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HIV testing and ethnicity among adolescent girls and young women aged 15–24 years in Ghana: what really matters?

Published online by Cambridge University Press:  13 September 2021

Ucheoma Nwaozuru Open the ORCID record for Ucheoma Nwaozuru [Opens in a new window] ,
Thembekile Shato ,
Chisom Obiezu-Umeh ,
Florida Uzoaru ,
Stacey Mason ,
Joyce Gyamfi  and
Juliet Iwelunmor
Ucheoma Nwaozuru*
Affiliation:
College for Public Health and Social Justice, Saint Louis University, Saint Louis, USA
Thembekile Shato
Affiliation:
College for Public Health and Social Justice, Saint Louis University, Saint Louis, USA
Chisom Obiezu-Umeh
Affiliation:
College for Public Health and Social Justice, Saint Louis University, Saint Louis, USA
Florida Uzoaru
Affiliation:
College for Public Health and Social Justice, Saint Louis University, Saint Louis, USA
Stacey Mason
Affiliation:
College for Public Health and Social Justice, Saint Louis University, Saint Louis, USA
Joyce Gyamfi
Affiliation:
Section for Global Health, Department of Population Health, NYU School of Medicine, New York, USA
Juliet Iwelunmor
Affiliation:
College for Public Health and Social Justice, Saint Louis University, Saint Louis, USA
*
*Corresponding author. Email: Nwaozur2@gmail.com
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Abstract

Despite the high prevalence of HIV among adolescent girls and young women (AGYW) aged 15–24 years in Ghana, HIV testing remains low among this population. The objective of this study was to examine the relationship between ethnicity and HIV testing among AGYW in Ghana. The 2014 Ghana Demographic and Health Survey data were used and analyses were restricted to 3325 female participants aged 15–24 years. Chi-squared tests and a logistic regression model were used to assess the association between ethnicity and HIV testing. Furthermore, the PEN-3 cultural model informed the conceptual framework that explained the relationship between ethnicity and HIV testing behaviour. Results from the bivariate analysis showed an association between ethnicity and HIV testing among AGYW (p<0.05). However, when controlling for other behavioural and socioeconomic determinants of HIV testing in the logistic regression, there was no association between ethnicity and HIV testing. The significant predictors of HIV testing were marital status, having multiple sexual partners, and condom use. The AGYW who were married (adjusted odds ratio [aOR] = 4.56, CI: 3.46–6.08) or previously married (aOR = 4.30, CI: 2.00–9.23) were more likely to test for HIV compared with those who were never married. Having multiple sexual partners (aOR = 0.41, CI: 0.20–0.85) and condom use (aOR = 0.56, CI: 0.38–0.84) were associated with lower odds of HIV testing. The results provide evidence that ethnicity is not associated with HIV testing among AGYW in Ghana, as the bivariate association was attenuated when other behavioural and socioeconomic determinants of HIV testing were accounted for. These findings highlight the importance of considering individual-level factors, community-level factors, and other socio-cultural factors as they really matter in the development of HIV prevention programmes for adolescent girls and young women in Ghana.

