Sejie, Thato Lebang, Gosego Ngole, Onneile Dichabe, Merapelo Selwane, Oratile Marapo, Kefilwe Madikwe, Goratang Malgas, Tumelo Ikaneng. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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- Evidence brief: Determinants of HIV testing uptake among adolescent girls and young women in mainland Tanzania: A stratified analysis of the 2016/17 and 2022/2023 national surveys
- Evidence brief: Geographic inequalities in HIV testing uptake among young women in sub-Saharan Africa: A hierarchical bayesian spatial analysis
- Evidence brief: Awareness of and positive attitudes toward HIV pre-exposure prophylaxis among reproductive-aged women in Ghana: A multilevel analysis of the 2022 Demographic and Health Survey
