Assessing Hiv Behavioral Risks and Their Associated Socio- Demographic Factors Among Adolescents: Survey Findings From Hiv Risk Education Program in Nimule Peri-urban Town, South Sudan

Abstract

INTRODUCTION: As the world advances toward HIV epidemic control, gains made are being slowed down by an increase in new HIV infections particularly among adolescents whose risky behaviors remain a public health concern. This study aimed to assess self-reported HIV behavioral risks and their associated socio-demographic factors among adolescents in Nimule peri-urban town in South Sudan. METHODS: We designed and undertook before and after the study with two cross-sectional surveys conducted at baseline and end line for adolescents aged 10-17 years who consented, enrolled, and participated in a peer-led HIV risk education program delivered in health clubs. Using a standardized adolescent survey questionnaire, data on ten (10) self-reported HIV risks including demographic factors of the respondents were collected between December 2020 and December 2021. A multi-level mixed-effect logistic regression analysis was performed using STATA version 16 statistical software to assess the associations between self-reported behavioral risks and associated sociodemographic factors. RESULTS: Among the 577 adolescents enrolled, 301 (54.0%) were female and 256 (46.0%) were males. The median age was 14 (IQR: 11-16) years at baseline and 15(IQR: 12-17) years at end-line. A slight decrease from 89 (16.0%) to 88 (15.8%) was observed between baseline and end-line in the proportion of adolescents who self-reported that they have never had sex in their lifetime with a corresponding increase from 58 (64.4%) at baseline to 70 (78.6%) at the end line in the proportion of adolescents self-reporting having used condoms in their last sex. Compared with the baseline survey, the odds of self-reported HIV risks were 23% lower (aOR 0.77, 95% CI:0.73-0.80, p<0.001). Equally, higher odds of self-reported risks were observed among male adolescents (aOR 1.11, 95% CI:1.06-1.15, p<0.001), those in the age band 15-17 years (aOR 1.27, 95% CI:1.21-1.34, p<0.001), those who were unemployed (aOR 1.2, 95% CI: 1.21-1.34, p<0.001) and those cared for by non-parents (aOR 1.29, 95% CI:1.21-1.36, p<0.001) CONCLUSION: Peer-led risk program education programs have the potential to reduce HIV risk behaviors among adolescents and this signifies the crucial role these programs can play in accelerating HIV prevention for young adolescents. We, therefore, recommend the integration of risk education into HIV prevention programs for adolescents in low- and middle-income countries like South Sudan