Influence and involvement of support people in adolescent and young adult HIV testing

ABSTRACT

HIV incidence and mortality are high among adolescents and young adults (AYA) in sub-Saharan Africa, but testing rates are low. Understanding how support people (SP), such as peers, partners, or parents, influence AYA may improve HIV testing uptake. AYA aged 14–24 seeking HIV testing at a referral hospital in Nairobi, Kenya completed a post-test survey assessing the role of SP. Among 1062 AYA, median age was 21. Overall, 12% reported their decision to test was influenced by a parent, 20% by a partner, and 22% by a peer. Young adults (20–24 years old) were more likely than adolescents (14–19 years old) to be influenced to test by partners (23% vs. 12%, p < .001), and less likely by parents (6.6% vs. 27%, p < .001), healthcare workers (11% vs. 16%, p < .05), or counselors (9.4% vs. 19%, p < .001). Half of AYA were accompanied for testing (9.9% with parent, 10% partner, 23% peer, 4.3% others, and 2.1% multiple types). Young adults were more likely than adolescents to present alone (58% vs. 32%, p < .001) or with a partner (12% vs. 6.7%, p < .05), and less likely with a parent (1.6% vs. 31%, p < .001). Similar proportions of adolescents and young adults came with a peer or in a group. Correlates of presenting with SP included: younger age (aRR = 1.55 [95%CI = 1.30–1.85]), female sex (aRR = 1.45 [95%CI = 1.21–1.73]), and school enrollment (aRR = 1.41 [95%CI = 1.05–1.88]). SP play an important role in AYAs’ HIV testing and varies with age. Leveraging SP may promote uptake of HIV testing and subsequent linkage care for AYA.

KEYWORDS:

• Adolescent
• young adult
• HIV
• support people
• testing

Acknowledgements

The authors thank the DASH study participants and their families, without whom this research would not be possible. We thank the Kenyatta National Hospital staff at the VCT, Youth Centre, and tents for their tremendous efforts. We thank the DASH administrative and data team for their dedication and support. We thank the Kenyan National AIDS and STI Control Programme (NASCOP) for valuable input during study design, conduct, and dissemination. We thank members of the Kizazi Working Group, UW Global Center for Integrated Health of Women, Adolescents and Children (Global WACh), and Kenya Research & Training Center (KRTC) for their support during the preparation of this article. Research reported in this publication was supported by the University of Washington / Fred Hutch Center for AIDS Research, an NIH-funded program under award number AI027757 which is supported by the following NIH Institutes and Centers: NIAID, NCI, NIMH, NIDA, NICHD, NHLBI, NIA, NIGMS, NIDDK.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research was funded by National Institutes of Health [Supplement to P30 AI027757]. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. Funding sources were not involved in the analyses or interpretation of data.