Association between family planning message exposure and related factors in HIV testing among women of reproductive age in The Gambia: an analysis of a national survey

Uptake of HIV testing among women of reproductive age in resource-limited settings remains a public health challenge. Thus, understanding the potential barriers to HIV testing uptake is relevant in designing HIV counseling interventions to improve utilization among women of reproductive age in these contexts. Therefore, this study aimed to identify the associations between family planning (FP) message exposure, its related factors, and HIV testing among women of reproductive age in The Gambia. This cross-sectional study utilized secondary data from The Gambia Demographic and Health Survey 2019–2020 (GDHS). The GDHS employs a two-stage stratified cluster sampling method to recruit participants. This study recruited 11,562 women from the GDHS. Multilevel hierarchical models were used to examine the relationships between exposure and outcome, with significance set at p < 0.05 and a 95% confidence interval. The prevalence of FP message exposure with testing was 86.6%. Overall, women exposed to FP messages had 84.3% [aOR: 1.843 (95% CI 1.549–2.193; p < 0.001)] increased odds of HIV testing uptake compared with those who were not, after accounting for confounders. Compared with their reference groups, women with higher education [aOR: 3.536 (95% CI 2.866–4.363; p < 0.001)], higher household wealth index (rich) [aOR: 1.432 (95% CI 1.250–1.641; p < 0.001)], rural dwellers [aOR: 1.604 (95% CI 1.357–1.896; p < 0.001)], married women [aOR: 1.326 (95% CI 1.089–1.613; p < 0.001)], and those with single partners [aOR: 1.577 (95% CI 1.370–1.815; p < 0.001)] had increased odds of HIV testing uptake compared to their reference groups. The HIV testing uptake rate among women of reproductive age in The Gambia is low. FP message exposure was significantly associated with HIV testing uptake among reproductive-aged women. In addition, women with higher education, higher household wealth index, rural dwellers, married women, and those with single partners were more likely to undergo HIV testing. The Ministry of Health of The Gambia should intensify and localise FP messaging in community education to reduce stigma, create school-based HIV-friendly services, provide free test kits to major private pharmacies, and strengthen monitoring and evaluation systems. These will enhance early testing and treatment, ultimately contributing to achieving the UNAIDS 95-95-95 targets by 2030.