{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T17:55:55Z","timestamp":1782496555956,"version":"3.54.5"},"reference-count":55,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"unspecified","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,1,21]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite several intensive interventions, HIV remains a major public health challenge affecting many individuals worldwide and highlighting ongoing gaps in HIV testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the proportion of \u2018never been tested for HIV\u2019 and the risk factors associated therewith among women aged 15\u201349 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The 2022 Tanzania Demographic and Health Survey data were used for this study. The variable of interest was whether women of reproductive age (WRA) reported never being tested for HIV. A total weighted sample of 15 254 WRA participated in the study. A survey logistic regression model was employed to determine factors associated with never being tested for HIV, as it accounts for the complexity of the sampling design. Analysis was performed at a 5% level of significance using R statistical software V. 4.5.2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 15 254 WRA that participated, 3082 (20.2%) reported never being tested for HIV. The median (IQR) age of participants was 28 (21\u201337) years. The odds of never being tested for HIV decreased with increasing age (OR=0.96; 95%\u2009CI 0.95 to 0.97). Furthermore, factors such as having primary or secondary education, being pregnant or breastfeeding, marital status (married, living with a partner, widowed, divorced or separated), living in a female-headed household, using the internet, abstaining from sex, being aware of HIV test kits but never using them, media exposure, belonging to the middle wealth index category, using contraceptives and having other sexual partners besides a spouse within the past 12 months was found to be associated with never being tested for HIV among WRA in Tanzania.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This current study identified several factors associated with never being tested for HIV among WRA. To enhance HIV testing uptake in this population, government and public health stakeholders should design targeted interventions that address these determinants, particularly by improving access to education, promoting health awareness and integrating HIV testing into routine reproductive health services.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-098901","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T15:45:14Z","timestamp":1770651914000},"page":"e098901","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Proportion and risk factors associated with \u2018never been tested for HIV\u2019 among women of reproductive age in Tanzania: evidence from the 2022 Tanzania Demographic and Health Survey"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8077-3833","authenticated-orcid":false,"given":"Sizwe Vincent","family":"Mbona","sequence":"first","affiliation":[{"name":"Department of Statistics, Faculty of Applied Sciences, Durban University of Technology, Durban, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Retius","family":"Chifurira","sequence":"additional","affiliation":[{"name":"School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Faculty of Science and Agriculture, Durban, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bonginkosi Duncan","family":"Ndlovu","sequence":"additional","affiliation":[{"name":"Department of Statistics, Faculty of Applied Sciences, Durban University of Technology, Durban, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anisha","family":"Ananth","sequence":"additional","affiliation":[{"name":"Department of Statistics, Faculty of Applied Sciences, Durban University of Technology, Durban, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"key":"2026062610412434000_16.2.e098901.1","first-page":"129","article-title":"Strategies for laboratory HIV testing: an examination of alternative approaches not requiring Western blot","volume":"72","author":"Sato","year":"1994","journal-title":"Bull World Health Organ"},{"key":"2026062610412434000_16.2.e098901.2","doi-asserted-by":"crossref","first-page":"2471","DOI":"10.21767\/2471-9676.100027","article-title":"Factors Associated with Non-Acceptance of HIV Screening Test among Pregnant Women","volume":"02","author":"Damian","year":"2016","journal-title":"J HIV Retrovirus"},{"key":"2026062610412434000_16.2.e098901.3","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1186\/s13690-018-0299-8","article-title":"Gender disparity in epidemiological trend of HIV\/AIDS infection and treatment in Ethiopia","volume":"76","author":"Girum","year":"2018","journal-title":"Arch Public Health"},{"key":"2026062610412434000_16.2.e098901.4","doi-asserted-by":"crossref","DOI":"10.1186\/s13690-021-00758-2","article-title":"What explains gender inequality in HIV infection among high-risk people? A Blinder-Oaxaca decomposition","volume":"80","author":"Sajadipour","year":"2022","journal-title":"Arch Public Health"},{"key":"2026062610412434000_16.2.e098901.5","unstructured":"Global HI . AIDS statistics\u2014fact sheet. UNAIDS. Available: https:\/\/www.unaids.org\/en\/resources\/fact-sheet [Accessed 12 Oct 2021]."