Keywords

HIV testingEthnicityAdolescent girls and young women
Type
Research Article
Information
Journal of Biosocial Science , Volume 54 , Issue 5 , September 2022 , pp. 812 - 828
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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References

Airhihenbuwa, CO (1994) Health promotion and the discourse on culture: implications for empowerment. Health Education Quarterly 21(3), 345–353.CrossRefGoogle ScholarPubMed
Airhihenbuwa, CO (2007) Healing Our Differences: The Crisis of Global Health and the Politics of Identity. Rowman & Littlefield.Google Scholar
Airhihenbuwa, CO, Ford, CL and Iwelunmor, JI (2014) Why culture matters in health interventions: lessons from HIV/AIDS stigma and NCDs. Health Education & Behavior 41(1), 78–84.CrossRefGoogle ScholarPubMed
Airhihenbuwa, CO and Webster, JD (2004) Culture and African contexts of HIV/AIDS prevention, care and support. Sahara-J: Journal of Social Aspects of HIV/AIDS 1(1), 4–13.CrossRefGoogle Scholar
Ambasa-Shisanya, CR (2009) Cultural Determinants of Adoption of HIV/AIDS Prevention Measures and Strategies among Girls and Women in Western Kenya. African Books Collective.Google Scholar
Amoateng, AY and Baruwa, O (2018) Changes in the timing of sexual intercourse in Ghana: evidence from the Demographic and Health Survey data, 1988–2014. African Population Studies 32(3), 4588–4597.CrossRefGoogle Scholar
Anderson, KG, Beutel, AM and Maughan-Brown, B (2007) HIV risk perceptions and first sexual intercourse among youth in Cape Town, South Africa. International Family Planning Perspectives 33(3), 98–105.Google Scholar
Andoh-Robertson, T (2018) HIV testing and counselling among the youth of Ghana: the case of Tarkwa-Nsuaem and FanteAkwa District. Advances in Social Sciences Research Journal 5(6), 199213.Google Scholar
Asaolu, IO, Gunn, JK, Center, KE, Koss, MP, Iwelunmor, JI and Ehiri, JE (2016) Predictors of HIV testing among youth in sub-Saharan Africa: a cross-sectional study. PloS One 11(10), e0164052.CrossRefGoogle ScholarPubMed
BeLue, R, Okoror, TA, Iwelunmor, J, Taylor, KD, Degboe, AN, Agyemang, C and Ogedegbe, G (2009) An overview of cardiovascular risk factor burden in sub-Saharan African countries: a socio-cultural perspective. Globalization and Health 5(1), 10.Google ScholarPubMed
Branson, BM, Handsfield, HH, Lampe, MA, Janssen, RS, Taylor, AW, Lyss, SB and Clark, JE (2006) Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. Morbidity and Mortality Weekly Report: Recommendations and Reports 55(14), 1-CE-4.Google ScholarPubMed
BusinessGhana (2019) Know the 16 Regional Capitals of Ghana. Ghana Business. URL: http://www.businessghana.com/site/news/general/182246/Know-the-16-regional-capitals-of-Ghana (accessed 19th July 2021).Google Scholar
Fayehun, O, Sanuade, OA, Ajayi, AI and Isiugo-Abanihe, U (2020) Ethnicity, sex composition of living children, and unrealized fertility in Nigeria. Population Studies 77(3), 351–361.CrossRefGoogle Scholar
GDHS (2015) Ghana Demographic and Health Survey 2014. Ghana Statistical Service, ICF International, Rockville, MD, USA.Google Scholar
Gyasi, RM and Abass, K (2018) Sexual risk behavior and uptake of HIV counseling and testing among youth in Metropolitan Kumasi, Ghana. Journal of HIV/AIDS & Social Services 17(2), 127–145.CrossRefGoogle Scholar
Gyimah, SO (2002) Ethnicity and infant mortality in sub-Saharan Africa: the case of Ghana. PSC Discussion Papers Series 16(10), 1.Google Scholar
Idele, P, Gillespie, A, Porth, T, Suzuki, C, Mahy, M, Kasedde, S and Luo, C (2014) Epidemiology of HIV and AIDS among adolescents: current status, inequities, and data gaps. Journal of Acquired Immune Deficiency Syndromes 66, S144–S153.CrossRefGoogle ScholarPubMed
Imasiku, EN, Odimegwu, CO, Adedini, SA and Ononokpono, DN (2014) Variations in unmet need for contraception in Zambia: does ethnicity play a role? Journal of Biosocial Science 46(3), 294–315.CrossRefGoogle ScholarPubMed
