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<p>Men in sub-Saharan Africa lag behind women in HIV testing and awareness. We pooled 2019–2023 Population-based HIV Impact Assessments from seven countries (Eswatini, Lesotho, Malawi, Mozambique, Tanzania, Uganda, Zimbabwe). Among 59,293 men, HIV prevalence was 5.9% (95% CI 5.7–6.2). Of 5,394 HIV-positive men, 22.1% (95% CI 20.0–24.3) were unaware of their status (8.4% in Eswatini; 31.5% in Mozambique), declining with age (41.0% at 15–29 vs. 11.5% at ≥ 50). Survey-weighted Poisson regression identified independent correlates: condom-free last sex (aPR 2.5), hazardous drinking (aPR 1.3), infrequent/no prior testing (aPR 1.9), and higher wealth (lower 60% vs. upper 40%: aPR 0.8). Age amplified behavioral gaps in condom use. Among men classified as aware, 5.4% were identified solely through ARV biomarker detection despite self-reported unawareness. Youth-centered, behavior-tailored retesting strategies are essential to close the awareness gap.</p>

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Unawareness of HIV-Positive Status among Men in Seven Sub-Saharan African Countries: Age, Behavioral, and Structural Determinants

  • 期刊论文

  • 发表日期：

    2026年2月25日

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  • Mansoor Farahani,
  • Shannon M. Farley,
  • David Hoos,
  • Theodore F. Smart,
  • Giles A. Reid,
  • Eduardo Samo Gudo,
  • Wilford L. Kirungi,
  • Rose Kolola Nyirenda,
  • Limpho Maile,
  • Owen Mugurungi,
  • Prosper Faustine Njau,
  • Sindisiwe Dlamini,
  • Wafaa M. El-Sadr

摘要

Men in sub-Saharan Africa lag behind women in HIV testing and awareness. We pooled 2019–2023 Population-based HIV Impact Assessments from seven countries (Eswatini, Lesotho, Malawi, Mozambique, Tanzania, Uganda, Zimbabwe). Among 59,293 men, HIV prevalence was 5.9% (95% CI 5.7–6.2). Of 5,394 HIV-positive men, 22.1% (95% CI 20.0–24.3) were unaware of their status (8.4% in Eswatini; 31.5% in Mozambique), declining with age (41.0% at 15–29 vs. 11.5% at ≥ 50). Survey-weighted Poisson regression identified independent correlates: condom-free last sex (aPR 2.5), hazardous drinking (aPR 1.3), infrequent/no prior testing (aPR 1.9), and higher wealth (lower 60% vs. upper 40%: aPR 0.8). Age amplified behavioral gaps in condom use. Among men classified as aware, 5.4% were identified solely through ARV biomarker detection despite self-reported unawareness. Youth-centered, behavior-tailored retesting strategies are essential to close the awareness gap.