Sexual behaviors, HIV self-testing awareness, and uptake among Young People (YP) attending a Ghanaian high school.
Outcomes: Human Immunodeficiency Virus, Sexual and Reproductive Health
View SourceKey Social Norms Take-aways Social and gender norms may be important barriers to HIV self-testing among young people. The discussion highlights conservative community expectations around adolescent sexuality, stigma surrounding sexual health discussions, and fear of judgment as factors that may discourage young people from requesting or being seen using HIV self-testing kits. The authors also suggest that masculinity norms and stigma may contribute to lower testing among young men, underscoring the importance of gender-sensitive approaches that address the social environment surrounding HIV testing.
Objectives To examine sexual behaviors, awareness of HIV self-testing, uptake of oral HIV self-testing, and factors associated with non-uptake among adolescents and young adults attending a senior high school in rural Ghana.
Methods This cross-sectional study included 231 young people attending Donkorkrom Agric Senior High School. Participants were selected through stratified and simple random sampling and completed a pre-tested, self-administered electronic questionnaire assessing sociodemographic characteristics, HIV self-testing awareness and uptake, and sexual practices. Descriptive statistics and binary logistic regression were used to examine factors associated with non-uptake. The study did not directly measure social norms; rather, social and gender norms were discussed as contextual explanations for testing behaviors.
Results Among participants, 34.6% were sexually active and 29.9% reported at least one risky sexual behavior, including early sexual debut, multiple sexual partnerships, transactional sex, or inconsistent/non-use of condoms. Although 43.7% were aware of HIV self-testing, only 20.3% of the total sample had used an oral self-test. Male participants had significantly higher odds of non-uptake than females (adjusted odds ratio: 2.21; 95% confidence interval: 1.01–4.84). Other measured characteristics, including risky sexual behavior, were not significantly associated with non-uptake.
Conclusions Despite substantial sexual risk and growing awareness of HIV self-testing, uptake remained low, particularly among boys and young men. The authors recommend identifying informational and structural barriers and developing youth-friendly, gender-responsive interventions to close the gap between awareness and use.
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