Decadal trends in HIV prevalence among socio-demographic groups and health behaviours in Ethiopia: a cross-sectional seroprevalence study.
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BACKGROUND: Preventing HIV infections remains a key objective for global health initiatives. However, monitoring new infection rates and long-term prevalence trends is often underutilized in evaluating intervention success. This study assessed HIV prevalence patterns over the past decade across socio-demographic and behavioural groups to better understand the changing dynamics of transmission. METHODS: A health facility–based cross-sectional seroprevalence study was conducted using convenience sampling. Data were obtained daily through the District Health Information System and entered into Google Microsoft Excel online. The dataset comprised routine HIV testing and counselling services at Asella Teaching and Referral Hospital, including both client-initiated and provider-initiated testing. Yearly aggregated data (2015–2024) were analysed using IBM SPSS Statistics 31 to calculate HIV prevalence and examine its associations with socio-demographic factors and health-related behaviours. RESULTS: A total of 158,115 individuals received HIV test results during the study period (2015–2024), with 1,235 (0.781%) testing positive for HIV. Prevalence showed no significant change over the decade, with 0.87% in 2015 (n = 1,850) and the same 0.87% in 2022 (n = 15,472), regardless of sample size fluctuations. Higher infection odds were found among individuals aged ≥50 years compared with those aged 15–49 (AOR = 1.53; 95% CI: 1.26–1.85). Elevated risks were observed among long-distance drivers (AOR = 1.76; 95% CI: 1.02–3.21), female commercial sex workers (AOR = 2.48; 95% CI: 1.66–3.72), and mobile/daily labourers (AOR = 2.82; 95% CI: 2.27–3.50). The highest vulnerability was among children of people living with HIV (AOR = 4.32), highlighting urgent needs for strengthened prevention of mother-to-child transmission (PMTCT) services. Additionally, TB clients (AOR = 1.84) and women attending cervical cancer screening (AOR = 3.86) had significantly higher infection odds. Syphilis-screened prgnant women (AOR = 1.40) and other most-at-risk populations (AOR = 1.64) also showed increased prevalence. CONCLUSIONS: HIV prevalence over the past decade have remained stable, high-risk pockets persist among specific occupational, clinical, and demographic groups. Sustaining progress toward epidemic control will require targeted, context-specific prevention, early detection, and treatment strategies tailored to these vulnerable populations, alongside reinforcement of PMTCT and outreach services.