{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T23:15:12Z","timestamp":1790118912770,"version":"4.0.1"},"reference-count":75,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T00:00:00Z","timestamp":1713398400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Belgium Directorate-General for Development Cooperation"},{"name":"Flanders Research Foundation","award":["1221821N"],"award-info":[{"award-number":["1221821N"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Introduction<\/jats:title><jats:p>Adolescents and young adults (AYA) face multiple barriers to accessing healthcare services, which can interact, creating complex needs that often impact health behaviours, leading to increased vulnerability to HIV. We aimed to identify distinct AYA subgroups based on patterns of barriers to HIV testing services and assess the association between these barrier patterns and sexual behaviour, socio-demographics, and HIV status.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>Data were from Nigeria\u2019s AIDS Indicator and Impact Survey (NAIIS, 2018) and included 18,612 sexually active AYA aged 15\u201324 years who had never been tested for HIV and reported barriers to accessing HIV testing services. A Latent class analysis (LCA) model was built from 12 self-reported barrier types to identify distinct subgroups of AYA based on barrier patterns. Latent class regressions (LCR) were conducted to compare the socio-demographics, sexual behaviour, and HIV status across identified AYA subgroups. Sex behaviour characteristics include intergenerational sex, transactional sex, multiple sex partners, condom use, and knowledge of partner\u2019s HIV status.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>Our LCA model identified four distinct AYA subgroups termed \u2019low-risk perception\u2019 (n = 7,361; 39.5%), \u2019consent and proximity\u2019 (n = 5,163; 27.74%), \u2019testing site\u2019 (n = 4,996; 26.84%), and \u2019cost and logistics\u2019 (n = 1,092; 5.87%). Compared to adolescents and young adults (AYA) in the low-risk perception class, those in the consent and proximity class were more likely to report engaging in intergenerational sex (aOR 1.17, 95% CI 1.02\u20131.35), transactional sex (aOR 1.50, 95% CI 1.23\u20131.84), and have multiple sex partners (aOR 1.75, 95% CI 1.39\u20132.20), while being less likely to report condom use (aOR 0.79, 95% CI 0.63\u20130.99). AYA in the testing site class were more likely to report intergenerational sex (aOR 1.21, 95% CI 1.04\u20131.39) and transactional sex (aOR 1.53, 95% CI 1.26\u20131.85). AYA in the cost and logistics class were more likely to engage in transactional sex (aOR 2.12, 95% CI 1.58\u20132.84) and less likely to report condom use (aOR 0.58, 95% CI 0.34\u20130.98). There was no significant relationship between barrier subgroup membership and HIV status. However, being female, aged 15\u201324 years, married or cohabiting, residing in the Southsouth zone, and of Christian religion increased the likelihood of being HIV infected.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusions<\/jats:title><jats:p>Patterns of barriers to HIV testing are linked with differences in sexual behaviour and sociodemographic profiles among AYA, with the latter driving differences in HIV status. Findings can improve combination healthcare packages aimed at simultaneously addressing multiple barriers and determinants of vulnerability to HIV among AYA.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0300220","type":"journal-article","created":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T17:32:22Z","timestamp":1713461542000},"page":"e0300220","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Latent class analysis of barriers to HIV testing services and associations with sexual behaviour and HIV status among adolescents and young adults in Nigeria"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8124-7018","authenticated-orcid":true,"given":"Okikiolu","family":"Badejo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin","family":"Wouters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Van