HIV related knowledge and practices among undergraduate students in Africa: A cross-sectional multinational study

Abstract

Background

Africa has the highest burden of HIV/AIDS globally, with young people being the most affected. This study aimed to assess HIV knowledge and practices among undergraduate students in Africa.

Methods

An analytical cross-sectional study was conducted in ten African countries using an online, self-administered, pre-validated questionnaire. The study was conducted in 10 African countries, located in 5 different regions across Africa including Kenya, Algeria, Botswana, Burkina Faso, Ethiopia, Nigeria, Rwanda, Sudan, Tanzania, and Uganda, during the academic year 2022–2023. A convenience sampling approach was utilized to collect the data. African undergraduates who were 18 years and older, enrolled in universities across ten African countries and were willing to participate and gave an e-informed consent were included.

Shapiro-Wilk test was utilized to check the data normality. Student’s t-test and Chi-square test were used for continuous and categorical variables in independent samples. Mann-Whitney U and Kruskal-Wallis tests were used for nonparametric comparisons. Logistic regression was used for identifying the predictors for the knowledge regarding HIV. Significance level was set at p < 0.05.

Results

A total of 3727 undergraduate students responded to the questionnaire. Most students were medical students (68.1 %), single (94.9 %), and living in urban areas (78.7 %). The overall median HIV knowledge score was 14, and medical students had significantly higher knowledge than non-medical students (p < 0.001). While the students had a strong understanding of HIV transmission, some aspects of their knowledge were inadequate. Most students relied on academic curricula for HIV information (72.3 %) and their institutions provided formal HIV prevention strategies (57.8 %). A low percentage engaged in risky sexual behaviors. The results indicated that being male (AOR (95 % CI) = 4 (1.2–13.2)), pursuing medical education (AOR (95 % CI) = 2.4 (2–2.8)), being in the final years of study (i.e. fourth, fifth, and sixth years) (AOR (95 % CI) = 1.3 (1.02–1.6), 1.6 (1.2–2.1), 2.4 (1.6–3.8), ever testing for HIV (AOR (95 % CI) = 2.3 (1.9–2.8), and ever engaging in sexual activity (AOR (95 % CI) = 2.6 (2.3–3) were independent predictors of good knowledge of HIV.

Conclusion

The findings of this study reveal a notable proficiency in HIV knowledge among African undergraduate students, particularly those enrolled in medical programs. However, there remains scope for enhancing their HIV-related practices, particularly in the areas of routine HIV testing and the establishment of Voluntary Counseling and Testing (VCT) services.