Prevalence and determinants of not testing for HIV among young adult women in Papua New Guinea: findings from the 2016–2018 Demographic and Health Survey

Abstract

AbstractObjectiveThe study investigated the factors associated with not ever testing for HIV among women aged 15–29 years in Papua New Guinea (PNG).Design and settingThe study used secondary data from the 2016–2018 Demographic and Health Survey (DHS) of PNG, a nationally representative cross-sectional survey that used a two-stage stratified sampling.ParticipantsA total weighed sample of 5,164 young adult women aged 15–29 years were included in the study.Primary outcome measureEver been tested for HIV was the primary outcome of the study. All analyses were adjusted using survey weights to account for unequal sampling probabilities.ResultsThe prevalence of not testing for HIV was 58.8% (95% CI: 57.4%, 60.1%). The mean age was 21.65 (SD ± 4.23) years. The majority (62.9%) of young adult women in rural areas were not tested for HIV. In the multivariable analysis, those who were never married (AOR: 4.9, 95% CI: 3.6–6.6), had poor wealth index (AOR: 1.8, 95% CI: 1.3–2.5), from rural areas (AOR: 2.0, 95% CI: 1.5–2.6), from the Momase region (AOR: 1.3, 95% CI: 1.0–1.7, did not read newspaper or magazine (AOR: 1.7, 95% CI: 1.3–2.1), did not listen to radio (AOR: 1.5, 95% CI: 1.1–2.0), experienced early sexual debut (AOR: 1.5, 95% CI: 1.1–1.9), had one sexual partner (AOR: 1.5, 95% CI: 1.2–2.0), and reported no STI in the past 12 months (AOR: 1.8, 95% CI: 1.1–3.1) had higher odds of not testing for HIV.ConclusionsOur study found a very high unmet need for HIV testing among young adult women in PNG. Health promotion programmes should be designed to increase HIV knowledge and access to HIV testing services. Furthermore, efforts to optimise HIV testing services should target women who are disadvantaged and from rural areas.Strengths and limitations of this studyThis study used a nationally representative large sample of young adult women aged 15–29 years from the 2016–2018 PNGDHS; thus, the findings are generalisable to the entire population of this age group.The study provides much-needed data for strategic planning and programming to improve the health outcomes of young adult women in the country.This is a cross-sectional study, and as such, it is not possible to make causal inferences.The level of knowledge or awareness of where to get tested for HIV was not included in the analysis, and it remains unknown whether this variable contributes to the high proportion of respondents who remain unaware of their HIV status.Responses to the questions from respondents were self-reported, and this could have resulted in behavioural desirability bias.