Belle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Buve","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3599-1719","authenticated-orcid":true,"given":"Tom","family":"Smekens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Plang","family":"Jwanle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Laga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiana","family":"N\u00f6stlinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,4,18]]},"reference":[{"issue":"8","key":"pone.0300220.ref001","doi-asserted-by":"crossref","first-page":"e0272405","DOI":"10.1371\/journal.pone.0272405","article-title":"Achieving the 95 95 95 targets for all: A pathway to ending AIDS.","volume":"17","author":"L Frescura","year":"2022","journal-title":"PLoS ONE"},{"key":"pone.0300220.ref002","volume-title":"90-90-90: an ambitious treatment target to help end the AIDS epidemic","author":"Joint United Nations Programme on HIV\/AIDS (UNAIDS).","year":"2014"},{"key":"pone.0300220.ref003","first-page":"32","author":"UNAIDS","year":"2016","journal-title":"Ending the AIDS epidemic for adolescents, with adolescents"},{"issue":"3","key":"pone.0300220.ref004","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1097\/COH.0000000000000449","article-title":"The global epidemiology of adolescents living with HIV: Time for more granular data to improve adolescent health outcomes.","volume":"13","author":"AL Slogrove","year":"2018","journal-title":"Curr Opin HIV AIDS"},{"key":"pone.0300220.ref005","author":"UNAIDS","year":"2021","journal-title":"Young people and HIV"},{"key":"pone.0300220.ref006","author":"UAIDS","year":"2020","journal-title":"2025 Targets"},{"issue":"S3","key":"pone.0300220.ref007","doi-asserted-by":"crossref","first-page":"21520","DOI":"10.7448\/IAS.20.4.21520","article-title":"Living and dying to be counted: What we know about the epidemiology of the global adolescent HIV epidemic","volume":"20","author":"AL Slogrove","year":"2017","journal-title":"Journal of the International AIDS Society"},{"key":"pone.0300220.ref008","author":"UNAIDS","year":"2022","journal-title":"IN DANGER: UNAIDS Global AIDS Update"},{"key":"pone.0300220.ref009","article-title":"Nigeria HIV\/AIDS Indicator and Impact Survey (NAIIS) 2018: Technical Report.","author":"Federal Ministry of Health, Nigeria","year":"2019","journal-title":"Abuja, Nigeria"},{"issue":"1","key":"pone.0300220.ref010","doi-asserted-by":"crossref","first-page":"60","DOI":"10.21307\/sjcapp-2019-009","article-title":"Towards a definition of multiple and complex needs in children and youth: Delphi study in Flanders and international survey.","volume":"7","author":"H Van Den Steene","year":"2019","journal-title":"Scandinavian Journal of Child and Adolescent Psychiatry and Psychology"},{"key":"pone.0300220.ref011","author":"A Rosengard","year":"2007","journal-title":"A Literature Review on Multiple and Complex Needs"},{"issue":"1","key":"pone.0300220.ref012","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s12981-020-00292-1","article-title":"Adolescents living with HIV, complex needs and resilience in Blantyre","volume":"17","author":"BN Kaunda-Khangamwa","year":"2020","journal-title":"Malawi. AIDS Res Ther"},{"issue":"3","key":"pone.0300220.ref013","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1111\/j.1468-1293.2012.01049.x","article-title":"Meeting complex needs: young people with HIV in London: Young people living with HIV.","volume":"14","author":"A Hughes","year":"2013","journal-title":"HIV Med"},{"issue":"11","key":"pone.0300220.ref014","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1089\/apc.2022.0111","article-title":"Preferences Across Pre-Exposure Prophylaxis Modalities Among Young Men Who Have Sex with Men in the United States: A Latent Class Analysis Study","volume":"36","author":"PK Valente","year":"2022","journal-title":"AIDS Patient Care and STDs"},{"issue":"2","key":"pone.0300220.ref015","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/s11904-020-00487-1","article-title":"Opportunities and Challenges in HIV Treatment as Prevention Research: Results from the ANRS 12249 Cluster-Randomized