{
  "abstract": "Objectives This study assessed the spatial distribution of HIV test non-uptake among pregnant women who attended antenatal care (ANC) in sub-Saharan Africa.Design Cross-sectional study design.Setting Sub-Saharan Africa (SSA) region. 24 SSA countries were included in this study.Data source Demographic and Health Survey (DHS), 2016–2024.Participants 82 397 women who were pregnant in the last 2 years preceding the survey.Outcome measure HIV test non-uptake, which is a legacy indicator of HIV test among pregnant women.Result The HIV test non-uptake among ANC attending pregnant women was 39.6% (95% CI 39.27% to 39.93%). The spatial autocorrelation test revealed that HIV testing non-uptake among pregnant women was clustered. The global Moran’s I value was 0.48 with a p value <0.01. Hotspot areas were those with high rates of HIV testing non-uptake. These hotspot areas were located in most parts of Mali, Mauritania, Madagascar, Guinea, Senegal, central parts of Angola, eastern part of Senegal and northern parts of Ethiopia. The Multiscale Geographical Weighted Regression (MGWR) model explained 91% of the spatial variation of HIV test non-uptake among pregnant women, who were in the age group 15–19 years, had no formal education and no health insurance, and less than four antenatal care contacts were significantly associated with HIV test non-uptake.Conclusion There was a significant geographical variation in HIV test non-uptake among pregnant women attending antenatal care (ANC) in sub-Saharan Africa. Prioritising hotspot areas with high rates of HIV test non-uptake for spatially targeted interventions is essential. Policymakers, health professionals, and other stakeholders should focus on improving women’s formal education, expanding health insurance coverage, and increasing ANC contacts to ensure that each visit includes HIV screening. Moreover, special attention should be given to younger women to enhance HIV testing uptake among those attending ANC in sub-Saharan Africa.",
  "authors": [
    {
      "affiliations": [
        "Department of Public Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia",
        "Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia"
      ],
      "name": "Eyob Akalewold Alemu"
    },
    {
      "affiliations": [
        "Department of Veterinary Epidemiology and Public Health, School of Veterinary Medicine, Bahir Dar University, Bahir Dar, Ethiopia"
      ],
      "name": "Simachew Getaneh Endalamew"
    },
    {
      "affiliations": [
        "Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia"
      ],
      "name": "Helen Brhan Alemaw"
    },
    {
      "affiliations": [
        "Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia"
      ],
      "name": "Halima Ayalew Kebede"
    },
    {
      "affiliations": [
        "Department of Public Health, Pawi Health Science College, Pawi, Ethiopia"
      ],
      "name": "Solomon Keflie Assefa"
    },
    {
      "affiliations": [
        "Department of Public Health, School of Public Health, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Birhan, Ethiopia"
      ],
      "name": "Endalew Minwuy Andarge"
    },
    {
      "affiliations": [
        "Department of Health Informatics, College of Medicine and Health Sciences, University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia"
      ],
      "name": "Eliyas Addisu Taye"
    },
    {
      "affiliations": [
        "Department of Public Health, College of Medicine and Health Science, Samara University, Samara, Ethiopia"
      ],
      "name": "Dejen Kahsay Asgedom"
    },
    {
      "affiliations": [
        "Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia"
      ],
      "name": "Sofiya Ayalew Kebede"
    },
    {
      "affiliations": [
        "Department of Health Informatics, College of Medicine and Health Sciences, University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia"
      ],
      "name": "Adem Tsegaw Zegeye"
    },
    {
      "affiliations": [
        "University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia"
      ],
      "name": "Belayneh Jejaw Abate"
    }
  ],
  "title": "Spatial variation in HIV test non-uptake among antenatal care–attending pregnant women in sub-Saharan Africa: a cross-sectional study using demographic and health survey data",
  "uid": "1c22c97c-91de-5265-abda-cb02762f8a42"
}