Unlocking self-testing: predictors of HIV self-testing kit use among reproductive-aged women in tanzania; a multilevel analysis of the 2022 demographic and health survey

Abstract

BACKGROUND: The introduction of HIV self-testing (HIVST) kits has revolutionized HIV prevention by offering a confidential and accessible option, particularly for vulnerable groups. Despite this, uptake varies widely due to multiple influencing factors. In Tanzania, where HIV prevalence among women remains high, the determinants of HIVST use are not well understood. This study addresses this gap by analyzing the 2022 Tanzania Demographic and Health Survey (TDHS), aiming to identify key predictors of HIVST uptake among women of reproductive age. METHODS: This study conducted a cross-sectional analysis using 2022 TDHS data. Data management and analysis were performed using Stata 18. Given the survey's complex design, a multilevel mixed-effect logistic regression model was used to identify predictors of HIVST kit use, with results presented as adjusted odds ratios (AORs) and 95% confidence intervals (CIs). Statistical significance was set at p < 0.05. RESULTS: The prevalence of HIVST kit usage among women of reproductive age in Tanzania was 3.2% (95% CI: 2.8-3.7%). Individual-level factors associated with a higher likelihood of HIVST kit use included age, 25-34 (AOR = 1.93, 95%CI: 1.43-2.60) and 35-49 (AOR = 1.60, 95%CI:1.43-2.26), secondary/higher education (AOR = 2.77, 95%CI: 1.57-4.85), belonging to the rich wealth quintile (AOR = 2.69, 95%CI: 1.52-4.77), internet use (AOR = 3.04, 95%CI: 2.04-4.52), awareness of sexually transmitted infections (STIs) (AOR = 2.03, 95%CI: 1.21-3.42), and one or higher number of sexual partners. At the community level, geographical zone was associated with increased odds of use, while living in a high poverty level community (AOR = 0.52, 95%CI: 0.30-0.89) was associated with a lower likelihood of HIVST kit use. CONCLUSION: This study highlights a low uptake of HIVST kits among reproductive-aged women in Tanzania, driven by both individual and community factors. Higher education and STI awareness significantly increase HIVST use, indicating the need for education and targeted health communication. Additionally, community poverty underscores the importance of economic empowerment and resource support to improve access. Addressing these factors can help tailor interventions to boost HIVST uptake and reduce HIV transmission in Tanzania.