Trial and Associated Population Cohort.","volume":"17","author":"F Tanser","year":"2020","journal-title":"Curr HIV\/AIDS Rep"},{"issue":"3","key":"pone.0300220.ref016","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1080\/00224499.2014.883590","article-title":"The influence of relationship power dynamics on HIV testing in rural Malawi.","volume":"52","author":"AA Conroy","year":"2015","journal-title":"J Sex Res"},{"key":"pone.0300220.ref017","article-title":"Re-conceptualising gender and power relations for sexual and reproductive health: contrasting narratives of tradition, unity, and rights.","author":"AA Conroy","year":"2020","journal-title":"Culture, Health & Sexuality"},{"issue":"5","key":"pone.0300220.ref018","doi-asserted-by":"crossref","first-page":"e0233368","DOI":"10.1371\/journal.pone.0233368","article-title":"Low coverage of HIV testing among adolescents and young adults in Nigeria: Implication for achieving the UNAIDS first 95.","volume":"15","author":"AI Ajayi","year":"2020","journal-title":"PLOS ONE"},{"issue":"4","key":"pone.0300220.ref019","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1007\/s00038-020-01350-1","article-title":"HIV vulnerability among adolescent girls and young women: a multi-country latent class analysis approach.","volume":"65","author":"S Mathur","year":"2020","journal-title":"Int J Public Health"},{"key":"pone.0300220.ref020","unstructured":"Folayan MO, Odetoyinbo M, Brown B, Harrison A. Addressing the Socio-Development Needs of Adolescents Living with HIV\/AIDS in Nigeria: A Call for Action.: 9."},{"issue":"1","key":"pone.0300220.ref021","doi-asserted-by":"crossref","first-page":"e11","DOI":"10.1097\/QAI.0000000000002088","article-title":"\u201cFANMI\u201d: A Promising Differentiated Model of HIV Care for Adolescents in Haiti.","volume":"82","author":"LK Reif","year":"2019","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"3","key":"pone.0300220.ref022","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1097\/COH.0000000000000454","article-title":"Youth-friendly services and differentiated models of care are needed to improve outcomes for young people living with HIV","volume":"13","author":"LK Reif","year":"2018","journal-title":"Current Opinion in HIV and AIDS"},{"key":"pone.0300220.ref023","author":"Federal Ministry of Health","year":"2018","journal-title":"Nigeria National Standards & Minimum Service Package for Adolescent &Youth-Friendly Health Services"},{"issue":"1","key":"pone.0300220.ref024","doi-asserted-by":"crossref","first-page":"20859","DOI":"10.7448\/IAS.19.1.20859","article-title":"Impact of a youth-friendly HIV clinic: 10 years of adolescent outcomes in Port-au-Prince, Haiti.","volume":"19","author":"LK Reif","year":"2016","journal-title":"Journal of the International AIDS Society"},{"issue":"12","key":"pone.0300220.ref025","doi-asserted-by":"crossref","first-page":"e0208167","DOI":"10.1371\/journal.pone.0208167","article-title":"The DREAMS core package of interventions: A comprehensive approach to preventing HIV among adolescent girls and young women.","volume":"13","author":"J Saul","year":"2018","journal-title":"PLoS ONE"},{"issue":"4","key":"pone.0300220.ref026","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1177\/0095798420930932","article-title":"Latent Class Analysis: A Guide to Best Practice","volume":"46","author":"BE Weller","year":"2020","journal-title":"Journal of Black Psychology"},{"issue":"4","key":"pone.0300220.ref027","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1080\/10705510701575396","article-title":"Deciding on the Number of Classes in Latent Class Analysis and Growth Mixture Modeling: A Monte Carlo Simulation Study.","volume":"14","author":"KL Nylund","year":"2007","journal-title":"Structural Equation Modeling: A Multidisciplinary Journal"},{"key":"pone.0300220.ref028","article-title":"Auxiliary Variables in Mixture Modeling: Using the BCH Method in Mplus to Estimate a Distal Outcome Model and an Arbitrary Secondary Model","volume":"21","author":"Tihomir Asparouhov","year":"2021","journal-title":"Mplus We Notes: