Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter May 5, 2016

Prevalence of HIV testing and counseling and associated factors among secondary school students in Botswana

  • Stephane M. Bodika EMAIL logo , Phenyo E. Lekone , Peter Loeto , Mary G. Alwano , Thekiso C. Zulu , Evelyn Kim , Gape Machao and Andrew C. Voetsch


Background: The World Health Organization recommends HIV testing and counseling (HTC) for all adolescents living in countries with generalized HIV epidemics. In Botswana, HIV prevalence among adolescents 15–19 years is 3.7% and among pregnant adolescents is 10%. We describe the proportion and characteristics of secondary school students who have accessed HTC.

Methods: A multistage sample survey was conducted among students in Botswana’s public secondary schools in 2010. The survey was self-administered using a personal digital assistant device. The HTC rate was estimated using self-reported history of HIV testing.

Results: Of 1,632 participants, 52% were girls, 43% aged below 16 years, and 27% had ever had sexual intercourse. Most (81%) students knew where to get tested for HIV. Overall, 2.2% of students were HIV positive by self-report. The HTC rate was 23% overall, 34% among students who had ever had sexual intercourse, and 45% among students who had sexual intercourse in the past 12 months. Being pregnant or having made someone pregnant and having had sexual intercourse in the past 12 months were associated with having been tested for HIV among students who had ever had sexual intercourse.

Discussion: Overall, the HTC rate was low, and the self- reported HIV prevalence was high among secondary students in Botswana. Most sexually active students have never been tested for HIV. Health communications efforts for adolescents that increase demand for HTC, routine opt-out HIV testing in healthcare facilities, and school-based HIV testing are needed as part of a national HIV prevention strategy.

Corresponding author: Stephane M. Bodika, MD, MPH, CDC-Botswana/US Embassy, P.O. Box 90, Gaborone, Botswana, Phone: +267 367-2400


Authors would like to acknowledge and thank the students who participated, their parents for allowing the students to participate, the leadership of the Botswana Ministry of Education and Skills Development, members of the technical working group, stakeholders, and staff members from the University of San Francisco California (UCSF) for their guidance, advice, and contributions to the survey. This work was supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention under the terms of grant number 5U62PS025095-05.


1. Botswana Central Statistics Office. 2008 Botswana AIDS Impact Survey: Statistical Report. 2009; Available at: Accessed on April 22, 2016.Search in Google Scholar

2. Botswana Ministry of Health. 2011 Botswana Second Generation HIV/AIDS Antenatal Sentinel Surveillance Technical Report. 2012, Gaborone, Botswana.Search in Google Scholar

3. Botswana Central Statistics Office. Population Projections for Botswana: 2001 – 2031. 2005; Available at: Accessed on April 22, 2016.Search in Google Scholar

4. Copenhaver MM, Fisher JD. Experts outline ways to decrease the decade-long yearly rate of 40,000 new HIV infections in the US. AIDS Behav 2006;10:105–14.10.1007/s10461-005-9034-xSearch in Google Scholar PubMed

5. Rositch AF, Cherutich P, Brentlinger P, Kiarie JN, Nduati R, et al. HIV infection and sexual partnerships and behaviour among adolescent girls in Nairobi, Kenya. Int J STD AIDS 2012;23:468–74.10.1258/ijsa.2012.011361Search in Google Scholar PubMed PubMed Central

6. Idele P, Gillespie A, Porth T, Suzuki C, Mahy M, et al. Epidemiology of HIV and AIDS among adolescents: current status, inequities, and data gaps. J Acquir Immune Defic Syndr 2014;66 Suppl 2:S144–53.10.1097/QAI.0000000000000176Search in Google Scholar PubMed

7. Fonner VA, Denison J, Kennedy CE, O’Reilly K, Sweat M. Voluntary counseling and testing (VCT) for changing HIV-related risk behavior in developing countries. Cochrane Database Syst Rev 2012;9:CD001224.10.1002/14651858.CD001224.pub4Search in Google Scholar PubMed PubMed Central

8. World Health Organization. HIV and adolescents: guidance for HIV testing and counselling and care for adolescents living with HIV. 2013; Available at: Accessed on April 22, 2016Search in Google Scholar

9. Steen TW, Seipone K, Gomez Fde L, Anderson MG, Kejelepula M, et al. Two and a half years of routine HIV testing in Botswana. J Acquir Immune Defic Syndr 2007;44:484–8.10.1097/QAI.0b013e318030ffa9Search in Google Scholar PubMed

10. Creek TL, Ntumy R, Seipone K, Smith M, Mogodi M, et al. Successful introduction of routine opt-out HIV testing in antenatal care in Botswana. J Acquir Immune Defic Syndr 2007;45:102–7.10.1097/QAI.0b013e318047df88Search in Google Scholar PubMed

11. Creek TL, Alwano MG, Molosiwa RR, Roels TH, Kenyon TA, et al. Botswana’s Tebelopele voluntary HIV counseling and testing network: use and client risk factors for HIV infection, 2000–2004. J Acquir Immune Defic Syndr 2006;43:210–8.10.1097/01.qai.0000230525.71717.5dSearch in Google Scholar PubMed

12. Botswana Central Statistics Office. Botswana AIDS Impact Survey II: Statistical Report. 2005, Gaborone, Botswana.Search in Google Scholar

13. Thriemer K, Ley B, Ame SM, Puri MK, Hashim R, et al. Replacing paper data collection forms with electronic data entry in the field: findings from a study of community-acquired bloodstream infections in Pemba, Zanzibar. BMC Res Notes 2012;5:113.10.1186/1756-0500-5-113Search in Google Scholar PubMed PubMed Central

14. Staveteig S, Shanxiao W, Head SK, Bradley SEK, Nybro E. Demographic Patterns of HIV Testing Uptake in Sub-Saharan Africa. In: DHS M, ed. DHS Comparative Reports No. 30. Calverton, Maryland, USA: ICF International; 2013.Search in Google Scholar

15. Fako TT. Social and psychological factors associated with willingness to test for HIV infection among young people in Botswana. AIDS Care 2006;18:201–7.10.1080/09540120500456623Search in Google Scholar PubMed

16. Leston JD, Jessen CM, Simons BC. Alaska Native and rural youth views of sexual health: a focus group project on sexually transmitted diseases, HIV/AIDS, and unplanned pregnancy. Am Indian Alsk Native Ment Health Res 2012;19:1–14.10.5820/aian.1901.2012.1Search in Google Scholar PubMed

17. Kessler JA, Ponce P, Saleshando G, Gluckman S, Friedman HM, et al. Risk factors for failure to be offered routine HIV testing among adult medical inpatients in Botswana. J Acquir Immune Defic Syndr 2008;47:525–6.10.1097/QAI.0b013e31815b0d5bSearch in Google Scholar PubMed

Article Note:

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. The preliminary results were presented at the XIX International AIDS Conference in Washington DC, USA in July, 2012.

Received: 2014-11-10
Accepted: 2015-3-3
Published Online: 2016-5-5
Published in Print: 2016-5-1

©2016 by De Gruyter

Downloaded on 25.3.2023 from
Scroll Up Arrow