Prevalence and predictors of not testing for HIV among young men in Papua New Guinea: a cross-sectional analysis from a nationally representative sample

BackgroundHIV testing is an important component of HIV prevention and serves as a gateway to other HIV-related services. However, the uptake remains suboptimal among young people, particularly in highly prevalent settings such as Papua New Guinea (PNG). This study used nationally representative data to assess the prevalence and determine predictors of HIV testing uptake among young men aged 15-24 years in PNG. MethodsThe 2016-2018 PNG Demographic and Health Survey (PNGDHS) data was used. A total of 1,275 young men aged 15-24 years were included in the final analysis. Descriptive, bivariate, and multivariable logistic regression analyses were performed to determine independent predictors of HIV testing. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported. All analyses were adjusted using survey weights to account for unequal sampling probabilities. ResultsThe overall prevalence of HIV testing among young men was 17.2% (95% CI: 15-19). Of those who were tested for HIV, most lived in rural areas (73%), about one-third had a sexual debut at age <15 years (32.9%), and 33.9% inconsistently used condoms during sex. In multivariable analysis, men aged 20-24 years (AOR 1.18, 95% CI: 1.00-2.31), who own mobile phones (AOR 1.43, 95% CI: 1.00- 2.55), who were aware that consistent condom use during sex can reduce HIV risk (AOR 2.18, 95% CI: 1.18-4.04), who had paid for sex (AOR 1.75, 95% CI: 1.01-5.83), and who had two or more sexual partners (AOR 1.37, 95% CI: 1.01-3.14) had increased odds of HIV testing. However, decreased odds of HIV testing were found among men who were never married (AOR 0.51, 95% CI: 0.29-0.88), lived in rural areas (AOR 0.54, 95% CI: 0.32-0.92), and consistently used condoms during sex (AOR 0.59, 95% CI: 0.34-1.01). ConclusionThe findings show that HIV testing is low among young men in PNG. To increase HIV testing uptake among young men, it is crucial to implement comprehensive youth-friendly HIV/STI education and tailored sensitization programs and enable more accessible and affordable HIV testing services. Also, outreach and community-based testing programs for young men in prioritized areas requiring urgent prevention intervention are feasible options in PNG.