No"},{"key":"pone.0300220.ref029","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.jclinepi.2022.05.008","article-title":"Part I: A friendly introduction to latent class analysis.","volume":"147","author":"K Aflaki","year":"2022","journal-title":"Journal of Clinical Epidemiology"},{"issue":"1","key":"pone.0300220.ref030","doi-asserted-by":"crossref","first-page":"e63","DOI":"10.1097\/CCM.0000000000004710","article-title":"Practitioner\u2019s Guide to Latent Class Analysis: Methodological Considerations and Common Pitfalls.","volume":"49","author":"P Sinha","year":"2021","journal-title":"Crit Care Med"},{"key":"pone.0300220.ref031","unstructured":"Shaunna L., Clark Bengt Muth\u00e9n. Relating Latent Class Analysis results to variables not included in the analysis. Available from: https:\/\/www.statmodel.com\/download\/relatinglca.pdf"},{"issue":"4","key":"pone.0300220.ref032","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1002\/bimj.201200020","article-title":"Latent class regression: Inference and estimation with two\u2010stage multiple imputation.","volume":"55","author":"O Harel","year":"2013","journal-title":"Biometrical J"},{"issue":"5","key":"pone.0300220.ref033","doi-asserted-by":"crossref","first-page":"e0232598","DOI":"10.1371\/journal.pone.0232598","article-title":"Vulnerability profiles and prevalence of HIV and other sexually transmitted infections among adolescent girls and young women in Ethiopia: A latent class analysis.","volume":"15","author":"CA Comins","year":"2020","journal-title":"PLOS ONE"},{"issue":"S2","key":"pone.0300220.ref034","doi-asserted-by":"crossref","first-page":"e25518","DOI":"10.1002\/jia2.25518","article-title":"Creating HIV risk profiles for men in South Africa: a latent class approach using cross-sectional survey data","volume":"23","author":"A Gottert","year":"2020","journal-title":"Journal of the International AIDS Society"},{"issue":"1","key":"pone.0300220.ref035","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s12889-019-7959-7","article-title":"Latent class analysis of sexual health markers among men and women participating in a British probability sample survey.","volume":"20","author":"A Parkes","year":"2020","journal-title":"BMC Public Health"},{"issue":"1","key":"pone.0300220.ref036","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1186\/s12889-019-7310-3","article-title":"Protective sexual behaviours among young adults in Nigeria: influence of family support and living with both parents.","volume":"19","author":"AI Ajayi","year":"2019","journal-title":"BMC Public Health"},{"issue":"7","key":"pone.0300220.ref037","doi-asserted-by":"crossref","first-page":"e0129106","DOI":"10.1371\/journal.pone.0129106","article-title":"Differences in Sexual Practices, Sexual Behavior and HIV Risk Profile between Adolescents and Young Persons in Rural and Urban Nigeria.","volume":"10","author":"MO Folayan","year":"2015","journal-title":"PLoS ONE"},{"issue":"05","key":"pone.0300220.ref038","doi-asserted-by":"crossref","first-page":"463","DOI":"10.4236\/health.2016.85049","article-title":"Relationship between Sexual Risk Behaviors and HIV Counseling and Testing (HCT) Uptake among Young People in Nigeria.","volume":"08","author":"A Oguegbu","year":"2016","journal-title":"Health"},{"key":"pone.0300220.ref039","article-title":"Comparative Trends in Ethno-Regional Inequalities in Ghana and Nigeria: Evidence from Demographic and Health Surveys.","author":"Luca Mancini","year":"2009","journal-title":"In: Centre for Research on Inequality, Human Security and Ethnicity"},{"issue":"1","key":"pone.0300220.ref040","doi-asserted-by":"crossref","first-page":"8389","DOI":"10.1038\/s41598-022-12621-7","article-title":"Geographic and socioeconomic inequalities in the survival of children under-five in Nigeria.","volume":"12","author":"CI Okoli","year":"2022","journal-title":"Sci Rep"},{"issue":"1","key":"pone.0300220.ref041","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1186\/1471-2458-12-430","article-title":"Survival probability and predictors for woman experience childhood death in Nigeria: \u201canalysis of north\u2013south differentials.