Determinants of HIV prevalence among Ugandans aged 15-49 years: A multidimensional analysis.

Abstract

Despite ongoing HIV prevention interventions, HIV remains a major public health challenge in Uganda, particularly among reproductive age populations. The study aimed to identify sociodemographic, economic, behavioral factors associated with HIV prevalence among reproductive age individuals in Uganda. The study utilized secondary data obtained from the Uganda Population-based HIV Impact Assessment 2020-2021. A quantitative cross-sectional research design was employed. The study population consisted of men and women aged 15–49 years. Both descriptive and inferential statistical analyses were conducted using Stata. Univariate analysis was used to describe respondents’ characteristics, while bivariate analysis examined associations between independent variables and HIV prevalence using chi-square tests. Multivariate logistic regression analysis was conducted to identify significant predictors of HIV prevalence after controlling for other variables. Descriptive findings show variation in HIV prevalence across regions, with the highest proportions observed in the Central region (7.24%) and the lowest in the Eastern region (3.77%). Age-specific patterns indicate increasing HIV prevalence with age, peaking among individuals aged 40–44 years (9.68%) and 35–39 years (10.05%). Females (11.59%) exhibited higher HIV prevalence compared to males (3.9%). Marital status was also significant, with formerly married individuals reporting the highest prevalence (24.16%). Bivariate analysis revealed statistically significant associations between HIV status and key variables including region, age, gender, marital status, wealth index, occupation, number of sexual partners, age at first sex, condom use, male circumcision, and alcohol use before sex (p < 0.05). Multivariate logistic regression results indicated that region, age, gender, marital status, occupation, number of sexual partners, and age at first marriage were significant predictors of HIV status. Specifically, individuals with multiple sexual partners had higher odds of HIV infection (4–5 partners: OR = 2.927, p = 0.003; 6+ partners: OR = 3.729, p = 0.001). Older age groups showed progressively higher odds of HIV infection compared to those aged 15–19 years. Females had significantly higher odds of HIV infection compared to males (OR = 6.151, p = 0.006). Being not in union or formerly married was associated with higher odds of HIV infection (OR = 2.359, p = 0.001). The study concludes that HIV prevalence among reproductive-age individuals in Uganda is influenced by multiple interacting demographic, region, and behavioral factors. The study recommends strengthening targeted HIV prevention interventions focusing on older age groups, high-risk populations, behavioral change communication, regional HIV programming, and expansion of HIV testing and prevention services.