Determinants of HIV infection among adolescent girls and young women age 15-25 years: analysis of Rwanda demographic heaalth survey 2014-2015

Abstract

Background: In Rwanda, the prevalence of Human Immunodeficiency Virus (HIV) is 3% over ten years in Adolescent Girls and Young Women (AGYW) it is most significant, impacting their ability to achieve and accomplish future plans. The Government of Rwanda, through the Ministry of Health, has initiated a number of measures to address HIV infection among AGYW. Still, the rate of HIV infection in this population remains high. This study analyzes factors of HIV infection among AGYW aged 15-24 years old. Methods: Descriptive statistics were summarized, and subsequently bivariate logistic regression was computed to determine associations between health risk behaviors and HIV among AGYW using the Rwanda Demographic Health Survey from 2014-15. From the bivariate analysis, odd ratios were determined (unadjusted and adjusted odd ratios) with 95% confidence interval. Adjusted odd ratios, using backward selection method, was used to find actual association with a p. value < 0.005. Results: A total of 737 AGYW aged 15-24 years old that completed the national survey questionnaires and interview made up the sample size for this study. Among them 4.2% (n=31) tested HIV positive. The results demonstrate that HIV infection was negatively significantly associated with AGYW having secondary school students [OR=0.14, 95% CI: 0.31-0.59, p=0.008] and residents of rural area [OR=0.33, 95% CI: 0.14-0.75, p=0.009]. The findings reveal that having 2 or more sexual partners is positively and significantly associated with HIV infection [OR=7.43, 95% CI: 1.79-30.86, p= 0.006]. Conclusion: These results recommend designing combined preventive interventions targeting AGYW focusing on socioeconomic needs of this fragile group. Moreover, there is need to improve the access and promote education and special follow-up for those who are in school in order to reduce the vulnerability of AGYW to HIV infection. An education package should include knowledge; attitudes and skills specifically aimed at HIV prevention, promoting behaviors such us condom use.