Trends and Determinants of HIV Testing Uptake among Men Aged 15–59 Years in Zambia: A Multilevel Analysis of the Zambia Demographic and Health Surveys, 2007–2024

Abstract HIV testing remains the primary entry point to HIV prevention, treatment, and care. Although Zambia has made substantial progress in its HIV response, men remain less consistently reached by HIV testing services. This study assessed trends and determinants of HIV testing uptake among men aged 15–59 years in Zambia using repeated nationally representative survey data. We pooled men’s data from the Zambia Demographic and Health Surveys (ZDHS) conducted in 2007, 2013/14, 2018, and 2024. The outcome was HIV testing uptake, defined as ever tested for HIV and received results (DHS variable mv781). Analyses accounted for the complex survey design using sampling weights in Stata 14.2. Trends were examined using weighted proportions and design-adjusted chi-square tests. Determinants were assessed using multilevel logistic regression with men nested within clusters, reporting adjusted odds ratios (AORs) and 95% confidence intervals (CIs). HIV testing uptake increased markedly from 20.7% (2007) to 62.9% (2013/14) and peaked at 77.4% (2018), with a modest decline in 2024 (73.5%); differences across survey years were statistically significant (p