},{"key":"2026062610412434000_16.2.e098901.6","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-022-14903-1","article-title":"Family support in the management of diabetes patients\u2019 perspectives from Limpopo province in South Africa","volume":"22","author":"Mphasha","year":"2022","journal-title":"BMC Public Health"},{"key":"2026062610412434000_16.2.e098901.7","doi-asserted-by":"publisher","DOI":"10.14745\/ccdr.v47i02a03"},{"key":"2026062610412434000_16.2.e098901.8","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1016\/S0140-6736(21)01258-7","article-title":"Tracking development assistance for health and for COVID-19: a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990\u20132050","volume":"398","author":"Micah","year":"2021","journal-title":"Lancet"},{"key":"2026062610412434000_16.2.e098901.9","unstructured":"UNAIDS . Country progress report \u2013 United Republic of Tanzania (2020). 2020. Available: https:\/\/www.unaids.org\/sites\/default\/files\/country\/documents\/TZA_2020_countryreport.pdf [Accessed 18 Apr 2023]."},{"key":"2026062610412434000_16.2.e098901.10","unstructured":"UNAIDS . Country progress report \u2014 United Republic of Tanzania. 2020. Available: https:\/\/www.unaids.org\/sites\/default\/files\/country\/documents\/TZA_2020_countryreport.pdf [Accessed 18 Apr 2023]."},{"key":"2026062610412434000_16.2.e098901.11","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-017-1848-9"},{"key":"2026062610412434000_16.2.e098901.12","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.15585\/mmwr.mm6946a1","article-title":"Vital Signs: Deaths Among Persons with Diagnosed HIV Infection, United States, 2010-2018","volume":"69","author":"Bosh","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2026062610412434000_16.2.e098901.13","unstructured":"World Health Organization . Global health sector strategies on, respectively, HIV, viral hepatitis and sexually transmitted infections for the period 2022\u20132030, License: CC BY-NC-SA 3.0 IGO, 2022. Available: https:\/\/iris.who.int\/handle\/10665\/360348"},{"key":"2026062610412434000_16.2.e098901.14","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1004102","article-title":"HIV prevention for the next decade: Appropriate, person-centred, prioritised, effective, combination prevention","volume":"19","author":"Godfrey-Faussett","year":"2025","journal-title":"PLoS Med"},{"key":"2026062610412434000_16.2.e098901.15","doi-asserted-by":"crossref","first-page":"2015","DOI":"10.1097\/QAD.0000000000003343","article-title":"Correlations between community-level HIV preexposure prophylaxis coverage and individual-level sexual behaviors among United States MSM","volume":"36","author":"Mann","year":"2022","journal-title":"AIDS"},{"key":"2026062610412434000_16.2.e098901.16","doi-asserted-by":"crossref","first-page":"283","DOI":"10.2147\/HIV.S299812","article-title":"Predictors of Discrimination Towards People Living with HIV\/AIDS Among People Aged 15\u201349 Years in Ethiopia: A Multilevel Analysis","volume":"Volume 13","author":"Arefaynie","year":"2021","journal-title":"HIV"},{"key":"2026062610412434000_16.2.e098901.17","doi-asserted-by":"crossref","first-page":"22","DOI":"10.13181\/mji.v22i1.518","article-title":"HIV-related stigma and discrimination: a study of health care workers in Banda Aceh, Indonesia","volume":"22","author":"Harapan","year":"2013","journal-title":"Med J Indones"},{"key":"2026062610412434000_16.2.e098901.18","first-page":"347","article-title":"Prevalence of, and factors associated with, HIV\/AIDS-related stigma and discriminatory attitudes in Botswana","volume":"21","author":"Letamo","year":"2003","journal-title":"J Health Popul Nutr"},{"key":"2026062610412434000_16.2.e098901.19","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-024-52652-w","article-title":"Predictors of never testing for HIV among sexually active individuals aged 15-56 years in Rwanda","volume":"14","author":"Niyompano","year":"2024","journal-title":"Sci Rep"},{"key":"2026062610412434000_16.2.e098901.20","doi-asserted-by":"crossref","DOI":"10.1186\/s12884-020-02967-z","article-title":"Is it home delivery or health facility? Community perceptions on place of childbirth in rural Northwest Tanzania using a qualitative approach","volume":"20","author":"Konje","year":"2020","journal-title":"BMC Pregnancy Childbirth"},{"key":"2026062610412434000_16.2.e098901.21","doi-asserted-by":"crossref","DOI":"10.1186\/s12978-017-0397-z","article-title":"Understanding the preference for homebirth; an exploration of key barriers to facility delivery in rural Tanzania","volume":"14","author":"Moshi","year":"2017","journal-title":"Reprod Health"},{"key":"2026062610412434000_16.2.e098901.22","doi-asserted-by":"crossref","DOI":"10.3402\/gha.v8.28567","article-title":"Women\u2019s perceptions of antenatal, delivery, and postpartum services in rural