TEMPORAL TRENDS AND DETERMINANTS OF HIV TESTING UPTAKE AMONG ADOLESCENTS AND YOUNG PEOPLE IN MOZAMBIQUE: EVIDENCE FROM FIVE NATIONAL SURVEYS, 2003–2023

  • Edmilson Filimone1,2,
  • Sheyla Cassy2,3,
  • Assucênio Chissaque4,
  • Esperança Guimarães1,
  • Edy Chissaque1,
  • Orvalho Augusto5,6,7
  1. Instituto Nacional de Saúde, Mozambique;
  2. Universidade Eduardo Mandane, Mozambique;
  3. Universidade Nova de Lisboa, Portugal;
  4. Elizabeth Glaser Pediatric AIDS Foundation, Mozambique;
  5. Department of Global Health, University of Washington, Seattle, WA 98105, United States of America;
  6. Centro de Investigação em Saúde da Manhiça, Manhiça 12th Street, Distrito da Manhiça, Maputo Province 1929, Mozambique;
  7. Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo City, Mozambique.
Status: Submitted to the Evidence to Impact Symposium, Nairobi, Kenya 2026

Background: HIV/AIDS remains a major public health challenge in eastern and southern Africa. In Mozambique, an estimated 2.3 million people were living with HIV in 2024, representing one of the highest burdens globally. Among adolescent and young people aged 15–24 years, HIV prevalence was 5.4% according to the 2021 PHIA survey, yet only 53.8% were aware of their status. Over the past two decades, Mozambique has implemented numerous interventions, including mobile testing brigades and stigma-reduction campaigns, to increase HIV testing and linkage to care.

Objective: This study examines 20-year trends in HIV testing uptake among youth aged 15–24 years and identifies key determinants of testing behavior to assess progress toward improving knowledge of HIV serostatus.

Methods: We conducted a repeated cross-sectional analysis using data from five nationally representative household surveys (DHS and AIS) conducted in Mozambique between 2003 and 2023. The pooled sample included 36,697 youth aged 15–24 years. The primary outcome was ever having received an HIV test. Weighted prevalence estimates and temporal trends in testing uptake were calculated across all surveys. Determinants of HIV testing were examined using multivariable weighted logistic regression based solely on the most recent Demographic and Health Survey (DHS 2022–23).

Key Findings: HIV testing uptake among Mozambican youth increased dramatically from 5.4% (95% CI: 4.4–6.6) in 2003 to 50.5% (95% CI: 48.7–52.4) in 2022–23, though half remain untested. Testing was consistently higher among young women than men. In adjusted analysis, significantly higher odds of ever testing were observed among youth with knowledge of contraceptive methods (aOR = 3.55, 95% CI: 2.42–5.20) and sexually transmitted infections (aOR = 1.83, 95% CI: 1.55–2.17), young women (aOR = 2.50, 95% CI: 1.90–2.91), those aged 20–24 years (aOR = 2.80, 95% CI: 2.32–3.38), individuals with secondary or higher education (aOR = 2.79, 95% CI: 2.08–3.75), married youth (aOR = 5.21, 95% CI: 4.24–6.40), urban residents (aOR = 1.69, 95% CI: 1.38–2.08), employed youth (aOR = 1.33, 95% CI: 1.09–1.61), and those from the wealthiest households (aOR = 1.54, 95% CI: 1.03–2.30).

Policy/Programmatic Implications: Despite substantial progress over two decades, HIV testing uptake among young people in Mozambique remains suboptimal, with half still unaware of their status. Knowledge of sexual and reproductive health, gender, age, education, marital status, urban residence, employment, and household wealth are strong predictors of testing. Targeted interventions addressing these socioeconomic and knowledge-related barriers are critical to achieving the first 95 of the UNAIDS 95-95-95 targets among youth.

Keywords: HIV Testing, Adolescents, Young People, Temporal Trends, Mozambique, Health Surveys