Published in PLOS One on 2026-07-17, 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 study title: Geographic inequalities in HIV testing uptake among young women in sub-Saharan Africa: A hierarchical bayesian spatial analysis
Original authors: Bewuketu Terefe, Nebiyu Mekonnen Derseh, Tadesse Awoke Ayele, Josue Mbonigaba
Source: PLOS One • DOI 10.1371/journal.pone.0353117
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Despite the high prevalence of HIV infection among young women in sub-Saharan Africa (SSA), the adoption of HIV testing and counseling remains low. The uptake of HIV testing among young women in SSA remains poorly understood. Consequently, identifying the spatial distributions, prevalence, and factors that influence HIV testing among these marginalized groups of the population is crucial for policymakers, implementers, and researchers to achieve the 2030 Sustainable Development Goal plans to tackle the progress of the disease. Hence, the aim of this study was to assess HIV testing uptake, its spatial variation, and associated factors among young women in SSA from 2016 to 2023.
A community-based cross-sectional study was conducted among a weighted sample of 140,054 young women in SSA using recent demographic and health survey data. Statistical analyses were performed using R version 4.3.2, incorporating spatial analysis techniques (autocorrelation, interpolation, and SaTScan) and Bayesian hierarchical logistic regression to identify the factors associated with HIV testing uptake. Model parameters were estimated using Markov Chain Monte Carlo methods, and the results are reported as adjusted odds ratios (ORs) with 95% credible intervals.
Spatial analyses showed that HIV testing uptake was distributed unevenly; hotspots of high HIV testing uptake were found in Eastern and Southern Africa, and low uptake areas were found in Western Africa. The overall pooled prevalence of HIV testing was 38.9%. Primary education, secondary/higher education, employment, mass media, being married, widowed/divorced, modern contraceptive use, age, middle income, rich, risky sexual behaviors, poor attitude towards HIV patients, literacy rates, alcohol consumption, pregnant women, female households, rural residents, and distance to a health facility were statistically significant outcome variables.
The study revealed that HIV testing uptake among young women in SSA is significantly below the 95%−95%−95% target, with notable spatial clustering and variation across countries. Key factors influencing uptake included age, education, HIV knowledge, employment, media exposure, marital status, pregnancy status, and socioeconomic conditions. To improve testing rates, it is critical to implement targeted policy interventions, such as enhancing educational programs, addressing sociocultural barriers, and expanding access to healthcare, particularly in underrepresented regions. These actions are essential not only to increase HIV testing coverage but also to move closer to achieving the 95-95-95 targets and reducing new HIV infections in SSA.
Introduction
HIV/AIDS remains a significant global public health concern, with an estimated 40.4 million lives lost to the disease so far [1]. Ongoing transmission of HIV is observed in all countries worldwide, and some countries are experiencing increasing trends in new infections, even after previously showing declines [1]. At the end of 2022, approximately 39.0 million people were living with HIV, with two-thirds of them residing in the World Health Organization (WHO) African Region, totaling 25.6 million individuals [1,2]. In 2022 alone, 630,000 individuals died from HIV-related causes, and 1.3 million people acquired HIV. These statistics highlight the continued impact of HIV and the urgent need for prevention, treatment, and control efforts to curb the spread of the disease and improve health outcomes globally [1,2].
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 hospital systems 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 Bewuketu Terefe, Nebiyu Mekonnen Derseh, Tadesse Awoke Ayele, Josue Mbonigaba. 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.
Explore connected evidence
- Evidence brief: Lifetime HIV testing frequency among women in Sub-Saharan Africa: A DHS-based analysis using zero-inflated negative binomial regression
- Evidence brief: Anemia among HIV‑positive women in LMICs: Multilevel analysis of recent DHS survey
- Evidence brief: Barriers to healthcare access among women in sub-Saharan Africa: A pooled analysis of multi-country DHS data (2019–2023)