Tanzania","volume":"8","author":"Mahiti","year":"2015","journal-title":"Glob Health Action"},{"key":"2026062610412434000_16.2.e098901.23","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czab080"},{"key":"2026062610412434000_16.2.e098901.24","doi-asserted-by":"crossref","first-page":"24","DOI":"10.56279\/tjpsd.v27i1.104","article-title":"Exploring Factors Influencing Dropping-out of CommunityBased Health Insurance Schemes in Mpwapwa District, Tanzania","volume":"27","author":"Alex","year":"2020","journal-title":"Tanz J Popul Stud Dev"},{"key":"2026062610412434000_16.2.e098901.25","doi-asserted-by":"crossref","DOI":"10.1186\/s12939-019-1040-0","article-title":"Leaving no one behind? Social inclusion of health insurance in low- and middle-income countries: a systematic review","volume":"18","author":"van Hees","year":"2019","journal-title":"Int J Equity Health"},{"key":"2026062610412434000_16.2.e098901.26","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-018-0721-4"},{"key":"2026062610412434000_16.2.e098901.27","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-015-1179-3"},{"key":"2026062610412434000_16.2.e098901.28","unstructured":"George C , Myamba F , Ulriksen M . Social protection in tanzania: challenges in the shift of financing PSSN from external funding to government. Report PB. 2021.5. Available: https:\/\/www.researchgate.net\/publication\/351281724_Social_Protection_in_Tanzania_Challenges_in_the_shift_of_financing_PSSN_from_external_funding_to_government"},{"key":"2026062610412434000_16.2.e098901.29","unstructured":"Parmar D , Victora C , Barros A , et al . Breaking barriers: towards more gender\u2013responsive and equitable health systems. In: Salama P , Asma S , eds. Primary health care on the road to universal health coverage: 2019 global monitoring report. Geneva: World Health Organization, 2019. Available: https:\/\/www.who.int\/docs\/default-source\/documents\/gender\/gender-gmr-2019.pdf"},{"key":"2026062610412434000_16.2.e098901.30","doi-asserted-by":"crossref","unstructured":"Hosmer DW , Lemeshow S , Sturdivant RX . Applied logistic regression. John Wiley & Sons, 2013. Available: https:\/\/doi.org\/10.1002\/9781118548387","DOI":"10.1002\/9781118548387"},{"key":"2026062610412434000_16.2.e098901.31","unstructured":"MoHCDGEC, MoH, NBS, OCGS . Tanzania demographic and health survey and Malaria indicator survey (TDHS-MIS) 2022\u20132023. Dar es Salaam, Tanzania, and Rockville, Maryland, USA, 2023."},{"key":"2026062610412434000_16.2.e098901.32","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czx063"},{"key":"2026062610412434000_16.2.e098901.33","unstructured":"World Health Organization . Consolidated guidelines on hiv testing services, 2019. 2020. Available: https:\/\/www.who.int\/publications\/i\/item\/978-92-4-155058-1 [Accessed 20 Aug 2024]."},{"key":"2026062610412434000_16.2.e098901.34","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0062637","article-title":"Factors associated with not testing for HIV and consistent condom use among men in Soweto, South Africa","volume":"8","author":"Mhlongo","year":"2013","journal-title":"PLoS One"},{"key":"2026062610412434000_16.2.e098901.35","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/78.3.691"},{"key":"2026062610412434000_16.2.e098901.36","doi-asserted-by":"crossref","unstructured":"Sweet SA , Grace-Martin K . Data analysis with SPSS. Boston, MA, USA Allyn & Bacon; 1999. Available: https:\/\/doi.org\/10.2307\/3211435","DOI":"10.2307\/3211435"},{"key":"2026062610412434000_16.2.e098901.37","first-page":"141","article-title":"Prevalence and Risk Factors Associated with Anemia among Women of Childbearing Age in Rwanda","volume":"24","author":"Habyarimana","year":"2020","journal-title":"Afr J Reprod Health"},{"key":"2026062610412434000_16.2.e098901.38","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1093\/inthealth\/ihad031","article-title":"HIV testing among women of reproductive age in 28 sub-Saharan African countries: a multilevel modelling","volume":"15","author":"Zegeye","year":"2023","journal-title":"Int Health"},{"key":"2026062610412434000_16.2.e098901.39","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-018-5051-3","article-title":"Determinants of HIV infection among adolescent girls and young women aged 15-24 years in South Africa: a 2012 population-based national household survey","volume":"18","author":"Mabaso","year":"2018","journal-title":"BMC Public Health"},{"key":"2026062610412434000_16.2.e098901.40","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-020-09660-y","article-title":"Women\u2019s healthcare decision-making capacity and HIV testing in sub-Saharan Africa: a multi-country analysis of demographic and health surveys","volume":"20","author":"Seidu","year":"2020","journal-title":"BMC Public Health"},{"key":"2026062610412434000_16.2.e098901.41","doi-asserted-by":"crossref","unstructured":"Terefe B , Jembere MM , Reda GB , et al . Knowledge, and utilization of HIV self-testing, and its associated factors among women in sub\u2013Saharan Africa: evidence from 21 countries demographic and health survey. BMC Public Health 