Trends and Determinants of changes in HIV Testing Uptake Among Adolescent Girls and Young Women in Mainland Tanzania: a secondary analysis of the 2011/12, 2016/17, and 2022/2023 National Survey Data

BackgroundAdolescent girls and young women (AGYW) in sub-Saharan Africa, including Tanzania, remain disproportionately vulnerable to HIV. Despite expanded HIV testing services (HTS), many AGYW remain unaware of their HIV status. AimThis study aimed to assess trends and drivers of changes in HIV Testing Uptake among AGYW in mainland Tanzania using data from three national surveys conducted over time. MethodologyA cross-sectional secondary data analysis was conducted using data from the Tanzania HIV and Malaria Indicator Survey (2011/12) and the Tanzania HIV Impact Surveys (2016/17 and 2022/23). Descriptive statistics summarized AGYW characteristics. A P-trend chi-squared test was used to identify significant changes in HIV testing uptake across survey years. A multivariable Poisson decomposition analysis was used to assess the drivers of changes in HIV testing uptake among AGYW in mainland Tanzania over time, as observed in the THMIS 2011/12, THIS 2016/17, and THIS 2022/23 surveys. ResultsOverall HIV testing uptake among AGYW increased from 54% (2011/12) to 61% (2016/17) and 64% (2022/23. Changes in the study participants characteristics in the phase II compared with both Phase III and I contributed 68.5% in increase HIV testing uptake, the main contributors to changes in testing uptake were being aged 20-24 years (39.6%, p-value< 0.001) and women with one sexual partner (38.8%, p-value<:0.001), followed by being with a STI history (24.9%, p-value<:0.001). Whereas 31.5% were attributed to the coefficient. ConclusionHIV testing uptake among AGYW in Tanzania has improved over time, with significant disparities between adolescents and young women. Being aged 20-24 years and changing sexual behavior patterns emerged as the strongest contributor to the observed changes. These findings highlight the need for age-specific strategies, intensifying adolescent-focused interventions while sustaining efforts among young women and reinforcing integrated reproductive health and HIV services.