The Prevalence and Factors Associated With HIV Testing among Adolescent Girls and Young Women in the Gambia-Evidence From the 2019/2020 Demographic and Health Survey.

BACKGROUND AND AIM: Human Immuno-deficiency Virus (HIV) testing serves as the essential entry point to prevention, treatment, and care. Despite progress, uptake remains low among adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA), specifically The Gambia. Identifying sociodemographic and behavioural determinants of HIV testing can guide targeted interventions. METHODS: This cross-sectional study analysed 1,083 AGYW from the 2019/20 Gambia Demographic and Health Survey, a nationally representative population-based survey. We assessed the prevalence of ever having tested for HIV and examined its associations with sociodemographic, reproductive, and behavioural factors, among AGYW aged 15 to 24 years. Bivariate and multivariable logistic regression models were applied to identify independent predictors of HIV testing, with analyses adjusted for unequal probability selection using survey weights. RESULTS: Of 1,083 AGYW analysed, 45.33% (95%CI: 41.20-49.60) had tested for HIV, lower among adolescent girls aged 15-19 years at 34.92% (95%CI: 28.60-41.80) compared to 49.39% (95%CI: 44.37-54.41) for young women aged 20-24 years. In adjusted analyses, higher education (aOR 2.97, 95%CI: 1.15-7.72), being married/in union (aOR 2.82, 95%CI: 1.43-5.58), comprehensive HIV knowledge (aOR 2.82, 95%CI: 1.73-4.60), having ever been pregnant (aOR 7.11, 95%CI: 4.14-12.20), and being in the poorer (aOR 2.09, 95%CI: 1.18-3.70) or middle (aOR 1.93, 95%CI: 1.00-3.71) quintiles, were significantly associated with HIV testing. However, age category, residence, employment status, and behavioural risk factors were not significantly associated with HIV testing. CONCLUSION: We observed less than half of AGYW in The Gambia ever had an HIV test, highlighting the need for targeted, youth friendly, and equitable HIV testing strategies.