Out-of-Care HIV-Positive Young People Aged 15-24 years in Mozambique: Findings from the 2021 Population-Based HIV Impact Assessment Survey

Out-of-Care HIV-Positive Young People Aged 15-24 years in Mozambique: Findings from the 2021 Population-Based HIV Impact Assessment Survey | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Out-of-Care HIV-Positive Young People Aged 15-24 years in Mozambique: Findings from the 2021 Population-Based HIV Impact Assessment Survey Orrin Tiberi, K. Carter McCabe, Cynthia Sema Baltazar, Makini Boothe, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7770475/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 30 Jan, 2026 Read the published version in BMC Infectious Diseases → Version 1 posted 15 You are reading this latest preprint version Abstract Background Globally, young people are falling behind in the push to end the HIV epidemic. Understanding the characteristics of HIV-positive young people who are out-of-care (not on antiretroviral treatment [ART]) in Mozambique is important to effectively reach and ensure access to services for this priority population. Methods Using data from the 2021 Mozambique Population-based HIV Impact Assessment, we conducted a sub-analysis of HIV-positive young people aged 15–24 years whose blood specimens were tested for the presence of antiretrovirals. Participants testing negative for the presence of antiretrovirals were classified as out-of-care. We report weighted prevalence estimates of HIV-care status and select covariates. We used multivariable logistic regression to assess factors associated with out-of-care status. Results Among the 245 HIV-positive young people included, 58.0% (n = 141, 95% Confidence Interval [CI] 49.9–65.7%) were out-of-care. Out-of-care young people were mostly female (75.0%) living in a rural area (68.3%). Adjusting for education, young people who talked about HIV with a parent or guardian (20.0% of participants) (adjusted Odds Ratio [aOR]: 0.33, 95% CI: 0.17–0.66) or previously heard of pre-exposure prophylaxis (PrEP) (6.1% of participants) (aOR: 0.25, 95% CI: 0.09–0.65) were less likely to be out-of-care than those who had not. Odds of being out-of-care were increased for those from the northern compared to the central provinces (aOR: 2.37, 95% CI: 1.09–5.15) and those who had participated in prevention programs (aOR: 3.19, 95% CI: 1.37–7.41). Discussion Over half of young people with HIV in Mozambique met our definition for out-of-care in 2021. Our results reveal important geographic and sex gaps in HIV care. Strengthening existing programs to include components centered on creating a lasting link to health services could improve the identification of new HIV-positive young people. The important role of parents and guardians in young people’s health behaviors and decision-making presents an opportunity to engage families with interventions to strengthen needed services to this priority population in Mozambique. Young People HIV HIV treatment antiretroviral therapy Mozambique Figures Figure 1 Introduction Knowledge of human immunodeficiency virus (HIV) status is the first step in preventing HIV transmission and is crucial to ending HIV/AIDS as a global health threat.(1) The Joint United Nations Programme on HIV/AIDS (UNAIDS) 95-95-95 cascade targets envision 95% of people living with HIV (PLHIV) knowing their status, of those, 95% on antiretroviral treatment (ART), and 95% of PLHIV on treatment achieving viral load suppression by 2025. The targets are essential to reaching the United Nation’s Sustainable Development Goal 3.3, which aims to reduce the number of people newly infected with HIV per 1,000 population to 0.05 by 2025 and to 0.025 by 2030.(3) Increasing the proportion of people with HIV who have HIV viral load suppression is a key strategy to ending the HIV epidemic. People on ART with an undetectable viral load have essentially no risk of transmitting HIV to their sexual partners.(3–6) A prospective study following 1,166 sero-discordant couples found no transmission between couples with HIV viral suppression (<200 copies/ml).(6) Additionally, a systematic review of studies from 25 countries showed no sexual transmission of HIV in sero-discordant couples when the viral load was less than 200 copies/ml in the HIV-positive partner.(7) The priority for the next phase of HIV epidemic control is to ensure all people living with HIV have access to ART, especially priority populations such as young people aged 15–24 years.(8) Increasing HIV treatment coverage can be achieved through targeted testing and treatment interventions that are based on current epidemiological and demographic profiles. Over the last five years, there have been major advances in prevention and treatment of HIV in Mozambique, including the introduction of HIV self-testing, pre-exposure prophylaxis (PrEP), peer ART adherence counselors, and a large scale expansion of differentiated service delivery models, resulting in a rapid scale up of ART coverage from 59% in 2019 to 85% in 2023.(9,10) Despite these advances, many challenges remain, including the testing and inclusion of young people in HIV treatment and care services. In 2021, Mozambique conducted the Mozambican Population-based HIV Impact Assessment (INSIDA) survey, which interviewed participants aged 15 years and older about socio-demographic factors, HIV-related behaviors, and performed a rapid HIV test. Survey results found that 71.6% of PLHIV knew their HIV status, a proportion still distant from the goal of 95% by 2025.(11) Both male and female young PLHIV, aged 15–24 years, had lower knowledge of their HIV serostatus compared to those aged 25–34 years (65.4% vs 74.5% among females, respectively, and 45.3% vs 53.8% among males, respectively).(11) The preceding population-based survey in 2015 had found that 77.5% of females and 35.7% of males aged 15–24 years had knowledge of their HIV serostatus, showing the difficulty of sustained testing coverage over the last six years in this age group.(12) Young people (15–24-year-olds) have the highest HIV incidence in Mozambique. The UNAIDS Spectrum model for Mozambique estimates that there were 4.7 new infections per 1,000 persons among young people compared to 2.6 new infections per 1,000 persons in the general population in 2023.(13,14) That same year, an estimated 31,000 new infections occurred among young people, approximately 38% of the total yearly infections in Mozambique.(13) HIV incidence in young people also has an elevated impact on Mozambique’s HIV epidemic due to the population distribution – approximately 20% of the national population are young people.(15) The considerable contribution of young people to national incidence is common to countries in the region; in Botswana, 15–24-year-olds make up 35% of the new infections, in Eswatini 34%, in Malawi 27%, and in South Africa 40%.(16) In the Mozambican National Strategic Plan for the HIV/SIDA Response 2021–2025, the first of the nine strategic objectives is to reduce overall new infections by 50% to 65,000 by 2025, prioritizing the identification and treatment of PLHIV, particularly among young people.(17) This study aims to estimate the proportion of HIV-positive young people (aged 15–24 years) in Mozambique who are out of care and to describe associated demographic and social characteristics. . Findings may inform targeted strategies to identify, test, and link youth to care—critical steps toward meeting both national HIV goals and the UNAIDS 95-95-95 targets. . Methods Study Design and Procedures We conducted a sub-analysis using data from the 2021 Mozambique Population-based HIV Impact Assessment (INSIDA) study,a nationally representative, cross-sectional household-based survey conducted between April 2021 and February 2022. The survey aimed to measure the progress of the country’s HIV response, both nationally and at the provincial level. Study Sample The survey used a four-stage probability sample design that randomly selected 11,375 households from 311 enumeration areas throughout Mozambique’s 11 provinces. Eligibility criteria were established on age, 15 years or older, and residency, requiring that respondents (usual household members or visitors) had slept in the sampled household the night before the interview. Interviewers conducted face-to-face interviews with consenting individuals using a standard questionnaire, which included household composition, socio-economic questions, and questions on the HIV testing and care continuum. Participants consented separately to a blood draw, which was then used for HIV, viral load, and CD4 testing. Of the 5,283 participants aged 15–24 years who were interviewed, 4,479 (85.2% weighted response rate) had blood drawn and definite lab results, and of those, 245 (5.4% weighted) tested HIV-positive. (Figure 1). HIV Testing Trained phlebotomists collected venous blood draws from all consenting participants through household-based HIV testing and counseling following the two-test national guideline: Determine™ HIV-1/2 rapid diagnostic test followed by the Uni-Gold™ HIV confirmatory test. If the first test returned nonreactive, the sample was classified as HIV-negative. If both tests were reactive, the blood specimen was classified as HIV-positive, if non-reactive the algorithm was repeated. Household-based HIV test results were returned to the participants the same day, with counseling and HIV services referral. All blood specimens with a positive or indeterminate result during the household testing were retested in a laboratory with Geenius HIV 1/2 Supplemental Assay (Bio-Rad, Hercules, California, United States). A positive laboratory result confirmed HIV-positive status, and confirmed HIV-positive specimens were subsequently measured for CD4-T cell count and viral load. Testing results were used to create the variable HIV status within the household, which was grouped based off respondents’ unique identifiers. Antiretroviral Detection Samples from confirmed HIV-positive participants were screened for detectable concentrations of the antiretrovirals atazanavir, lopinavir, efavirenz, and dolutegravir. A combination of these medications totaled 99.9% of all antiretrovirals distributed in health facilities with electronic medical records in 2021.(18) Prevention Program Participation Due to the small number of participants in the various HIV-prevention programs included in the survey questionnaire, a variable was created that categorized all participants who responded positively to participating in at least one prevention program. These youth-focused HIV programs include DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) partnership, which focuses on reducing HIV incidence in adolescent girls and young women, and the SAAJ ( Serviços Amigos dos Adolescentes e Jovens ) program, which is the Mozambique Ministry of Health flagship program for young people friendly services at health facilities and includes both dedicated space and clinicians for young people. All programs provide HIV-prevention information, sexual health decision-making empowerment and linkages to comprehensive health services.