Iwelunmor, J, Blackstone, S, Jennings, L, Converse, D, Ehiri, J and Curley, J (2018) Determinants of HIV testing and receipt of test results among adolescent girls in Nigeria: the role of assets and decision-making. International Journal of Adolescent Medicine and Health 32(3), 1–17.Google ScholarPubMed
Iwelunmor, J, Newsome, V and Airhihenbuwa, CO (2014) Framing the impact of culture on health: a systematic review of the PEN-3 cultural model and its application in public health research and interventions. Ethnicity & Health 19(1), 20–46.CrossRefGoogle ScholarPubMed
Iwelunmor, J, Sofolahan-Oladeinde, Y and Airhihenbuwa, CO (2015) Sociocultural factors influencing HIV disclosure among men in South Africa. American Journal of Men’s Health 9(3), 193–200.CrossRefGoogle ScholarPubMed
Kenu, E, Obo-Akwa, A, Nuamah, GB, Brefo, A, Sam, M and Lartey, M (2014) Knowledge and disclosure of HIV status among adolescents and young adults attending an adolescent HIV clinic in Accra, Ghana. BMC Research Notes 7(1), 844.CrossRefGoogle Scholar
Kruk, E, Johnson, JC, Gyakobo, M, Agyei-Baffour, P, Asabir, K, Kotha, SR et al. (2010) Rural practice preferences among medical students in Ghana: a discrete choice experiment. Bulletin of the World Health Organization 88, 333–341.CrossRefGoogle ScholarPubMed
Kurth, AE, Lally, MA, Choko, AT, Inwani, IW and Fortenberry, JD (2015) HIV testing and linkage to services for youth. Journal of the International AIDS Society 18, 19433.CrossRefGoogle ScholarPubMed
Mancini, L (2009) Comparative trends in ethno-regional inequalities in Ghana and Nigeria: evidence from Demographic and Health Surveys. Centre for Research on Inequality, Human Security and Ethnicity (CRISE) Working Paper (72).Google Scholar
Mberu, BU and White, MJ (2011) Internal migration and sexual initiation among never married youths in Nigeria. Social Science & Medicine 72(8), 1284.CrossRefGoogle ScholarPubMed
Mobolaji, JW, Fatusi, AO and Adedini, SA (2020) Ethnicity, religious affiliation and girl-child marriage: a cross-sectional study of nationally representative sample of female adolescents in Nigeria. BMC Public Health 20, 1–10.CrossRefGoogle ScholarPubMed
MOH (2013) National AIDS/STI Control Programme. HIV Sentinel Survey Report. Ministry of Health, Ghana.Google Scholar
MOH (2015a) Country AIDS Response Progress Report – Ghana. Ministry of Health, Ghana.Google Scholar
MOH (2015b) Ghana Country AIDS Response Progress Report. Ministry of Health, Ghana.Google Scholar
MOH (2016) National HIV and AIDS Strategic Plan 2016–2020. Ministry of Health, Ghana.Google Scholar
Musheke, M, Ntalasha, H, Gari, S, Mckenzie, O, Bond, V, Martin-Hilber, A and Merten, S (2013) A systematic review of qualitative findings on factors enabling and deterring uptake of HIV testing in Sub-Saharan Africa. BMC Public Health 13(1), 220.CrossRefGoogle ScholarPubMed
Odimegwu, C, Somefun, OD and Chisumpa, VH (2018) Regional differences in positive sexual behaviour among youth in sub-Saharan Africa. Journal of Biosocial Science 51(2), 254–272.CrossRefGoogle ScholarPubMed
Okigbo, CC, Speizer, IS, Domino, ME, Curtis, SL, Halpern, CT and Fotso, JC (2018) Gender norms and modern contraceptive use in urban Nigeria: a multilevel longitudinal study. BMC Womens Health 18(1), 178.CrossRefGoogle ScholarPubMed
Okoror, TA, Belue, R, Zungu, N, Adam, AM and Airhihenbuwa, CO (2014) HIV positive women’s perceptions of stigma in health care settings in Western Cape, South Africa. Health Care Women International 35(1), 27–49.CrossRefGoogle ScholarPubMed
Ononokpono, DN, Odimegwu, CO, Adedini, SA and Imasiku, EN (2016) Ethnic diversity and maternal health care in Nigeria. Women’s Reproductive Health 3(1), 45–59.CrossRefGoogle Scholar
