{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:29:49Z","timestamp":1786123789767,"version":"build-2736575974"},"reference-count":22,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Social Behavioral Science D44 Program","award":["D43 TW009595"],"award-info":[{"award-number":["D43 TW009595"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Assoc Provid AIDS Care"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    Adolescent girls and young women (AGYW) are among the high-risk groups for new HIV infection, particularly in Sub-Saharan Africa (SSA). HIV testing is an entry path to HIV care and treatment and is crucial in ending the HIV epidemic by 2023. Despite the availability of HIV Testing Services (HTS) in most SSA countries, including Tanzania, most AGYW are undiagnosed HIV or have ongoing HIV exposure. This study explored the enablers for and barriers to the uptake of HTS among AGYW aged 15-24 in northern Tanzania. This qualitative study was conducted between 4\n                    <jats:sup>th<\/jats:sup>\n                    October and 30\n                    <jats:sup>th<\/jats:sup>\n                    November 2024 in the Kilimanjaro Region, northern Tanzania. We included AGYW attending four purposively selected Care and Treatment (CTC) sites. Four Focused Group Discussions (FGDs) (two for 15-19 years and 20-24 years, respectively) were conducted using a semi-structured interview guide to explore perceived enablers for and barriers to the uptake of HTS among AGYW. Data were analyzed using thematic content analysis, and findings were presented narratively, using verbatim quotes. A total of 32 AGYW participated in the FGDs, more than half (53%) were aged 20- 24 years old and had primary education, and 63% (n = 20\/32) were still in school. Perceived enablers that may facilitate the uptake of HTS include small blood samples collected, trust of a sexual partner, confidentiality of HIV test results, and existing social support. Other perceived enablers were the provider-centred HIV approach, comprehensive HIV education, health benefits of ARV use, and antenatal care as an entry point to HTS. Perceived barriers to HTS uptake include lack of HTS knowledge, being asymptomatic, fear of HIV test results, spiritual healing beliefs, being visible at the health facility, and anticipated stigma. Other perceived barriers were the provider\u2019s negative attitudes, long waiting times, lack of confidentiality of HIV test results, and transport costs. This calls for a multifaceted, client-centred intervention that strengthens the perceived enablers and simultaneously addresses the perceived barriers to create an enabling environment for uptake of HTS among AGYW.\n                  <\/jats:p>","DOI":"10.1177\/23259582261470679","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T06:49:17Z","timestamp":1785912557000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Perceived Enablers and Barriers to HIV Testing Service Uptake Among Adolescent Girls and Young Women in Kilimanjaro, Tanzania: A Contextual Analysis"],"prefix":"10.1177","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7143-8400","authenticated-orcid":false,"given":"Bernard","family":"Njau","sequence":"first","affiliation":[{"name":"School of Public Health, KCMC University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasrath","family":"Fadhili","sequence":"additional","affiliation":[{"name":"School of Public Health, KCMC University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3324-1965","authenticated-orcid":false,"given":"Editruda","family":"Gamassa","sequence":"additional","affiliation":[{"name":"School of Public Health, KCMC University"},{"name":"Internal Medicine Department, Kilimanjaro Christian Medical Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damian","family":"Jeremia","sequence":"additional","affiliation":[{"name":"School of Public Health, KCMC University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"e_1_3_8_2_2","unstructured":"World Health Organization. HIV\/AIDS Fact Sheet. 2020. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/hiv-aids. Accessed 4\/10\/2024."},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.13560"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12978-018-0640-2"},{"key":"e_1_3_8_5_2","article-title":"Tanzania HIV Impact Survey(THIS) 2022-2023","author":"Tanzania Commission for AIDS(TACAIDS), Zanzibar AIDS Commission ( ZAC)","year":"2024","unstructured":"Tanzania Commission for AIDS(TACAIDS), Zanzibar AIDS Commission ( ZAC). Tanzania HIV Impact Survey(THIS) 2022-2023. Final Report. 2024.","journal-title":"Final Report"},{"issue":"69","key":"e_1_3_8_6_2","first-page":"1","article-title":"\u201cAshamed of being seen in an HIV clinic\u201d: a qualitative analysis of barriers to engaging in HIV care from the perspectives of patients and health care workers in the Daraja clinical trial","volume":"25","author":"Okello ES","year":"2025","unstructured":"Okello ES, Peck RN, Issarow B, et al. \u201cAshamed of being seen in an HIV clinic\u201d: a qualitative analysis of barriers to engaging in HIV care from the perspectives of patients and health care workers in the Daraja clinical trial. BMC Public Health. 2025;25(69):1-12.","journal-title":"BMC Public Health"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.12.04038"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0000536"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0232883"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2021.1981818"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/pr.2016.28"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1080\/17441692.2020.1775867"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0164052"},{"key":"e_1_3_8_14_2","doi-asserted-by":"publisher","DOI":"10.4314\/ahs.v13i4.22"},{"key":"e_1_3_8_15_2","first-page":"963","article-title":"Barriers and facilitators for HIV testing practice among Ethiopian women aged 15-24 years: Analysis of the 2016 Ethiopian demographic and health survey","volume":"12","author":"Diress G","year":"2020","unstructured":"Diress G, Ahmed M, Adane S, Linger M, Alemnew B. Barriers and facilitators for HIV testing practice among Ethiopian women aged 15-24 years: Analysis of the 2016 Ethiopian demographic and health survey. Research and Palliative Care. 2020;12:963-970.","journal-title":"Research and Palliative Care"},{"key":"e_1_3_8_16_2","doi-asserted-by":"publisher","DOI":"10.1080\/00224499.2017.1292493"},{"key":"e_1_3_8_17_2","first-page":"1","article-title":"\u201cI felt very small and embarrassed by the health care provider when I requested syphilis\u201d: barriers and facilitators of regular syphilis and HIV testing among female sex workers in Uganda","volume":"21","author":"Muhindo R","year":"2021","unstructured":"Muhindo R, Mujugira A, Castelnuovo B, Sewankambo NK, Parkes-Ratanshi R, Tumwesigye NM. \u201cI felt very small and embarrassed by the health care provider when I requested syphilis\u201d: barriers and facilitators of regular syphilis and HIV testing among female sex workers in Uganda. BMC infectious Diseases. 2021;21:1-10.","journal-title":"BMC infectious Diseases"},{"key":"e_1_3_8_18_2","article-title":"Determinants of HIV testing and receipt of test results among adolescent girls in Nigeria: the role of assets and decision-making","volume":"32","author":"Iwelunmor J","year":"2018","unstructured":"Iwelunmor J, Blackstone S, Jennings L, Converse D, Ehiri J, Curley J. Determinants of HIV testing and receipt of test results among adolescent girls in Nigeria: the role of assets and decision-making. 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