(19,20) Data Analysis Among HIV-positive young people aged 15–24 years with a valid HIV-positive test result, antiretroviral screening results were used to define the outcome of care status. In this study, we classify participants with detectable antiretroviral concentrations in their blood sample as “in care” and those without antiretrovirals detected as “out-of-care”. Participants with missing antiretroviral laboratory testing results were excluded from the analysis. All analyses were weighted using the jackknife replication method, per the Population-based HIV Impact Assessment survey standard of practice, to account for complex sampling. Descriptive analysis was conducted among young people in care and out-of-care, and weighted proportions and corresponding 95% confidence intervals (CI) are reported. Weighted chi-square tests and bivariate logistic regression analyses were conducted to assess demographic and behavioral factors significantly associated with out-of-care status among young people with HIV. Variables with a chi-square p-value of 0.15 and below were entered into a multivariable regression model and were then removed in a stepwise fashion, manually comparing AIC scores, until the best model was found. Two variables of interest, participation in a prevention program and the household member HIV status, were continued in the final model to better understand any possible interactions with the outcome of interest. To assess confounding, variables removed in the previous step were individually added back into the model and were considered confounders if their addition changed the adjusted odds ratio (aOR) by 10% or more, in which case they were included in the final model. Finally, all potential variables with interactions found in the literature were already excluded from the final model. Odds ratios (OR), aORs, and associated 95% confidence intervals and p-values are reported. All analyses were performed using R Studio version 4.1.3.(21) Human Ethics and Consent to Participate The study was conducted in accordance with the Declaration of Helsinki and was reviewed and approved by the Mozambique National Bioethics Committee (CNBS), the Columbia University Medical Center, and the U.S. Centers for Disease Control and Prevention (CDC) (protocol #7258) Institutional Review Boards (IRBs).[a] All participants provided written consent prior to the interview and blood draw, and additional parental consent was given for all respondents ages 15 to 17 years. A detailed description of the study protocol and procedures to protect confidentiality can be found in the final INSIDA report.(11) [a] See 45 C.F.R. part 46.114; 21 C.F.R. part 56.114 Results Of the 245 HIV-positive young people included in our analysis, 58.0% (n=141) were out-of-care, of whom 31.7% were aged 15–19 years (Table 1). The majority of out-of-care participants were female (75.0%), lived in a rural area (68.3%) in the northern provinces of Cabo Delgado, Nampula and Niassa (43.9%) had primary education (56.2%), were either married or living together (46.6%), and had not worked in the past 12 months (73.6%). Among out-of-care young people with HIV, most believed it would be easy to obtain a condom (53.8%), had never discussed sex (87.5%) or HIV (80.0%) with their parents or guardians, had never heard of PrEP (93.9%), had not participated in an HIV-prevention program (81.2%). Finally, 33.2% of HIV-positive out-of-care young people lived in a household with another HIV-positive individual. Table 1: Demographic and social characteristics among HIV-positive young people (15–24 years old) by HIV care status, Mozambique, 2021 (n=245) Table 1: Characteristic Out of Care (n=141) In Care (n=101) N Chi-Sq p-value Percent 95% CI Percent 95% CI Sex Male 25.0 18.6-32.4 20.7 12.3-31.6 53 0.472 Female 75.0 67.6-81.4 79.3 68.4-87.7 192 Age Group (Years) 15-19 31.7 23.4-41.1 29.8 20.1-41.1 66 0.762 20-24 68.3 58.9-76.6 70.2 58.9-79.9 179 Residence Urban 35.4 23.7-48.7 46.0 29.7-63.1 111 0.139 Rural 64.6 51.3-76.3 54.0 36.9-70.3 134 Geographic Area of Residence North (Cabo Delgado, Nampula, Niassa) 43.9 31.8-56.6 25.5 15.9-37.3 80 0.030 Central (Zambézia, Tete, Manica, Sofala) 37.2 27.7-47.5 51.1 38.3-63.9 92 South ( Inhambane, Gaza, Maputo, Maputo Cidade ) 18.9 12.0-27.5 23.4 14.9-33.8 73 Education No education 12.7 6.9-20.9 13.0 7.7-20.1 29 0.023 Primary education 56.2 47.2-64.9 38.7 28.3-49.9 114 Secondary or higher 31.1 23.6-39.3 48.3 36.4-60.4 100 Marital Status Never married 32.7 24.8-41.5 40.4 29.3-52.1 93 0.501 Married or living together 46.6 37.5-55.9 44.0 31.8-56.7 107 Divorced, separated or widowed 20.7 12.6-31.0 15.7 8.4-25.7 45 Employed in the past 12 months Yes 26.4 18.5-35.5 18.1 10.2-28.6 64 0.189 No 73.6 64.5-81.5 81.9 71.4-89.8 181 Easy to Access Condoms Yes 53.8 44.8-62.6 63.0 53.3-71.9 152 0.116 No 25.4 17.5-34.6 26.8 17.4-38.1 59 Missing (3) 20.8 13.8-29.4 10.2 4.4-19.5 34 Have you ever talked with a parent or guardian about sex? Yes 12.5 7.6-19.1 21.0 14.1-29.3 45 0.048 No 87.5 80.9-92.4 79.0 70.7-85.9 198 Have you ever discussed HIV with your parents or guardian? Yes 20.0 13.6-27.9 40.0 28.0-53.0 71 0.002 No 80.0 72.1-86.4 60.0 47.0-72.0 174 Have you previously heard of PrEP? Yes 6.1 2.9-10.9 16.8 8.6-28.3 25 0.013 No 93.9 89.1-97.1 83.2 71.7-91.4 216 Participated in a Prevention Program 1 or more 13.8 6.9-23.8 11.4 4.9-21.4 29 0.749 No 81.2 73.1-87.7 84.5 76.8-90.5 205 Missing (2) 5.0 2.0-10.1 4.1 0.9-11.2 11 Additional HIV+ person in the household 1 or more 33.2 26.4-40.5 40.0 30.8-49.9 87 0.234 No 66.8 59.5-73.6 60.0 50.1-69.2 158 CI = Confidence Interval, N = number Percentages and confidence intervals are weighted and adjusted to account for the survey design. Respondents with missing values were excluded from tabulations (education, 2; ever discussed sex with a parent/guardian, 2; ever heard of PrEP, 4). In the bivariate regression (Table 2), we did not detect an association between HIV care status and sex, age, residence, and employment status. Young people who were divorced, separated, or widowed (OR: 0.44, 95% CI: 0.24-0.81) had decreased odds of being out-of-care compared to those who were married or living together. Odds of being out of care were decreased among those who had discussed sex (OR: 0.54, 95% CI: 0.29-1.00) or HIV (OR: 0.38, 95% CI: 0.20-0.71) with their parents or guardians compared to those who hadn’t. The final multivariable model was adjusted for region, education, easy access to condoms, having discussed HIV with a parent or guardian, having heard of PrEP, participating in an HIV-prevention program, and having an HIV-positive person in the household (Table 2). Young people with HIV residing in the northern provinces (Cabo Delgado, Nampula, Niassa) (aOR: 2.37, 95% CI: 1.09-5.15) had increased odds to be out-of-care than those in central provinces (Sofala, Manica, Zambézia, Tete). Those who had discussed HIV with their parents or guardians (aOR: 0.33, 95% CI: 0.17-0.66) or who had previously heard of PrEP (aOR: 0.25, 95% CI: 0.09-0.65) had decreased odds to be out-of-care than those who hadn’t. Young people who participated in at least one HIV prevention program had over three times the odds of being out of care (aOR: 3.19, 95% CI: 1.37-7.41) compared to those who had never participated. This variable was not found significant in the bivariate model, suggesting that one of the variables in the analysis could influence participation more than care status. Table 2: Unadjusted and adjusted logistic regression models of association with being out-of-care among HIV-positive young people 15-24 years old by select demographic and social factors, Mozambique, 2021 Table 2: Characteristic OR (out of care) 95% CI p-value aOR (out of care) 95% CI p-value Sex Male 1.28 0.65-2.49 0.473 Female (ref) Age Group (Years) 15-19 (4) 1.10 0.60-2.00 0.763 20-24 (5) (ref) Residence Urban 0.64 0.36-1.16 0.142 Rural (ref) Geographic Area of Residence North (Cabo Delgado, Nampula, Niassa) 2.36 1.14-4.87 0.020 2.37 1.09-5.15 0.030 Central (Zambézia, Tete, Manica, Sofala) (ref) (ref) South ( Inhambane, Gaza, Maputo, Maputo Cidade ) 1.11 0.57-2.16 0.757 1.29 0.59-2.82 0.520 Education No education 0.77 0.39-1.50 0.436 0.82 0.30-2.21 0.692 Primary education (ref) (ref) Secondary or higher 1.25 0.53-2.95 0.613 0.53 0.24-1.18 0.119 Marital Status Never married 0.67 0.29-1.58 0.361 Married or living together (ref) Divorced, separated or widowed 0.44 0.24-0.81 0.009 Employed in the past 12 months Yes 1.62 0.79-3.32 0.185 No (ref) Easy to Access Condoms Yes (ref) (ref) No 1.11 0.58-2.11 0.757 0.81 0.40-1.64 0.554 Missing 2.38 1.02-5.56 0.045 1.32 0.52-3.31 0.557 Have you ever talked with a parent or guardian about sex? Yes 0.54 0.29-1.00 0.049 No (ref) Have you ever discussed HIV with your parents or guardians? Yes 0.38 0.20-0.71 0.003 0.33 0.17-0.66 0.002 No (ref) (ref) Have you previously heard of PrEP? Yes 0.32 0.13-0.79 0.013 0.25 0.09-0.65 0.005 No (ref) (ref) Participated in a Prevention Program 1 or more 1.27 0.66-2.42 0.470 3.19 1.37-7.41 0.007 No (ref) (ref) Missing 1.27 0.41-3.96 0.680 1.33 0.41-4.26 0.631 Additional HIV+ person in the household 1 or more 0.74 0.46-1.21 0.235 0.70 0.39-1.26 0.230 No (ref) (ref) OR = Odds Ratio, aOR = Adjusted Odds Ratio, CI = Confidence Interval, ref = reference group Six respondents with missing values for one or more variables excluded from final model Discussion Over half (58.0%) of HIV-positive young people aged 15 to 24 years were not on antiretroviral treatment in Mozambique in 2021. Although there exists low coverage of ART nationwide in this age group, young people residing in the northern provinces of Cabo Delgado, Niassa, and Nampula were more likely to be out-of-care.( 11 ) A variety of factors may have influenced these findings, including distance from the economic and political capital of Maputo, on-going insurgent activity centered in Cabo Delgado but impacting neighboring Nampula and Niassa provinces over the last five years, quality and availability of healthcare services and providers, and a greater percentage of the population residing in rural areas where health literacy could be lower and health care access may be more difficult.( 22 , 23 ) This highlights the challenge in reaching universal HIV care and treatment services in rural areas especially in the three northern provinces. Universal health coverage is emphasized as a priority intervention area in the Mozambican National Strategic Plan for the HIV/SIDA Response 2021–2025, and this finding suggests that, though progress has been made since 2015 when only 23.6% of all PLHIV in rural areas were in HIV care, considerable gaps remain, including for young people.