Knowledge of HIV status among men aged 20–35 years in Lusaka, Zambia: Findings from a pilot time location sampling survey in the “Yaba Guy Che” (for the guys) study

Objectives: We conducted a pilot time location sampling survey with young men aged 20–35 years in Lusaka, Zambia and aimed to describe knowledge of HIV status and determine factors associated with knowledge of HIV status.

Methods: Hotspots where men congregate were identified in a densely populated community in Lusaka. Hotspots were grouped into five strata (betting shops; car parks/washes; bus stations/taxi ranks; churches; and markets/shopping streets) and day/times when hotspots were frequented by men were listed. Within each stratum, three hotspots were randomly selected. Subsequently, 1 day/time was randomly selected for each hotspot. Men aged 20–35 were approached for participation and data was collected between July and October 2022. We describe participation in the survey, socio-demographics, and sexual behaviours. Using logistic regression, we explored factors associated with knowledge of HIV status.

Results: 339 men were approached, among whom 304 (90%) were eligible and 297 (98%) consenting to participate. Overall, 61% knew their HIV status. Adjusting for recruitment strata, knowledge of HIV status was similar by age (20–24: 56%; 25–29: 68%; and 30–35: 55%; p = 0.19). Among men reporting sex in the last month, men reporting no condomless sex were more likely to know their HIV status (78.2%) compared to men reporting one condomless sex partner in the past 1 month (55.5%; age-adjusted OR = 3.02; 95%CI 1.07, 8.55; p = 0.07). Knowledge of HIV status was lower among men who thought their friends were testing every 2–5 years (48%; n = 12/29) compared to those assuming that their friends tested more frequently (70.0%; adjOR = 0.28; 95%CI 0.08, 0.98; p < 0.001).

Conclusion: The time location sampling survey was acceptable among men, as evidenced by high participation. Overall, 40% of young men did not know their HIV status. A hotspot-driven approach to delivering HIV testing services may prove effective at reaching men. Furthermore, time location sampling surveys should be explored as a tool to evaluate interventions targeting men.