Unpacking the drivers of HIV testing uptake among adolescents and adults in twelve sub-Saharan African countries using population HIV impact assessment data

HIV testing is essential for prevention and management, with socio-demographic and behavioral factors influencing uptake. This study analyzed data from 607,967 individuals aged 15 years and above including both adolescents and adults drawn from nationally representative Population HIV Impact Assessments conducted across twelve Sub-Saharan African countries. Associations between HIV testing uptake and key sociodemographic and behavioral variables were examined using generalized linear mixed model regression. All statistical analyses were performed using Stata version 18.0. Findings show that females were 3.1 times more likely to test than males, while individuals aged 26–35 had a 2.5 times higher likelihood compared to those aged 15–25. Married individuals were 1.5 times more likely to undergo testing than unmarried individuals. Education played a significant role, with higher odds among those with secondary, tertiary, and university-level education. Behavioral factors impacted uptake, with lower testing rates among those who did not use condoms or frequently consumed alcohol. Overall, the study highlights the importance of targeted interventions addressing gender, education, marital status, and risk behaviors to improve HIV testing rates in high-prevalence settings.