( 12 , 17 ) Socio-behavioral factors, such as health knowledge and engagement, were associated with care status. Our finding that divorced, separated or widowed individuals were less likely to be out of care compared to those who were married or living together might reflect the complexities of navigating testing and HIV status within a sexual relationship.( 24 ) Consistent with studies elsewhere, we found that young people who were able to talk about HIV with their parents or guardians had increased odds of being on ART. Family support and HIV disclosure were positively associated with ART adherence in a study in Thailand and identified as an important factor in a mixed-method study of treatment adherence in adolescents in Mozambique.( 25 , 26 ) Frequent conversations about HIV were found to be positively associated with HIV testing in South Africa and Zambia.( 27 , 28 ) These findings are important not just for prevention in their peer group, but also for potentially decreasing intergenerational HIV transmission that is helping drive the epidemic forward.( 29 , 30 ) Strengthening existing programs, or creating new initiatives focused on guided intra-familial discussions, such as community-based health literacy programs or family-based self-testing, could bring the necessary testing and treatment services to out-of-care young people. Contrary to current literature, our study did not find an association between ART status and living with an additional HIV-positive member in the household.( 26 , 31 , 32 ) Disclosure of HIV-positive status is difficult in Mozambique due to stigma. In northern Mozambique, 48% of both young people felt like they had no one to talk to about HIV-specific issues, and in the capital, Maputo, 43% of adults on ART had a fear of HIV-related stigma.( 26 , 33 ) In the same study, HIV-positive individuals who feared stigma were nearly three times as likely to have advanced HIV disease at the time of diagnosis than those who did not fear stigma.( 33 ) In Sofala province, located in the center of Mozambique, HIV-positive men who anticipated stigma were 35% less likely to have recently tested for HIV than those who did not anticipate stigma.( 34 ) Disclosure within the household for young people may be confronted with various cultural and societal hurdles including anticipated stigma, gender roles, and a lack of knowledge. As such, the challenges faced in HIV disclosure for young people may feel unsurmountable and result in their non-disclosure, nullifying the important benefits found in the literature. Finally, young people focused programs such as DREAMS and SAAJ are key initiatives to reduce HIV transmission in Mozambique and provide initial support to link young people to care in the case of seroconversion.( 19 , 20 ) Young people who had previously participated in a prevention program were three times more likely to be out-of-care. Despite many programs specific focus on HIV-negative populations, these findings may present a missed opportunity for ensuring sustained engagement in health services upon program completion. Reinforcing the inclusion of up-to-date information on transmission risks and testing frequency in HIV prevention programs, especially focused on testing continuation post program graduation, may create additional synergies with the involvement of parents or other family members in health literacy lessons, encouraging discussions and support around HIV and sex. Limitations While these findings provide crucial information regarding young people and their enrollment in care and treatment services, our analysis is subject to some limitations. Despite testing for the presence of the majority of antiretrovirals distributed in Mozambique in 2021, it is possible that some of the young people designated “out-of-care” in this analysis were prescribed and adherent to other medications not included in the ARV testing list. There is also the possibility of social desirability bias or self-selection bias during the interview, such that a young person who is out-of-care, but knowledgeable of their status, may be less likely to accurately self-report survey responses or to consent to survey participation due to confidentiality concerns. Finally, the recentness of infection was not assessed in this study, meaning the study team did not have access to recent versus long-term infection and hence cannot accurately identify new HIV-positive persons versus those who may have fallen out of care. Conclusions Our results revealed that more than half of HIV-positive young people in Mozambique were not in HIV care in 2021, with disparities in coverage by region and sex. The heightened HIV transmission risk among young people, and associated intergenerational HIV-transmission possibilities, threatens Mozambique’s progress towards meeting the 2025 UNAIDS targets in Mozambique. Future programs focused on social and demographic factors from this analysis, including geographic residence, the strong influence of parents and guardians in young people’s health knowledge and behaviors, and missed opportunities for reenforcing continual health engagement in existing prevention programs, may help address remaining coverage gaps and improve linkage to care in this priority population. Declarations Acknowledgements: We thank Ministry of Health Mozambique and CDC/ICAP for coordination, as well as the study teams that collected data in the field. Most importantly, the survey participants, without whom we would not have these data. Lastly, we thank the University of Cape Town Department of Clinical Pharmacology for conducting the ART biomarker testing. Competing interests: All authors declared no competing interests. Authors’ contributions: O.F.T., K.C.M, J.W and C.S.B conceived the study. K.C.M conducted the analyses. O.F.T drafted the manuscript with support from K.C.M in the methods and results sections. All authors contributed to critical review of the manuscript. Funding: The 2021 Mozambique Population-based HIV Impact Assessment was funded by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (CDC) under the terms of cooperative agreement award #U2GGH002173. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the funding agencies. Data Availability: The 2021 INSIDA public release datasets and files are available at the ICAP PHIA website (https://phia-data.icap.columbia.edu/datasets?country_id=15). Survey data, manuals and documentation are available for download with an account. References UNAIDS. Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030. Geneva, Swizterland: UNAIDS; 2021. UNAIDS. 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Mozambique: Instituto Nacional de Estatistica; 2019. UNAIDS. UNAIDS Data 2022. Geneva: Joint United Nations Programme on HIV/AIDS; 2022. Plano Estratégico Nacional de Resposta ao HIV e SIDA - PEN V (National Strategic Plan for the HIV/AIDS Repose). Maputo: Conselho Nacional de Combate ao HIV/SIDA; 2021. Relatório Trimestral do MozART (Quarterly MozART Report). Maputo, Mozambique; Centers for Disease Control and Prevention; 2021. Estratégia Nacional de Saúde Escolar e dos Adolescentes e Jovens em Moçambique (National Strategy for School, Adolescent and Youth Health in Mozambique). Mozambique: Ministério da Saúde; 2018. United States Agency for International Development. DREAMS: Partnership To Reduce HIV/AIDS In Adolescent Girls And Young Women. 2023. R: A Language and Environment for Statistical Computing. Internet: R Foundation for Statistical Computing; 2022. Inquérito Sobre Orçamento Familiar, 2022 (Household Budget Survey). Mozambique: Instituto Nacional de Estatística; 2022. Service availability and readiness assessment, 2018. Mozambique: Ministério de Saúde; 2018. Tabana H, Doherty T, Rubenson B, Jackson D, Ekström AM, Thorson A. ‘Testing Together Challenges the Relationship’: Consequences of HIV Testing as a Couple in a High HIV Prevalence Setting in Rural South Africa. PLoS ONE. 2013;8(6):e66390. Li L, Lee SJ, Wen Y, Lin C, Wan D, Jiraphongsa C. Antiretroviral therapy adherence among patients living with HIV/AIDS in Thailand. Nurs Amp Health Sci. 2010;12(2):212–20. Falcão J, Zerbe A, Mellins CA, Mantell J, Brittain K, Kapogiannis B, et al. The secret life of young adolescents living with HIV in northern Mozambique - a mixed methods study. BMC Public Health. 2021;21(1). Hendriksen ES, Hlubinka D, Chariyalertsak S, Chingono A, Gray G, Mbwambo J, et al. Keep Talking About It: HIV/AIDS-Related Communication and Prior HIV Testing in Tanzania, Zimbabwe, South Africa, and Thailand. AIDS Behav. 2009;13(6):1213–21. Qiao S, Zhang Y, Li X, Menon JA. Facilitators and barriers for HIV-testing in Zambia: A systematic review of multi-level factors. PLoS ONE. 2018;13(2):e0192327. De Oliveira T, Kharsany ABM, Gräf T, Cawood C, Khanyile D, Grobler A, et al. Transmission networks and risk of HIV infection in KwaZulu-Natal, South Africa: a community-wide phylogenetic study. Lancet HIV. 2017;4(1):e41–50. Schaefer R, Gregson S, Eaton JW, Mugurungi O, Rhead R, Takaruza A, et al. Age-disparate relationships and HIV incidence in adolescent girls and young women. AIDS. 2017;31(10):1461–70. Nabunya P, Ssewamala FM, Mukasa MN, Byansi W, Nattabi J. Peer mentorship program on HIV/AIDS knowledge, beliefs, and prevention attitudes among orphaned adolescents: an evidence based practice. Vulnerable Child Youth Stud. 2015 Oct 1;10(4):345–56. Shah P, Kibel M, Ayuku D, Lobun R, Ayieko J, Keter A, et al. A Pilot Study of “Peer Navigators” to Promote Uptake of HIV Testing, Care and Treatment Among Street-Connected Children and Youth in Eldoret, Kenya. AIDS Behav. 2019;23(4):908–19. Chone JS, Abecasis AB, Varandas L. Determinants of Late HIV Presentation at Ndlavela Health Center in Mozambique. Int J Environ Res Public Health. 2022;19(8):4568. Ha JH, Van Lith LM, Mallalieu EC, Chidassicua J, Pinho MD, Devos P, et al. Gendered relationship between HIV stigma and HIV testing among men and women in Mozambique: a cross-sectional study to inform a stigma reduction and male-targeted HIV testing intervention. BMJ Open. 2019;9(10):e029748. Additional Declarations No competing interests reported. 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15:52:35","extension":"html","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":125510,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7770475/v1/a68795aad2df7391724af6ab.html"},{"id":95285650,"identity":"5b789524-4332-4d16-941a-97fffb74d77f","added_by":"auto","created_at":"2025-11-06 09:57:43","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":102195,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eUnweighted number and weighted proportion of young people, 15-24 years old, with survey interview, blood draw and antiretroviral detection, INSIDA 2021\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7770475/v1/58b611e6c4776d5503ccb4a3.png"},{"id":101690452,"identity":"06c5923c-ba7c-4019-bf95-b678e8aedba1","added_by":"auto","created_at":"2026-02-02 16:03:31","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1401058,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7770475/v1/db0faae8-26a2-4e4f-b6ce-a32c8d882fc1.