Factors influencing the use of HIV self-testing kits among adolescents: a case of Kalingalinga compound, Lusaka.

In Zambia, HIV self-testing is vital for HIV prevention, but there's limited understanding of its use among adolescents. In Zambia, HIV self-testing has become integral to HIV prevention and control, yet a knowledge gap exists regarding its prevalence, utilization trends, and determinants among adolescents. This cross-sectional investigation, conducted in the Kalinglinga compound of Lusaka district, engaged 391 participants, with a robust response rate of 97.7%. Employing a
pretested questionnaire, data were analyzed at univariate, bivariate, and multivariate levels. Univariate analysis revealed a 79% non-usage prevalence. Bivariate analysis showed significant associations between non-usage and marital status (χ² = 7.064, p = 0.029), monthly income (χ² = 11.058, p = 0.030), kit availability (χ² = 16.868, p = 0.000), accessibility (χ² = 12.066, p = 0.002), and cost perception (χ² = 10.016, p = 0.007). Age, gender, education, religion, having a sexual
partner, unprotected sex, and drug use didn't significantly affect usage (p > 0.05). The analysis identified several key factors associated with a higher prevalence of non-usage of HIV self-test kits among the study participants. These factors included being aged 18-19 years, male gender, having primary or no formal education, being single, having a higher income, lacking a sexual partner, never engaging in unprotected sex, residing in areas with limited availability and
accessibility of self-test kits, and having uncertainty about the cost of acquiring these kits. These demographic and situational characteristics collectively contributed to a greater likelihood of non usage among the surveyed individuals. Multivariate analysis found higher income as a barrier (OR = 1.473, 95% CI: 1.222 - 2.252), while being single increased non-usage odds (OR = 2.424, 95% CI: 1.432 - 4.102). Areas without kits had higher non-usage odds (OR = 1.827, 95% CI: 1.129 - 2.956). Uncertainty about kit costs led to higher non-usage odds (OR = 2.708, 95% CI: 1.230 - 5.964). These findings underscore the need for tailored interventions addressing specific demographic, socioeconomic, and predisposing factors impeding HIV self-testing. The study enriches the body of knowledge on HIV self-testing, offering insights for policy and program development to bolster public health strategies for HIV prevention and control.