1960;24. doi:10.1186\/s12889-024-19529-z","DOI":"10.1186\/s12889-024-19529-z"},{"key":"2026062610412434000_16.2.e098901.42","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0242001","article-title":"Prenatal care coverage and correlates of HIV testing in sub-Saharan Africa: Insight from demographic and health surveys of 16 countries","volume":"15","author":"Awopegba","year":"2020","journal-title":"PLoS One"},{"key":"2026062610412434000_16.2.e098901.43","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0209782","article-title":"HIV incidence among pregnant and postpartum women in a high prevalence setting","volume":"13","author":"Machekano","year":"2018","journal-title":"PLoS One"},{"key":"2026062610412434000_16.2.e098901.44","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2018.00192","article-title":"Educational Attainment as a Predictor of HIV Testing Uptake Among Women of Child-Bearing Age: Analysis of 2014 Demographic and Health Survey in Zambia","volume":"6","author":"Muyunda","year":"2018","journal-title":"Front Public Health"},{"key":"2026062610412434000_16.2.e098901.45","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0315262","article-title":"Individual and contextual factors associated with abortion among reproductive age women in sub-Saharan Africa: Insights from 24 recent demographic and health surveys","volume":"19","author":"Seifu","year":"2024","journal-title":"PLoS One"},{"key":"2026062610412434000_16.2.e098901.46","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph19084860","article-title":"Factors Associated with HIV Testing among Reproductive Women Aged 15-49 Years in the Gambia: Analysis of the 2019-2020 Gambian Demographic and Health Survey","volume":"19","author":"Deynu","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"2026062610412434000_16.2.e098901.47","doi-asserted-by":"crossref","first-page":"S415","DOI":"10.1007\/s10461-014-0825-9","article-title":"HIV self-testing in resource-limited settings: regulatory and policy considerations","volume":"18 Suppl 4","author":"Wong","year":"2014","journal-title":"AIDS Behav"},{"key":"2026062610412434000_16.2.e098901.48","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000003174"},{"key":"2026062610412434000_16.2.e098901.49","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2024.1518314","article-title":"Factors associated with HIV testing among young women in Tanzania: Insights from the 2022 Tanzanian Demographic and Health Survey using Anderson\u2019s Behavioral Model","volume":"12","author":"Abebe","year":"2024","journal-title":"Front Public Health"},{"key":"2026062610412434000_16.2.e098901.50","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-024-10031-w","article-title":"Spatial distribution and factors associated with HIV testing among adolescent girls and young women in Sierra Leone","volume":"24","author":"Osborne","year":"2024","journal-title":"BMC Infect Dis"},{"key":"2026062610412434000_16.2.e098901.51","doi-asserted-by":"crossref","DOI":"10.1186\/s12913-024-12035-3","article-title":"Determinants of non-testing for HIV among women during antenatal care follow up in sub-saharan Africa: a hierarchical analysis of recent Demographic and Health Survey datasets","volume":"24","author":"Tamir","year":"2024","journal-title":"BMC Health Serv Res"},{"key":"2026062610412434000_16.2.e098901.52","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0154213","article-title":"Contraceptive Use and Uptake of HIV-Testing among Sub-Saharan African Women","volume":"11","author":"Center","year":"2016","journal-title":"PLoS One"},{"key":"2026062610412434000_16.2.e098901.53","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0004459","article-title":"Who has never tested for HIV following a community-based distribution of HIV self-test kits? Establishing associated predictors in rural Zimbabwe","volume":"5","author":"Murenjekwa","year":"2025","journal-title":"PLOS Glob Public Health"},{"key":"2026062610412434000_16.2.e098901.54","doi-asserted-by":"crossref","DOI":"10.4102\/sajhivmed.v23i1.1347","article-title":"Association between socio-economic factors and HIV self-testing knowledge amongst South African women","volume":"23","author":"Ekholuenetale","year":"2022","journal-title":"South Afr J HIV Med"},{"key":"2026062610412434000_16.2.e098901.55","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-021-11292-9","article-title":"Prevalence and associated factors of HIV testing among reproductive-age women in eastern Africa: multilevel analysis of demographic and health surveys","volume":"21","author":"Worku","year":"2021","journal-title":"BMC Public Health"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-098901","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T17:44:01Z","timestamp":1782495841000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-098901"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":55,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,9]]},"published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1136\/bmjopen-2025-098901"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-098901","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]}}}