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Out-of-Care HIV-Positive Young People Aged 15-24 years in Mozambique: Findings from the 2021 Population-Based HIV Impact Assessment Survey","fulltext":[{"header":"Introduction","content":"\u003cp\u003eKnowledge of human immunodeficiency virus (HIV) status is the first step in preventing HIV transmission and is crucial to ending HIV/AIDS as a global health threat.(1) The Joint United Nations Programme on HIV/AIDS (UNAIDS) 95-95-95 cascade targets envision 95% of people living with HIV (PLHIV) knowing their status, of those, 95% on antiretroviral treatment (ART), and 95% of PLHIV on treatment achieving viral load suppression by 2025. The targets are essential to reaching the United Nation\u0026rsquo;s Sustainable Development Goal 3.3, which aims to reduce the number of people newly infected with HIV per 1,000 population to 0.05 by 2025 and to 0.025 by 2030.(3)\u003c/p\u003e\n\u003cp\u003eIncreasing the proportion of people with HIV who have HIV viral load suppression is a key strategy to ending the HIV epidemic. \u0026nbsp;People on ART with an undetectable viral load have essentially no risk of transmitting HIV to their sexual partners.(3\u0026ndash;6)\u0026nbsp; A prospective study following 1,166 sero-discordant couples found no transmission between couples with HIV viral suppression (\u0026lt;200 copies/ml).(6) \u0026nbsp; Additionally, a systematic review of studies from 25 countries showed no sexual transmission of HIV in sero-discordant couples when the viral load was less than 200 copies/ml in the HIV-positive partner.(7) The priority for the next phase of HIV epidemic control is to ensure all people living with HIV have access to ART, especially priority populations such as young people aged 15\u0026ndash;24 years.(8) Increasing HIV treatment coverage can be achieved through targeted testing and treatment interventions that are based on current epidemiological and demographic profiles.\u003c/p\u003e\n\u003cp\u003eOver the last five years, there have been major advances in prevention and treatment of HIV in Mozambique, including the introduction of HIV self-testing, pre-exposure prophylaxis (PrEP), peer ART adherence counselors, and a large scale expansion of differentiated service delivery models, resulting in a rapid scale up of ART coverage from 59% in 2019 to 85% in 2023.(9,10) Despite these advances, many challenges remain, including the testing and inclusion of young people in HIV treatment and care services. In 2021, Mozambique conducted the Mozambican Population-based HIV Impact Assessment (INSIDA) survey, which interviewed participants aged 15 years and older about socio-demographic factors, HIV-related behaviors, and performed a rapid HIV test. Survey results found that 71.6% of PLHIV knew their HIV status, a proportion still distant from the goal of 95% by 2025.(11) Both male and female young PLHIV, aged 15\u0026ndash;24 years, had lower knowledge of their HIV serostatus compared to those aged 25\u0026ndash;34 years (65.4% vs 74.5% among females, respectively, and 45.3% vs 53.8% among males, respectively).(11) The preceding population-based survey in 2015 had found that 77.5% of females and 35.7% of males aged 15\u0026ndash;24 years had knowledge of their HIV serostatus, showing the difficulty of sustained testing coverage over the last six years in this age group.(12)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eYoung people (15\u0026ndash;24-year-olds) have the highest HIV incidence in Mozambique. The UNAIDS Spectrum model for Mozambique estimates that there were 4.7 new infections per 1,000 persons among young people compared to 2.6 new infections per 1,000 persons in the general population in 2023.(13,14) That same year, an estimated 31,000 new infections occurred among young people, approximately 38% of the total yearly infections in Mozambique.(13) HIV incidence in young people also has an elevated impact on Mozambique\u0026rsquo;s HIV epidemic due to the population distribution \u0026ndash; approximately 20% of the national population are young people.(15) The considerable contribution of young people to national incidence is common to countries in the region; in Botswana, 15\u0026ndash;24-year-olds make up 35% of the new infections, in Eswatini 34%, in Malawi 27%, and in South Africa 40%.(16) In the Mozambican National Strategic Plan for the HIV/SIDA Response 2021\u0026ndash;2025, the first of the nine strategic objectives is to reduce overall new infections by 50% to 65,000 by 2025, prioritizing the identification and treatment of PLHIV, particularly among young people.(17)\u003c/p\u003e\n\u003cp\u003eThis study aims to estimate the proportion of HIV-positive young people (aged 15\u0026ndash;24 years) in Mozambique who are out of care and to describe associated demographic and social characteristics. . Findings may inform targeted strategies to identify, test, and link youth to care\u0026mdash;critical steps toward meeting both national HIV goals and the UNAIDS 95-95-95 targets. .\u0026nbsp;\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cem\u003eStudy Design and Procedures\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eWe conducted a sub-analysis using data from the 2021 Mozambique Population-based HIV Impact Assessment (INSIDA) study,a nationally representative, cross-sectional household-based survey conducted between April 2021 and February 2022. The survey aimed to measure the progress of the country’s HIV response, both nationally and at the provincial level.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eStudy Sample\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe survey used a four-stage probability sample design that randomly selected 11,375 households from 311 enumeration areas throughout Mozambique’s 11 provinces. Eligibility criteria were established on age, 15 years or older, and residency, requiring that respondents (usual household members or visitors) had slept in the sampled household the night before the interview. Interviewers conducted face-to-face interviews with consenting individuals using a standard questionnaire, which included household composition, socio-economic questions, and questions on the HIV testing and care continuum. Participants consented separately to a blood draw, which was then used for HIV, viral load, and CD4 testing. Of the 5,283 participants aged 15–24 years who were interviewed, 4,479 (85.2% weighted response rate) had blood drawn and definite lab results, and of those, 245 (5.4% weighted) tested HIV-positive. \u0026nbsp;(Figure 1).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eHIV Testing\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eTrained phlebotomists collected venous blood draws from all consenting participants through household-based HIV testing and counseling following the two-test national guideline: Determine™ HIV-1/2 rapid diagnostic test followed by the Uni-Gold™ HIV confirmatory test. If the first test returned nonreactive, the sample was classified as HIV-negative. If both tests were reactive, the blood specimen was classified as HIV-positive, if non-reactive the algorithm was repeated. Household-based HIV test results were returned to the participants the same day, with counseling and HIV services referral. All blood specimens with a positive or indeterminate result during the household testing were retested in a laboratory with Geenius HIV 1/2 Supplemental Assay (Bio-Rad, Hercules, California, United States). A positive laboratory result confirmed HIV-positive status, and confirmed HIV-positive specimens were subsequently measured for CD4-T cell count and viral load. \u0026nbsp;Testing results were used to create the variable HIV status within the household, which was grouped based off respondents’ unique identifiers.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAntiretroviral Detection\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eSamples from confirmed HIV-positive participants were screened for detectable concentrations of the antiretrovirals atazanavir, lopinavir, efavirenz, and dolutegravir. A combination of these medications totaled 99.9% of all antiretrovirals distributed in health facilities with electronic medical records in 2021.(18)\u003c/p\u003e\n\u003cp\u003e\u003cem\u003ePrevention Program Participation\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eDue to the small number of participants in the various HIV-prevention programs included in the survey questionnaire, a variable was created that categorized all participants who responded positively to participating in at least one prevention program. These youth-focused HIV programs include DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) partnership, which focuses on reducing HIV incidence in adolescent girls and young women, and the SAAJ (\u003cem\u003eServiços Amigos dos Adolescentes e Jovens\u003c/em\u003e) program, which is the Mozambique Ministry of Health flagship program for young people friendly services at health facilities and includes both dedicated space and clinicians for young people. All programs provide HIV-prevention information, sexual health decision-making empowerment and linkages to comprehensive health services.(19,20)\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eData Analysis\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAmong HIV-positive young people aged 15–24 years with a valid HIV-positive test result, antiretroviral screening results were used to define the outcome of care status. In this study, we classify participants with detectable antiretroviral concentrations in their blood sample as “in care” and those without antiretrovirals detected as “out-of-care”. Participants with missing antiretroviral laboratory testing results were excluded from the analysis. All analyses were weighted using the jackknife replication method, per the Population-based HIV Impact Assessment survey standard of practice, to account for complex sampling. Descriptive analysis was conducted among young people in care and out-of-care, and weighted proportions and corresponding 95% confidence intervals (CI) are reported. Weighted chi-square tests and bivariate logistic regression analyses were conducted to assess demographic and behavioral factors significantly associated with out-of-care status among young people with HIV. Variables with a chi-square p-value of 0.15 and below were entered into a multivariable regression model and were then removed in a stepwise fashion, manually comparing AIC scores, until the best model was found. Two variables of interest, participation in a prevention program and the household member HIV status, were continued in the final model to better understand any possible interactions with the outcome of interest. To assess confounding, variables removed in the previous step were individually added back into the model and were considered confounders if their addition changed the adjusted odds ratio (aOR) by 10% or more, in which case they were included in the final model. Finally, all potential variables with interactions found in the literature were already excluded from the final model. Odds ratios (OR), aORs, and associated 95% confidence intervals and p-values are reported. All analyses were performed using R Studio version 4.1.3.