Public Health Pract (Oxf). 2026 Jul 8;12:100824. doi: 10.1016/j.puhip.2026.100824. eCollection 2026 Dec.
ABSTRACT
OBJECTIVES: Despite substantial progress in the fight against HIV/AIDS, the epidemic continues to pose a major global public health challenge, with persistent residential disparities. However, the contributing factor for urban-rural disparities in Ethiopia is limited. Therefore, this study aims to identify inequalities in HIV testing across residences and identify contributing factors in Ethiopia.
STUDY DESIGN: A cross-sectional study design was used to analyse secondary data.
METHODS: We used Individual Recode (IR) dataset, which includes women of reproductive age, and the Male Recode (MR) dataset, which includes men aged 15-59 years, from the 2016 Ethiopian Demographic and Health Survey (EDHS). Descriptive statistics summarised participants’ socioeconomic and demographic characteristics. A multivariate decomposition analysis was employed to assess residential disparities in HIV testing.
RESULT: Overall, 44.9% of participants reported having been tested for HIV. Uptake was substantially higher among urban residents, with 69.3% reporting HIV testing compared with 38.3% of rural residents. The urban-rural gap was explained by both differences in participant characteristics and differences in the effects of those characteristics. Overall, 23.5% of the disparity was attributable to compositional factors, while 76.5% was attributable to coefficient effects. Being married (-12.7%), secondary (12.2%), and higher education (17.3%), and metropolises (3.7%) were the major compositional factors.
CONCLUSION: There was a substantial disparity in HIV testing between urban and rural residents in Ethiopia. The residential difference in HIV testing was largely driven by differences in characteristics such as marital status, education level, and metropolises, which influenced HIV testing. Policy makers should strengthen interventions aiming to increase HIV testing, particularly in rural areas, with a focus on enhancing education and engagement with health services.
PMID:42502692 | PMC:PMC13400955 | DOI:10.1016/j.puhip.2026.100824
