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

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

Abstract

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

Acknowledgments

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.

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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

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