(21)\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eHuman Ethics and Consent to Participate\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe study was conducted in accordance with the Declaration of Helsinki and was reviewed and approved by the Mozambique National Bioethics Committee (CNBS), the Columbia University Medical Center, and the U.S. Centers for Disease Control and Prevention (CDC) (protocol #7258) Institutional Review Boards (IRBs).[a] All participants provided written consent prior to the interview and blood draw, and additional parental consent was given for all respondents ages 15 to 17 years. A detailed description of the study protocol and procedures to protect confidentiality can be found in the final INSIDA report.(11)\u003c/p\u003e\n\u003cp\u003e[a] See 45 C.F.R. part 46.114; 21 C.F.R. part 56.114\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eOf the 245 HIV-positive young people included in our analysis, 58.0% (n=141) were out-of-care, of whom 31.7% were aged 15\u0026ndash;19 years (Table 1). The majority of out-of-care participants were female (75.0%), lived in a rural area (68.3%) in the northern provinces of Cabo Delgado, Nampula and Niassa (43.9%) had primary education (56.2%), were either married or living together (46.6%), and had not worked in the past 12 months (73.6%). Among out-of-care young people with HIV, most believed it would be easy to obtain a condom (53.8%), had never discussed sex (87.5%) or HIV (80.0%) with their parents or guardians, had never heard of PrEP (93.9%), had not participated in an HIV-prevention program (81.2%). Finally, 33.2% of HIV-positive out-of-care young people lived in a household with another HIV-positive individual.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1: Demographic and social characteristics among HIV-positive young people (15\u0026ndash;24 years old) by HIV care status, Mozambique, 2021 (n=245)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"633\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"bottom\" style=\"width: 226px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 1: Characteristic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOut of Care (n=141)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIn Care (n=101)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eN\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChi-Sq\u0026nbsp;\u003cbr\u003e\u0026nbsp;p-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 566px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e25.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e18.6-32.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e20.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e12.3-31.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.472\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e75.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e67.6-81.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e79.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e68.4-87.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e192\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 566px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge Group (Years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003e15-19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e31.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e23.4-41.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e29.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e20.1-41.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.762\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003e20-24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e68.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e58.9-76.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e70.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e58.9-79.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e179\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 566px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eResidence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e35.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e23.7-48.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e46.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e29.7-63.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e111\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.139\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e64.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e51.3-76.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e54.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e36.9-70.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e134\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 566px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGeographic Area of Residence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eNorth \u003cem\u003e(Cabo Delgado, Nampula, Niassa)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e43.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e31.8-56.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e25.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e15.9-37.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.030\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"38\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eCentral \u003cem\u003e(Zamb\u0026eacute;zia, Tete, Manica, Sofala)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e37.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e27.7-47.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e51.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e38.3-63.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"38\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eSouth (\u003cem\u003eInhambane, Gaza, Maputo, Maputo Cidade\u003c/em\u003e)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e18.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e12.0-27.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e23.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e14.9-33.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"38\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 566px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eNo education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e12.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e6.9-20.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e13.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e7.7-20.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003ePrimary education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e56.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e47.2-64.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e38.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e28.3-49.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e114\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eSecondary or higher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e31.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e23.6-39.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e48.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e36.4-60.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 566px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital Status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eNever married\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e32.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e24.8-41.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e40.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e29.3-52.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.501\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"21\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eMarried or living together\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e46.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e37.5-55.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e44.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e31.8-56.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e107\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"21\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eDivorced, separated or widowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e20.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e12.6-31.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e15.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e8.4-25.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"41\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 566px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEmployed in the past 12 months\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e26.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e18.5-35.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e18.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e10.2-28.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.189\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"20\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e73.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e64.5-81.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e81.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e71.4-89.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e181\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 566px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEasy to Access Condoms\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e53.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e44.8-62.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e63.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e53.3-71.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e152\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e25.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e17.5-34.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e26.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e17.4-38.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eMissing (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e20.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e13.8-29.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e10.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e4.4-19.