Assessing factors associated with HIV testing among adolescents in Malawi.

Despite being at high risk of HIV/AIDS, most young people do not know their HIV status. Using survey data (n = 2428) and applying multilevel models, this paper assesses factors associated with HIV testing among adolescents in Northern Malawi. The results show that among both boys (OR = 0.39) and girls (OR = 0.47), orphan status is associated with low likelihood of HIV testing. Correct knowledge about HIV/AIDS (OR = 2.55) and having secondary education (OR = 3.24) are associated with HIV testing among boys and girls, respectively. At the household level, living in a household whose head has secondary or higher education is positively associated with testing for boys (OR = 2.63), while residing together with biological siblings predicts higher odds of testing (OR = 2.67) for girls. Notably, orphaned girls' disadvantage regarding HIV testing loses significance when residential arrangement is controlled. At the community level, having HIV testing facility (OR = 2.70) or post-test club (OR = 1.40) is positively associated with HIV testing for boys, while girls from areas where religious leaders hold judgmental views about HIV/AIDS are less likely (OR = 0.45) to test. These findings suggest that efforts to scale up HIV testing among youth could benefit greatly from an understanding of how individual and community factors operate to influence adolescents to know their sero-status.