\u201d","volume":"12","author":"AS Adebowale","year":"2012","journal-title":"BMC Public Health"},{"key":"pone.0300220.ref042","unstructured":"Latent Class Analysis: A Guide to Best Practice\u2014Bridget E. Weller, Natasha K. Bowen, Sarah J. Faubert, 2020 [Internet]. [cited 2023 Feb 6]. Available from: https:\/\/journals.sagepub.com\/doi\/full\/10.1177\/0095798420930932"},{"issue":"3","key":"pone.0300220.ref043","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1080\/10705511.2014.915181","article-title":"Auxiliary Variables in Mixture Modeling: Three-Step Approaches Using Mplus.","volume":"21","author":"T Asparouhov","year":"2014","journal-title":"Structural Equation Modeling: A Multidisciplinary Journal"},{"key":"pone.0300220.ref044","unstructured":"Asparouhov T, Muthen B. Auxiliary Variables in Mixture Modeling: Using the BCH Method in Mplus to Estimate a Distal Outcome Model and an Arbitrary Secondary Model.: 80."},{"key":"pone.0300220.ref045","volume-title":"Stata Statistical Software: Release 17","author":"StataCorp","year":"2021"},{"issue":"1","key":"pone.0300220.ref046","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1080\/24754269.2021.1980261","article-title":"An introduction to statistical learning with applications in R: by Gareth James, Daniela Witten, Trevor Hastie, and Robert Tibshirani, New York, Springer Science and Business Media, 2013, $41.98, eISBN: 978-1-4614-7137-7.","volume":"6","author":"F Sohil","year":"2022","journal-title":"Statistical Theory and Related Fields"},{"issue":"6","key":"pone.0300220.ref047","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1097\/QAD.0000000000001006","article-title":"HIV testing, risk perception, and behaviour in the British population","volume":"30","author":"S Clifton","year":"2016","journal-title":"AIDS"},{"issue":"2","key":"pone.0300220.ref048","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1080\/09540121.2011.597711","article-title":"Why some MSM present late for HIV testing: a qualitative analysis","volume":"24","author":"L Dowson","year":"2012","journal-title":"AIDS Care"},{"issue":"12","key":"pone.0300220.ref049","first-page":"1173","article-title":"HIV Knowledge and its Contribution to Sexual Health Behaviors of Low-Income African American Adolescents.","volume":"102","author":"RR Swenson","year":"2010","journal-title":"J Natl Med Assoc"},{"issue":"1","key":"pone.0300220.ref050","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/s12889-019-7890-y","article-title":"HIV comprehensive knowledge and prevalence among young adolescents in Nigeria: evidence from Akwa Ibom AIDS indicator survey, 2017.","volume":"20","author":"T Badru","year":"2020","journal-title":"BMC Public Health"},{"issue":"9","key":"pone.0300220.ref051","doi-asserted-by":"crossref","first-page":"e012600","DOI":"10.1136\/bmjgh-2023-012600","article-title":"Understanding why and how youth-friendly health services improve viral load suppression among adolescents and young people living with HIV in Nigeria: realist evaluation with qualitative comparative analysis","volume":"8","author":"O Badejo","year":"2023","journal-title":"BMJ Glob Health"},{"key":"pone.0300220.ref052","article-title":"Understanding the relationship between couple dynamics and engagement with HIV care services: insights from a qualitative study in Eastern and Southern Africa.","author":"J Wamoyi","year":"2017","journal-title":"Sex Transm Infect"},{"issue":"S2","key":"pone.0300220.ref053","doi-asserted-by":"crossref","first-page":"e25517","DOI":"10.1002\/jia2.25517","article-title":"Gendered health institutions: examining the organization of health services and men\u2019s use of HIV testing in Malawi","volume":"23","author":"K Dovel","year":"2020","journal-title":"Journal of the International AIDS Society"},{"issue":"11","key":"pone.0300220.ref054","doi-asserted-by":"crossref","first-page":"2946","DOI":"10.1007\/s10461-019-02611-8","article-title":"The relationship between economic deprivation, housing instability and transactional sex among women in North Carolina (HPTN 064).","volume":"23","author":"MCD Stoner","year":"2019","journal-title":"AIDS