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 566px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHave you ever talked with a parent or guardian about sex?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e7.6-19.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e21.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e14.1-29.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.048\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e87.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e80.9-92.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e79.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e70.7-85.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e198\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 566px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHave you ever discussed HIV with your parents or guardian?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e20.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e13.6-27.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e40.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e28.0-53.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e80.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e72.1-86.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e60.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e47.0-72.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e174\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 566px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHave you previously heard of PrEP?\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e6.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e2.9-10.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e16.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e8.6-28.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e93.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e89.1-97.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e83.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e71.7-91.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e216\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 566px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParticipated in a Prevention Program\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003e1 or more\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e13.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e6.9-23.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e11.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e4.9-21.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.749\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"21\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e81.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e73.1-87.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e84.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e76.8-90.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e205\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"21\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eMissing (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e5.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e2.0-10.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e4.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.9-11.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"21\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 566px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdditional HIV+ person in the household\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"21\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003e1 or more\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e33.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e26.4-40.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e40.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e30.8-49.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.234\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"19\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 208px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e66.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e59.5-73.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e60.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e50.1-69.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47px;\"\u003e\n \u003cp\u003e158\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"20\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" rowspan=\"2\" valign=\"top\" style=\"width: 633px;\"\u003e\n \u003cp\u003eCI = Confidence Interval, N = number\u0026nbsp;\u003cbr\u003e\u0026nbsp;Percentages and confidence intervals are weighted and adjusted to account for the survey design. Respondents with missing values were excluded from tabulations (education, 2; ever discussed sex with a parent/guardian, 2; ever heard of PrEP, 4).\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd height=\"30\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd height=\"67\" style=\"width: 0px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eIn the bivariate regression (Table 2), we did not detect an association between HIV care status and sex, age, residence, and employment status. Young people who were divorced, separated, or widowed (OR: 0.44, 95% CI: 0.24-0.81) had decreased odds of being out-of-care compared to those who were married or living together. Odds of being out of care were decreased among those who had discussed sex (OR: 0.54, 95% CI: 0.29-1.00) or HIV (OR: 0.38, 95% CI: 0.20-0.71) with their parents or guardians compared to those who hadn\u0026rsquo;t. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe final multivariable model was adjusted for region, education, easy access to condoms, having discussed HIV with a parent or guardian, having heard of PrEP, participating in an HIV-prevention program, and having an HIV-positive person in the household (Table 2). Young people with HIV residing in the northern provinces (Cabo Delgado, Nampula, Niassa) (aOR: 2.37, 95% CI: 1.09-5.15) had increased odds to be out-of-care than those in central provinces (Sofala, Manica, Zamb\u0026eacute;zia, Tete). Those who had discussed HIV with their parents or guardians (aOR: 0.33, 95% CI: 0.17-0.66) or who had previously heard of PrEP (aOR: 0.25, 95% CI: 0.09-0.65) had decreased odds to be out-of-care than those who hadn\u0026rsquo;t. Young people who participated in at least one HIV prevention program had over three times the odds of being out of care (aOR: 3.19, 95% CI: 1.37-7.41) compared to those who had never participated. This variable was not found significant in the bivariate model, suggesting that one of the variables in the analysis could influence participation more than care status.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2: Unadjusted and adjusted logistic regression models of association with being out-of-care among HIV-positive young people 15-24 years old by select demographic and social factors, Mozambique, 2021\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"661\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 236px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 2: Characteristic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOR (out of care)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eaOR (out of care)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 604px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e0.65-2.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.473\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e(ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 604px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge Group (Years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003e15-19 (4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.60-2.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.763\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003e20-24 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003e(ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 604px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eResidence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e0.36-1.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e(ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 604px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGeographic Area of Residence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003eNorth \u003cem\u003e(Cabo Delgado, Nampula, Niassa)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e2.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e1.14-4.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e2.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1.09-5.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.030\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003eCentral \u003cem\u003e(Zamb\u0026eacute;zia, Tete, Manica, Sofala)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e(ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e(ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003eSouth (\u003cem\u003eInhambane, Gaza, Maputo, Maputo Cidade\u003c/em\u003e)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e0.57-2.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.757\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.59-2.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.520\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 604px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003eNo education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e0.39-1.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.436\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.30-2.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.692\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003ePrimary education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e(ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e(ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003eSecondary or higher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e0.53-2.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.613\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.24-1.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.119\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 604px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital Status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003eNever married\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e0.29-1.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.361\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003eMarried or living together\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e(ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003eDivorced, separated or widowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e0.24-0.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 604px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEmployed in the past 12 months\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e0.79-3.