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Uptake of HIV Testing Services Through Novel Community-Based Sexual and Reproductive Health Services: An Analysis of the Pilot Implementation Phase of the Yathu Yathu Intervention for Adolescents and Young People Aged 15–24 in Lusaka, Zambia

AIDS and Behavior volume 26, pages 172–182 (2022)Cite this article

Abstract

Adolescents and young people aged 15–24 are underserved by available HIV-testing services (HTS). Delivering HTS through community-based, peer-led, hubs may prove acceptable and accessible to adolescents and young people, thus increasing HIV-testing coverage. We used data from the pilot phase of a cluster-randomised trial of community-based sexual and reproductive health services for adolescents and young people in Lusaka, Zambia, between September 2019 and January 2020, to explore factors associated with uptake of HTS through community-based hubs. 5,757 adolescents and young people attended the hubs (63% female), among whom 75% tested for HIV (76% of females, 75% of males). Community-based hubs provided HTS to 80% of adolescents and young people with no history of HIV-testing. Among females, uptake of HTS was lower among married/cohabiting females; among males, uptake was lower among unmarried males and among individuals at risk of hazardous alcohol use. The high number of adolescents and young people accessing hubs for HIV testing suggests they are acceptable. Enhanced targeting of HTS to groups who may not perceive their HIV risk needs to be implemented.

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Acknowledgements

Sincere thanks to the study staff, study community leaders, and the study participants.

Funding

This work was supported by the UK Medical Research Council, the Department for International Development, and the National Institute for Health Research (Grant Number: MR/R022216/1).

Author information

Authors and Affiliations

  1. Faculty of Infectious and Tropical Diseases, Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK

    B. Hensen & H. M. Ayles

  2. Zambart, Lusaka, Zambia

    M. Phiri, A. Schaap, L. Sigande, M. Simwinga, S. Belemu, M. Simuyaba, K. Shanaube & H. M. Ayles

  3. Faculty of Epidemiology and Population Health, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK

    A. Schaap, S. Floyd & R. Hayes

  4. Imperial College London, Imperial College National Institute of Heath Research BRC, London, UK

    S. Fidler

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Contributions

BH conceived and lead the analysis and wrote the first draft of the manuscript. AS, SF and RH provided critical input to the analyses, and AS, MP, SF, RH and HA to the presentation and interpretation of results. MP, AS and LS led delivery of the study, including overseeing data collection. SB lead community engagement activities. SFi, RH, and HA designed and led the Yathu Yathu trial. All authors contributed to the writing of the article and have agreed the final draft for submission.

Corresponding author

Correspondence to B. Hensen.

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Conflict of interest

The authors have no conflicts of interest to declare.

Ethical approval

The University of Zambia Biomedical Research Ethics Committee (007-04-19) and the London School of Hygiene and Tropical Medicine (17104) approved the study.

Consent to Participate and for Publication

Individuals aged 18 to 24 provided written informed consent to participate. For adolescents aged 15–17, parents/guardians provided written informed consent and adolescents written informed assent. Consent included consent to publication.

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Hensen, B., Phiri, M., Schaap, A. et al. Uptake of HIV Testing Services Through Novel Community-Based Sexual and Reproductive Health Services: An Analysis of the Pilot Implementation Phase of the Yathu Yathu Intervention for Adolescents and Young People Aged 15–24 in Lusaka, Zambia. AIDS Behav 26, 172–182 (2022). https://doi.org/10.1007/s10461-021-03368-9

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Keywords

  • HIV testing
  • HIV infection
  • Adolescents and young people
  • Zambia