Factors associated with low HIV testing rate among people aged 15 to 65 years in Maroua 1 Health District, Far North Region of Cameroon

BACKGROUND: The Human Immunodeficiency Virus/ Acquired Immunodeficiency Syndrome (HIV/AIDS) infection continues to cause enormous damage in the world despite the multiple strategies developed for the response. That's why the Joint United Nations Programme on HIV/AIDS (UNAIDS) has adopted an acceleration strategy for this response with a view to eliminating HIV/AIDS by the year 2030. Nevertheless, access to screening, which remains underserved in Cameroon, is the first pillar on which actions must be taken to achieve this objective. This study aimed to identify factors associated with low HIV testing in Maroua 1 Health District (MHD1). METHODS: A cross-sectional study was conducted among 808 participants aged 15 to 65 years living in the Maroua 1 Health District between September and December 2022. Data were collected by means of a non-probabilistic survey using a structured questionnaire sutured into socio-demographic characteristics, socio-cultural factors, and factors linked to the healthcare system. These factors were assessed by multiple logistic regression analysis, and associations were established by calculating Odds ratios, confidence intervals, and P-values. Statistical significance was declared at P < 0.05. RESULTS: The results showed that the study participants had a mean age of 32.7 years (SD ± 11) and males (57.18%) outnumbered females (42.82%). A total number of 383 (47.40%) participants had already taken a screening test, and 97 (12%) had done so in the last 12 months. Furthermore, it was noted that being a man (AOR = 2.79; CI = 1.83-4.31; P-value < 0.001), young (AOR = 7.95; CI = 4.02-16.2; p -p-value < 0.001), single (AOR = 1.97; CI = 1.19-3.27; p-value = 0.02), informal education (AOR = 5.25; CI = 2.26-12.45; p-value < 0.001 ), having low knowledge about HIV (AOR = 8.77; CI = 4.60-17.24; p-value < 0.001), having a stigmatizing opinion (AOR = 2.46; CI = 1.36-4.38; p-value < 0.001), not being in a relationship with a partner (AOR = 1.70; CI = 1.04-2.79; p-value = 0.03), never been sensitized by a health worker (AOR = 1.82; CI = 1.21-2.75; p-value = 0.001), and not visiting a health facility during the last 12 months (AOR = 1.75; CI = 1.06-2.75; p-value = 0.02) were associated with low screening. CONCLUSIONS: This study identified several factors associated with low HIV testing rates in the Maroua 1 health district in Cameroon, including male gender, young age, celibacy, lack of education, low HIV knowledge, stigmatizing attitudes, absence of a stable partner, lack of awareness by health care workers and low use of health services. Addressing these factors in HIV testing interventions is essential to achieving the UNAIDS 95-95-95 targets and eliminating HIV by 2030. Targeted public health policies and improved access to testing services are needed to combat the epidemic in this region.