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.185\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e(ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 604px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEasy to Access Condoms\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e(ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e(ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e0.58-2.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.757\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.40-1.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.554\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003eMissing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e2.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e1.02-5.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.045\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.52-3.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.557\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 604px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHave you ever talked with a parent or guardian about sex?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e0.29-1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.049\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e(ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 604px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHave you ever discussed HIV with your parents or guardians?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e0.20-0.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.17-0.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e(ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e(ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 604px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHave you previously heard of PrEP?\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e0.13-0.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.09-0.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e(ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e(ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 604px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParticipated in a Prevention Program\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003e1 or more\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e0.66-2.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.470\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e3.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e1.37-7.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e(ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e(ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003eMissing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e0.41-3.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.680\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.41-4.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.631\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"7\" valign=\"bottom\" style=\"width: 604px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdditional HIV+ person in the household\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003e1 or more\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e0.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e0.46-1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e0.235\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e0.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.39-1.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 57px;\"\u003e\n \u003cp\u003e0.230\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 218px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e(ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e(ref)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" valign=\"bottom\" style=\"width: 661px;\"\u003e\n \u003cp\u003eOR = Odds Ratio, aOR = Adjusted Odds Ratio, CI = Confidence Interval, ref = reference group\u003cbr\u003e\u0026nbsp;Six respondents with missing values for one or more variables excluded from final model\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Discussion","content":"\u003cp\u003eOver half (58.0%) of HIV-positive young people aged 15 to 24 years were not on antiretroviral treatment in Mozambique in 2021. Although there exists low coverage of ART nationwide in this age group, young people residing in the northern provinces of Cabo Delgado, Niassa, and Nampula were more likely to be out-of-care.(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e) A variety of factors may have influenced these findings, including distance from the economic and political capital of Maputo, on-going insurgent activity centered in Cabo Delgado but impacting neighboring Nampula and Niassa provinces over the last five years, quality and availability of healthcare services and providers, and a greater percentage of the population residing in rural areas where health literacy could be lower and health care access may be more difficult.(\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e) This highlights the challenge in reaching universal HIV care and treatment services in rural areas especially in the three northern provinces. Universal health coverage is emphasized as a priority intervention area in the Mozambican National Strategic Plan for the HIV/SIDA Response 2021\u0026ndash;2025, and this finding suggests that, though progress has been made since 2015 when only 23.6% of all PLHIV in rural areas were in HIV care, considerable gaps remain, including for young people.(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e)\u003c/p\u003e\u003cp\u003eSocio-behavioral factors, such as health knowledge and engagement, were associated with care status. Our finding that divorced, separated or widowed individuals were less likely to be out of care compared to those who were married or living together might reflect the complexities of navigating testing and HIV status within a sexual relationship.(\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e) Consistent with studies elsewhere, we found that young people who were able to talk about HIV with their parents or guardians had increased odds of being on ART. Family support and HIV disclosure were positively associated with ART adherence in a study in Thailand and identified as an important factor in a mixed-method study of treatment adherence in adolescents in Mozambique.(\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e) Frequent conversations about HIV were found to be positively associated with HIV testing in South Africa and Zambia.(\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e) These findings are important not just for prevention in their peer group, but also for potentially decreasing intergenerational HIV transmission that is helping drive the epidemic forward.(\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e) Strengthening existing programs, or creating new initiatives focused on guided intra-familial discussions, such as community-based health literacy programs or family-based self-testing, could bring the necessary testing and treatment services to out-of-care young people.\u003c/p\u003e\u003cp\u003eContrary to current literature, our study did not find an association between ART status and living with an additional HIV-positive member in the household.(\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e) Disclosure of HIV-positive status is difficult in Mozambique due to stigma. In northern Mozambique, 48% of both young people felt like they had no one to talk to about HIV-specific issues, and in the capital, Maputo, 43% of adults on ART had a fear of HIV-related stigma.(\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e) In the same study, HIV-positive individuals who feared stigma were nearly three times as likely to have advanced HIV disease at the time of diagnosis than those who did not fear stigma.(\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e) In Sofala province, located in the center of Mozambique, HIV-positive men who anticipated stigma were 35% less likely to have recently tested for HIV than those who did not anticipate stigma.(\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e) Disclosure within the household for young people may be confronted with various cultural and societal hurdles including anticipated stigma, gender roles, and a lack of knowledge. As such, the challenges faced in HIV disclosure for young people may feel unsurmountable and result in their non-disclosure, nullifying the important benefits found in the literature.\u003c/p\u003e\u003cp\u003e Finally, young people focused programs such as DREAMS and SAAJ are key initiatives to reduce HIV transmission in Mozambique and provide initial support to link young people to care in the case of seroconversion.(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e) Young people who had previously participated in a prevention program were three times more likely to be out-of-care. Despite many programs specific focus on HIV-negative populations, these findings may present a missed opportunity for ensuring sustained engagement in health services upon program completion. Reinforcing the inclusion of up-to-date information on transmission risks and testing frequency in HIV prevention programs, especially focused on testing continuation post program graduation, may create additional synergies with the involvement of parents or other family members in health literacy lessons, encouraging discussions and support around HIV and sex.\u003c/p\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eLimitations\u003c/h2\u003e\u003cp\u003eWhile these findings provide crucial information regarding young people and their enrollment in care and treatment services, our analysis is subject to some limitations. Despite testing for the presence of the majority of antiretrovirals distributed in Mozambique in 2021, it is possible that some of the young people designated \u0026ldquo;out-of-care\u0026rdquo; in this analysis were prescribed and adherent to other medications not included in the ARV testing list. There is also the possibility of social desirability bias or self-selection bias during the interview, such that a young person who is out-of-care, but knowledgeable of their status, may be less likely to accurately self-report survey responses or to consent to survey participation due to confidentiality concerns. Finally, the recentness of infection was not assessed in this study, meaning the study team did not have access to recent versus long-term infection and hence cannot accurately identify new HIV-positive persons versus those who may have fallen out of care.