Behav"},{"issue":"12","key":"pone.0300220.ref055","doi-asserted-by":"crossref","first-page":"1669","DOI":"10.1097\/QAD.0000000000001866","article-title":"Transactional sex and incident HIV infection in a cohort of young women from rural South Africa","volume":"32","author":"K Kilburn","year":"2018","journal-title":"AIDS"},{"key":"pone.0300220.ref056","volume-title":"Transactional sex and HIV risk: from analysis to action.","author":"UNAIDS","year":"2018"},{"issue":"1","key":"pone.0300220.ref057","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1186\/s12889-019-7137-y","article-title":"Relationship power and HIV sero-status: an analysis of their relationship among low-income urban Zimbabwean postpartum women.","volume":"19","author":"T Rwafa","year":"2019","journal-title":"BMC Public Health"},{"key":"pone.0300220.ref058","doi-asserted-by":"crossref","first-page":"2325958220978113","DOI":"10.1177\/2325958220978113","article-title":"Autonomy-Supportive Healthcare Climate and HIV-Related Stigma Predict Linkage to HIV Care in Men Who Have Sex With Men in Ghana, West Africa.","volume":"20","author":"LY Gu","year":"2021","journal-title":"J Int Assoc Provid AIDS Care"},{"key":"pone.0300220.ref059","article-title":"Strengthening adolescent agency for optimal health outcomes","author":"J Vijayaraghavan","year":"2022","journal-title":"BMJ"},{"issue":"7","key":"pone.0300220.ref060","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1080\/17441692.2016.1239270","article-title":"Women\u2019s agency and its relationship to current contraceptive use in lower- and middle-income countries: A systematic review of the literature.","volume":"13","author":"L James-Hawkins","year":"2018","journal-title":"Global Public Health"},{"issue":"1","key":"pone.0300220.ref061","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.jadohealth.2019.01.024","article-title":"Positive Youth Development Programs in Low- and Middle-Income Countries: A Conceptual Framework and Systematic Review of Efficacy.","volume":"65","author":"RF Catalano","year":"2019","journal-title":"Journal of Adolescent Health"},{"key":"pone.0300220.ref062","author":"G. Alvarado","year":"2017","journal-title":"A Systematic Review of Positive Youth Development Programs in Low- and Middle-Income Countries"},{"issue":"1","key":"pone.0300220.ref063","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1111\/tmi.13705","article-title":"HIV self\u2010testing and repeat testing in pregnancy and postpartum in Northern Nigeria.","volume":"27","author":"Z Iliyasu","year":"2022","journal-title":"Tropical Med Int Health"},{"issue":"9","key":"pone.0300220.ref064","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1177\/0956462420920136","article-title":"Acceptability and correlates of HIV self-testing among university students in northern Nigeria","volume":"31","author":"Z Iliyasu","year":"2020","journal-title":"Int J STD AIDS"},{"issue":"9972","key":"pone.0300220.ref065","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1016\/S0140-6736(15)60207-0","article-title":"Boko Haram insurgency: implications for public health","volume":"385","author":"O Omole","year":"2015","journal-title":"The Lancet"},{"issue":"1","key":"pone.0300220.ref066","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1186\/s12889-021-11583-1","article-title":"Socio-economic differences in the uptake of HIV testing and associated factors in South Africa.","volume":"21","author":"S Jooste","year":"2021","journal-title":"BMC Public Health"},{"issue":"2","key":"pone.0300220.ref067","doi-asserted-by":"crossref","first-page":"151","DOI":"10.24248\/eahrj.v5i2.666","article-title":"Correlates of Sexual Risky Behaviours, HIV Testing, and HIV Testing Intention among Sexually Active Youths in Northern Tanzania.","volume":"5","author":"B Njau","year":"2021","journal-title":"East Afr Health Res J"},{"key":"pone.0300220.ref068","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1186\/s12889-019-6570-2","article-title":"Sexual attitudes, sexual behaviors, and use of HIV prevention services among male undergraduate students 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