Key points are not available for this paper at this time.
OBJECTIVE: In Nigeria, adolescents and young adults (AYA) who engage in multiple sexual partnerships, transactional sex, and needle-sharing are eligible for preexposure prophylaxis (PrEP) and are prioritized for HIV testing. AYA with PrEP-eligible behaviors should be using facility-based HIV testing services. We examined associations between these behaviors and facility-based HIV testing among AYA aged 14-24 years. DESIGN: A longitudinal analysis of a stepped-wedge trial. METHODS: Using Innovative Tools to Expand Youth-friendly HIV Self-Testing (I-TEST) data, we fit generalized linear models using generalized estimating equations. We used a two-stage weighted approach to generalize I-TEST estimates to all AYA in Nigeria. RESULTS: Of 1429 trial participants, the median age was 20 years (IQR: 18-22), 50.3% were female, and 69.4% reported secondary education as highest level of education completed. Recent facility-based HIV testing uptake was higher among AYA with one unadjusted risk difference: 11.7%, 95% confidence interval (95% CI): 8.1-15.2, two 11% (5.3, 16.8), and three or more sexual partners in the past 3 months 17.3% (10.5, 24), compared to AYA with no recent sexual partners. AYA who engaged in transactional sex had higher facility-based testing uptake 14.7% (9.8, 19.5) than AYA who never engaged in transactional sex. AYA who shared needles had lower facility-based testing uptake -3.3% (-6.7, 0.2) than AYA with no needle-sharing history. The trial and generalized estimates were in the same direction. CONCLUSION: While facility-based testing may reach AYA who engaged in multiple sexual partnerships or transactional sex, AYA who shared needles may require more tailored HIV testing approaches.
Tahlil et al. (Wed,) studied this question.