\u003c/p\u003e\u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eOur results revealed that more than half of HIV-positive young people in Mozambique were not in HIV care in 2021, with disparities in coverage by region and sex. The heightened HIV transmission risk among young people, and associated intergenerational HIV-transmission possibilities, threatens Mozambique\u0026rsquo;s progress towards meeting the 2025 UNAIDS targets in Mozambique. Future programs focused on social and demographic factors from this analysis, including geographic residence, the strong influence of parents and guardians in young people\u0026rsquo;s health knowledge and behaviors, and missed opportunities for reenforcing continual health engagement in existing prevention programs, may help address remaining coverage gaps and improve linkage to care in this priority population.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u0026nbsp;\u003c/strong\u003eWe thank Ministry of Health Mozambique and CDC/ICAP for coordination, as well as the study teams that collected data in the field. Most importantly, the survey participants, without whom we would not have these data. Lastly, we thank the University of Cape Town Department of Clinical Pharmacology for conducting the ART biomarker testing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u0026nbsp;\u003c/strong\u003eAll authors declared no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions:\u0026nbsp;\u003c/strong\u003eO.F.T., K.C.M, J.W and C.S.B conceived the study. K.C.M conducted the analyses. O.F.T drafted the manuscript with support from K.C.M in the methods and results sections. All authors contributed to critical review of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eThe 2021 Mozambique Population-based HIV Impact Assessment was funded by the President\u0026rsquo;s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (CDC) under the terms of cooperative agreement award #U2GGH002173. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the funding agencies.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability:\u0026nbsp;\u003c/strong\u003eThe 2021 INSIDA public release datasets and files are available at the ICAP PHIA website (https://phia-data.icap.columbia.edu/datasets?country_id=15). Survey data, manuals and documentation are available for download with an account.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eUNAIDS. Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030. Geneva, Swizterland: UNAIDS; 2021.\u003c/li\u003e\n \u003cli\u003eUNAIDS. Ending Inequanlities and Getting on Track to end AIDS by 2030. 2021.\u003c/li\u003e\n \u003cli\u003eDepartment of Economic and Social Affairs (DESA). The Sustainable Development Goals Report 2016. New York, USA: United Nations; 2016.\u003c/li\u003e\n \u003cli\u003eCohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Antiretroviral Therapy for the Prevention of HIV-1 Transmission. N Engl J Med. 2016;375(9):830\u0026ndash;9.\u003c/li\u003e\n \u003cli\u003eUNAIDS. HIV Prevention 2025 \u0026ndash; Road Map: Getting on track to end AIDS as a public health threat by 2030. Geneva: Joint United Nations Programme on HIV/AIDS; 2022.\u003c/li\u003e\n \u003cli\u003eRodger AJ, Cambiano V, Bruun T, Vernazza P, Collins S, van Lunzen J, et al. Sexual Activity Without Condoms and Risk of HIV Transmission in Serodifferent Couples When the HIV-Positive Partner Is Using Suppressive Antiretroviral Therapy. JAMA. 2016 Jul 12;316(2):171\u0026ndash;81.\u003c/li\u003e\n \u003cli\u003eBroyles LN, Luo R, Boeras D, Vojnov L. The risk of sexual transmission of HIV in individuals with low-level HIV viraemia: a systematic review. The Lancet. 2023;402(10400):464\u0026ndash;71.\u003c/li\u003e\n \u003cli\u003eUNAIDS. Prevailing Against Pandemics by Putting People at the Centre. 2020.\u003c/li\u003e\n \u003cli\u003eRelat\u0026oacute;rio Anual de HIV, 2019 (Annual HIV Report). Mozambique: Programa Nacional de Controle de ITS e HIV/SIDA, Minist\u0026eacute;rio de Sa\u0026uacute;de; 2019.\u003c/li\u003e\n \u003cli\u003eRelat\u0026oacute;rio Anual de HIV, 2023 (Annual HIV Report). Mozambique: Programa Nacional de Controle de ITS e HIV/SIDA, Minist\u0026eacute;rio de Sa\u0026uacute;de; 2023.\u003c/li\u003e\n \u003cli\u003eMozambique Population-based HIV Impact Assessment, INSIDA 2021 Final Report. Maputo, Mozambique: Instituto Nacional de Sa\u0026uacute;de; 2021.\u003c/li\u003e\n \u003cli\u003eInqu\u0026eacute;rito de Indicadores de Imuniza\u0026ccedil;\u0026atilde;o, Mal\u0026aacute;ria e HIV/SIDA (The National Malaria and HIV Indicator Survey). 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AIDS. 2017;31(10):1461\u0026ndash;70.\u003c/li\u003e\n \u003cli\u003eNabunya P, Ssewamala FM, Mukasa MN, Byansi W, Nattabi J. Peer mentorship program on HIV/AIDS knowledge, beliefs, and prevention attitudes among orphaned adolescents: an evidence based practice. Vulnerable Child Youth Stud. 2015 Oct 1;10(4):345\u0026ndash;56.\u003c/li\u003e\n \u003cli\u003eShah P, Kibel M, Ayuku D, Lobun R, Ayieko J, Keter A, et al. A Pilot Study of \u0026ldquo;Peer Navigators\u0026rdquo; to Promote Uptake of HIV Testing, Care and Treatment Among Street-Connected Children and Youth in Eldoret, Kenya. AIDS Behav. 2019;23(4):908\u0026ndash;19.\u003c/li\u003e\n \u003cli\u003eChone JS, Abecasis AB, Varandas L. Determinants of Late HIV Presentation at Ndlavela Health Center in Mozambique. Int J Environ Res Public Health. 2022;19(8):4568.\u003c/li\u003e\n \u003cli\u003eHa JH, Van Lith LM, Mallalieu EC, Chidassicua J, Pinho MD, Devos P, et al. Gendered relationship between HIV stigma and HIV testing among men and women in Mozambique: a cross-sectional study to inform a stigma reduction and male-targeted HIV testing intervention. BMJ Open. 2019;9(10):e029748.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Young People, HIV, HIV treatment, antiretroviral therapy, Mozambique","lastPublishedDoi":"10.21203/rs.3.rs-7770475/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7770475/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eBackground\u003c/b\u003e\u003c/p\u003e\u003cp\u003eGlobally, young people are falling behind in the push to end the HIV epidemic. Understanding the characteristics of HIV-positive young people who are out-of-care (not on antiretroviral treatment [ART]) in Mozambique is important to effectively reach and ensure access to services for this priority population.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods\u003c/b\u003e\u003c/p\u003e\u003cp\u003eUsing data from the 2021 Mozambique Population-based HIV Impact Assessment, we conducted a sub-analysis of HIV-positive young people aged 15\u0026ndash;24 years whose blood specimens were tested for the presence of antiretrovirals. Participants testing negative for the presence of antiretrovirals were classified as out-of-care. We report weighted prevalence estimates of HIV-care status and select covariates. We used multivariable logistic regression to assess factors associated with out-of-care status.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e\u003cp\u003eAmong the 245 HIV-positive young people included, 58.0% (n\u0026thinsp;=\u0026thinsp;141, 95% Confidence Interval [CI] 49.9\u0026ndash;65.7%) were out-of-care. Out-of-care young people were mostly female (75.0%) living in a rural area (68.3%). Adjusting for education, young people who talked about HIV with a parent or guardian (20.0% of participants) (adjusted Odds Ratio [aOR]: 0.33, 95% CI: 0.17\u0026ndash;0.66) or previously heard of pre-exposure prophylaxis (PrEP) (6.1% of participants) (aOR: 0.25, 95% CI: 0.09\u0026ndash;0.65) were less likely to be out-of-care than those who had not. Odds of being out-of-care were increased for those from the northern compared to the central provinces (aOR: 2.37, 95% CI: 1.09\u0026ndash;5.15) and those who had participated in prevention programs (aOR: 3.19, 95% CI: 1.37\u0026ndash;7.41).\u003c/p\u003e\u003cp\u003e\u003cb\u003eDiscussion\u003c/b\u003e\u003c/p\u003e\u003cp\u003eOver half of young people with HIV in Mozambique met our definition for out-of-care in 2021. Our results reveal important geographic and sex gaps in HIV care. Strengthening existing programs to include components centered on creating a lasting link to health services could improve the identification of new HIV-positive young people. The important role of parents and guardians in young people\u0026rsquo;s health behaviors and decision-making presents an opportunity to engage families with interventions to strengthen needed services to this priority population in Mozambique.\u003c/p\u003e","manuscriptTitle":"Out-of-Care HIV-Positive Young People Aged 15-24 years in Mozambique: Findings from the 2021 Population-Based HIV Impact Assessment Survey","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-06 09:57:38","doi":"10.21203/rs.3.rs-7770475/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-11-13T16:00:26+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-13T11:48:25+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-06T20:33:02+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-03T15:24:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"189859342795680228840884383947278413304","date":"2025-11-03T05:05:52+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"309726834558636674489484130150238434014","date":"2025-11-01T15:16:03+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"175007472720464303085869921758394532821","date":"2025-10-29T13:00:43+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"260373532104630849936600588655121238605","date":"2025-10-27T20:10:29+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"10025205238402034890450870114545472948","date":"2025-10-27T19:01:46+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"53403886646324856097698083337974595413","date":"2025-10-27T13:00:52+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-27T12:56:22+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-27T10:28:02+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-10-09T04:05:19+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-08T16:01:16+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Infectious Diseases","date":"2025-10-08T15:49:17+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"30fc383f-d545-4550-910b-1537d83aec35","owner":[],"postedDate":"November 6th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-02-02T16:00:53+00:00","versionOfRecord":{"articleIdentity":"rs-7770475","link":"https://doi.org/10.1186/s12879-026-12745-5","journal":{"identity":"bmc-infectious-diseases","isVorOnly":false,"title":"BMC Infectious Diseases"},"publishedOn":"2026-01-30 15:58:10","publishedOnDateReadable":"January 30th, 2026"},"versionCreatedAt":"2025-11-06 09:57:38","video":"","vorDoi":"10.1186/s12879-026-12745-5","vorDoiUrl":"https://doi.org/10.1186/s12879-026-12745-5","workflowStages":[]},"version":"v1","identity":"rs-7770475","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7770475","identity":"rs-7770475","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}