Uptake of HIV testing among adolescents and associated adolescent-friendly services

HIV testing remains low among adolescents. Making public health services more adolescent-friendly is one strategy used to encourage testing. However, it remains unclear whether government-led initiatives have a meaningfully impact. The current study is observational and utilizes two sources of data...

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Published in:BMC health services research 2020-09, Vol.20 (1), p.881-10, Article 881
Main Authors: Kidman, Rachel, Waidler, Jennifer, Palermo, Tia
Format: Article
Language:English
Subjects:
Adolescent
Adolescent health services
Adolescent Health Services - statistics & numerical data
Adolescent-friendly services
Adolescents
Behavior
Care and treatment
Female
Gender-based violence
Health facilities
Health insurance
Health services
Health Services Accessibility
HIV
HIV testing
HIV Testing - statistics & numerical data
HIV tests
Households
Human immunodeficiency virus
Humans
Intervention
Male
Medical tests
Patient compliance
Primary care
Privacy
Questionnaires
Reproductive health
Reproductive Health Services - statistics & numerical data
Rural Population
Sexual Behavior
SRH
Statistics
Surveys and Questionnaires
Tanzania
Teachers
Teenagers
User statistics
Young Adult
Youth
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description HIV testing remains low among adolescents. Making public health services more adolescent-friendly is one strategy used to encourage testing. However, it remains unclear whether government-led initiatives have a meaningfully impact. The current study is observational and utilizes two sources of data (health-facility and adolescent-level) from one round of data collection of an on-going, longitudinal impact evaluation of a pilot cash plus program targeting adolescents. This study linked data from adolescent surveys (n = 2191) to data collected from nearby government-run health facilities (n = 91) in two rural regions of Tanzania. We used log binomial regression models to estimate the association between specific adolescent-friendly health service (AFHS) characteristics and adolescents' uptake of 1) HIV testing and 2) visiting a health care facility in the past year for sexual and reproductive health (SRH) services. Most adolescents (67%) lived in a village with a health facility, and all offered HIV services. We find, however, that AFHS have not been fully implemented. For example, less than 40% of facilities reported that they had guidelines for adolescent care. Only 12% of facilities had a system in place for referral and follow-up with adolescent clients, yet this was an important predictor of both past-year HIV testing (RR = 1.28, p 
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Making public health services more adolescent-friendly is one strategy used to encourage testing. However, it remains unclear whether government-led initiatives have a meaningfully impact. The current study is observational and utilizes two sources of data (health-facility and adolescent-level) from one round of data collection of an on-going, longitudinal impact evaluation of a pilot cash plus program targeting adolescents. This study linked data from adolescent surveys (n = 2191) to data collected from nearby government-run health facilities (n = 91) in two rural regions of Tanzania. We used log binomial regression models to estimate the association between specific adolescent-friendly health service (AFHS) characteristics and adolescents' uptake of 1) HIV testing and 2) visiting a health care facility in the past year for sexual and reproductive health (SRH) services. Most adolescents (67%) lived in a village with a health facility, and all offered HIV services. We find, however, that AFHS have not been fully implemented. For example, less than 40% of facilities reported that they had guidelines for adolescent care. Only 12% of facilities had a system in place for referral and follow-up with adolescent clients, yet this was an important predictor of both past-year HIV testing (RR = 1.28, p &lt; 0.1) and SRH visits (RR = 1.44, p &lt; 0.05). Less than half (44%) offered services for survivors of gender-based violence (GBV), a significant predictor of past-year HIV testing (RR = 1.20, p &lt; 0.05) and SRH visits (RR = 1.41, p &lt; 0.01) among sexually-active adolescents. We find that national guidelines on AFHS have not been fully translated into practice at the local level. We highlight particular gaps in adolescent referral systems and GBV services. 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subjects Adolescent
Adolescent health services
Adolescent Health Services - statistics & numerical data
Adolescent-friendly services
Adolescents
Behavior
Care and treatment
Female
Gender-based violence
Health facilities
Health insurance
Health services
Health Services Accessibility
HIV
HIV testing
HIV Testing - statistics & numerical data
HIV tests
Households
Human immunodeficiency virus
Humans
Intervention
Male
Medical tests
Patient compliance
Primary care
Privacy
Questionnaires
Reproductive health
Reproductive Health Services - statistics & numerical data
Rural Population
Sexual Behavior
SRH
Statistics
Surveys and Questionnaires
Tanzania
Teachers
Teenagers
User statistics
Young Adult
Youth
title Uptake of HIV testing among adolescents and associated adolescent-friendly services
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