Differentials in HIV testing and receipt of results between adolescent and non-adolescent women in Uganda: Application of non-linear Oaxaca decomposition

Abstract

The objective of this study was to assess differences in HIV Testing and receipt of Results (HTR) between adolescent and non-adolescent women in Uganda. The differences were decomposed into components attributed to variation in characteristics and variations in the effects of predictors in the two groups. The assessment was based on data sourced from 2011 Uganda Demographic Health Survey comprising of 8674 records of women aged 15-49 years. The investigation was made using women’s socio-demographic characteristics as well as knowledge and behavioral factors related to HIV. The analysis was done using a non-linear Oaxaca’ Blinder multivariate decomposition of the logistic regression.

In the results, HTR was higher in non-adolescent women (79.3%) than in adolescent women (45.5%). Overall, the gap in HTR between adolescent and non-adolescent women was significantly attributed to variations in characteristics and variation in the effects of characteristics/ coefficients (p<0.05). Decomposition changes in HTR reveals that 57.2% of the overall gap was due to variation in characteristics (endowment) while 42.8 percent was attributed to variation in the effects of characteristics (coefficients). The overall gap in HIV testing and receipt of results between adolescent and non-adolescent women would reduce by 31.6% and 34.7% if differences in ever given birth and ever had sex respectively were to disappear. On the other hand, the gap in HIV testing and receipt of results between adolescent and non-adolescent women would increase by 6.6 percent if the difference in level of education were to disappear. In relation to effects of predictors, the overall gap in HIV testing between adolescent and non- adolescent women would increase by 68.6% and 12.6% in the absence of variation in the effects of women’s education and marital status respectively

The findings of this study indicate that overall, there is a gap in HIV testing and receipt of results between adolescents and non-adolescent women which is attributed to variation in comprehensive knowledge, stigmatizing attitudes, ever had sex, ever given birth and level of education. In order to reduce on this gap, government and other development partners need to scale up HIV testing services targeting adolescents through tackling stigma, increasing on community outreach services and expanding adolescent friendly HIV services centers.