Perkins, JM, Nyakato, VN, Kakuhikire, B, Mbabazi, PK, Perkins, HW, Tsai, AC et al. (2018) Actual versus perceived HIV testing norms, and personal HIV testing uptake: a cross-sectional, population-based study in rural Uganda. AIDS and Behavior 22(2), 616–628.CrossRefGoogle ScholarPubMed
Puffer, ES, Meade, CS, Drabkin, AS, Broverman, SA, Ogwang-Odhiambo, RA and Sikkema, KJ (2011) Individual- and family-level psychosocial correlates of HIV risk behavior among youth in rural Kenya. AIDS and Behavior 15(6), 1264–1274.CrossRefGoogle ScholarPubMed
Russell, LT, Coleman, M and Ganong, L (2018) Conceptualizing family structure in a social determinants of health framework. Journal of Family Theory & Review 10(4), 735–748.CrossRefGoogle Scholar
Salazar-Austin, N, Kulich, M, Chingono, A, Chariyalertsak, S, Srithanaviboonchai, K, Gray, G et al. (2018) Age-related differences in socio-demographic and behavioral determinants of HIV testing and counseling in HPTN 043/NIMH Project Accept. AIDS and Behavior 22(2), 569–579.CrossRefGoogle ScholarPubMed
Sam-Agudu, NA, Folayan, MO and Ezeanolue, EE (2016) Seeking wider access to HIV testing for adolescents in sub-Saharan Africa. Pediatric Research 79(6), 838.CrossRefGoogle ScholarPubMed
Sambisa, W, Curtis, SL and Stokes, CS (2010) Ethnic differences in sexual behaviour among unmarried adolescents and young adults in Zimbabwe. Journal of Biosocial Science 42(1), 1–25.CrossRefGoogle Scholar
Schatz, E, Madhavan, S and Williams, J (2011) Female-headed households contending with AIDS-related hardship in rural South Africa. Health & Place 17(2), 598–605.CrossRefGoogle ScholarPubMed
Simbayi, LC, Chauveau, J and Shisana, O (2004) Behavioural responses of South African youth to the HIV/AIDS epidemic: a nationwide survey. AIDS Care 16(5), 605–618.CrossRefGoogle Scholar
GhanaStatistics (2017) Ghana Censuses and Surveys. URL: https://www.statsghana.gov.gh/ (accessed 19th August 2021).Google Scholar
Takyi, BK and Addai, I (2002) Effects of ethnicity on the onset of parenthood in a developing country: some evidence from the early 1990s. Journal of Comparative Family Studies 33(1), 57–71.CrossRefGoogle Scholar
Takyi, BK and Nii-Amoo Dodoo, F (2005) Gender, lineage, and fertility-related outcomes in Ghana. Journal of Marriage and Family 67(1), 251–257.CrossRefGoogle Scholar
Tan, K and Black, BP (2018) A systematic review of health care provider-perceived barriers and facilitators to routine HIV testing in primary care settings in the southeastern United States. Journal of the Association of Nurses in AIDS Care 29(3), 357–370.CrossRefGoogle ScholarPubMed
UNAIDS (2014) The Gap Report. Joint United Nations Programme on HIV/AIDS, UNAIDS, Geneva.Google Scholar
UNAIDS (2015) Understanding Fast-Track: Accelerating Action to End the AIDS Epidemic by 2030. UNAIDS, Geneva.Google Scholar
UNAIDS (2017) UNAIDS Data 2017. URL: https://www.unaids.org/en/resources/documents/2017/2017_data_book (accessed 19th August 2021).Google Scholar
UNICEF (2016) HIV and AIDS in adolescents. URL: https://data.unicef.org/topic/hivaids/adolescents-young-people/ (accessed 19th August 2021).Google Scholar
Van Rooyen, C, Stewart, R and De Wet, T (2012) The impact of microfinance in sub-Saharan Africa: a systematic review of the evidence. World Development 40(11), 2249–2262.CrossRefGoogle Scholar
Warren, EA, Paterson, P, Schulz, WS, Lees, S, Eakle, R, Stadler, J and Larson, HJ (2018) Risk perception and the influence on uptake and use of biomedical prevention interventions for HIV in sub-Saharan Africa: a systematic literature review. PloS One 13(6), e0198680.CrossRefGoogle ScholarPubMed
Wight, D, Plummer, M and Ross, D (2012) The need to promote behaviour change at the cultural level: one factor explaining the limited impact of the MEMA kwa Vijana adolescent sexual health intervention in rural Tanzania. A process evaluation. BMC Public Health 12(1), 788.CrossRefGoogle ScholarPubMed