Determinants of comprehensive HIV and AIDS knowledge among Tanzanian adolescent girls and young women: A multilevel application of Andersen's Behavioral Model based on national survey

Mussa Hassan Bago^1*Elihuruma Eliufoo Stephano¹Sanun Ally Kessy²Jovin R Tibenderana³Victoria Godfrey Majengo⁴Erick Donard Oguma¹Tegemea Patrick Mwalingo¹Immaculata P Kessy⁵Azan Nyundo⁶Mtoro J. Mtoro⁷

• ¹University of Dodoma, Dodoma, Tanzania
• ²Directorate of Research and Training, Benjamin Mkapa Hospital, 41218 Iyumbu, Dodoma, Tanzania, Dodoma, Tanzania
• ³Department of Public Health, St. Francis University, College of Health and Allied Sciences, Ifakara, Tanzania, Morogoro, Tanzania
• ⁴Department of Obstetrics and Gynecology, Dodoma Regional Referral Hospital, 41108 Dodoma, Tanzania, Dodoma, Tanzania
• ⁵TILAM International, Dar es Salaam, Tanzania
• ⁶Department of Psychiatry and Mental Health, School of Medicine and Dentistry, The University of Dodoma, Benjamin Mkapa Road, 41218 Iyumbu, Dodoma, Tanzania, Dodoma, Tanzania
• ⁷TILAM International, Dodoma, Tanzania

Background: Limited comprehensive HIV and AIDS knowledge is a significant factor contributing to the prevalence of HIV among adolescent girls and young women (AGYW). Therefore, this study aimed to determine the level of comprehensive HIV and AIDS knowledge and identify its associated factors among AGYW in Tanzania Methods: An Analytical cross-sectional study of the 2022 Tanzania Demographic and Health Surveys data was conducted. The study included 5,810 AGYW, selected through a two-stage sampling method. Multilevel logistic regression, accounting for the complex survey design, was used to identify individual and community-level factors associated with comprehensive HIV/AIDS knowledge. Analyses were conducted using Stata 18.5. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported, and statistical significance was set at p < 0.05.The prevalence of comprehensive HIV and AIDS knowledge among AGYW was 46.2% (95% CI: 44.3%-48.2%). In the final fitted multivariable analyses, AGYW in primary (AOR=1.97, 95%CI: 1.56-2.47), secondary (AOR=3.79, 95%CI: 2.96-4.85), AGYW in a rich quantile (AOR=1.38, 95%CI: 1.15-1.66), owning a mobile phone (AOR=1.26, 95%CI: 1.09-1.45), the use of the internet (AOR=1.40, 95%CI: 1.16-1.68) and AGWY who ever tested for HIV (AOR=1.61, 95%CI: 1.39-1.87) had higher odds of having comprehensive knowledge compared to their counterparts. At the community level, geographical zones exhibited higher odds of having comprehensive knowledge.Despite notable progress in HIV education, gaps persist, especially among AGYW, underscoring the need for focused, diversified interventions. By advancing understanding of these determinants, the study provides crucial evidence to inform tailored HIV prevention strategies aimed at enhancing knowledge and reducing infection rates within this vulnerable population and improving safer sex practices.