Sexual behaviours, HIV self-testing awareness, and uptake among Young People (YP) attending a Ghanaian high school

Human Immunodeficiency Virus (HIV) remains a significant global public health problem, with adolescents and young adults being particularly vulnerable to the infection due to risky sexual behaviours, leading to increased rates of HIV transmission. HIV self-testing (HIVST) has emerged as a promising strategy to enhance testing uptake, reduce stigma, facilitate early diagnosis, and reach underserved populations that traditional HIV testing services would otherwise not be able to reach. Globally, approximately 77 countries, including Ghana, have adopted the HIVST strategy to date. However, little is known about its awareness, sexual risky behaviours and non-uptake among Young People (YP), hence this study. This was a cross-sectional survey among 231 YP attending Donkokrom Senior High School. A stratified sampling method was used to recruit the respondents. Data were collected with a self-administered questionnaire using Computer-Assisted Personal Interviews (CAPI) through the KoboCollect application. Descriptive statistics were used to describe variables, while Binary logistic regression analysis was used to determine predictors of non-uptake of OraQuick HIVST. All data were analysed using Stata version 17.0. Of the 231 respondents, the majority (61.5%) were in their late teens (aged 16–18 years), with a median age of 18 years (IQR = 16–19). Females constituted 58.4% of the participants; 80 (34.6%) were sexually active, among whom 51(63.8%) had sexual debut before 16 years of age; 17.5% always used a condom during sex; and overall, 29.9% of them were involved in at least one risky sexual behaviour. Regarding the awareness of OralQuick HIVST, 101 (43.7%) participants said they were aware. Among these, 68 (67.3%) had ever received an OralQuick HIVST kit. Forty-seven (69.1%) of these participants used it to self-test for HIV. Overall, the prevalence of OralQuick HIVST uptake in the study population was 20.3% (n = 47). Logistic regression analysis showed that males had higher odds of not taking OraQuick HIVST compared to females (Adjusted Odds Ratio: 2.15; 95% CI: 1.01–4.58). Nearly one-third of the study’s participants engaged in risky sexual behaviours, yet the non-uptake of HIV self-testing remains high, especially among males, despite the growing awareness of the initiative. These findings highlight the need for targeted education and interventions to address misconceptions and barriers to HIV self-testing, particularly among males.