Angola youth surveys find uneven sexual health knowledge and variable HBsAg positivity

Researchers pooled data from independent community-based surveys conducted in 2021 and 2024 in four municipalities of Benguela Province. The surveys used the same procedures and recruited participants aged 15–25 through convenience sampling at public spaces, youth centres and churches. Participants completed a structured sexual and reproductive health (SRH) questionnaire and were offered point-of-care testing for HIV, hepatitis B surface antigen (HBsAg), hepatitis C and syphilis. The analysis included 2,802 participants and used multivariable logistic regression, accounting for survey year.

Adequate SRH knowledge was associated with female sex (adjusted odds ratio [aOR] 1.49), older age (aOR 1.06 per year), higher education (aOR 5.30) and urban residence (aOR 1.75). Participants surveyed in 2024 had lower odds of adequate knowledge than those surveyed in 2021 (aOR 0.61). Overall, 35% tested positive for HBsAg, but positivity was approximately 13.6% in 2021 and 56.3% in 2024. HIV, HCV and syphilis positivity were 1.2%, 0.5% and 1.0%, respectively.

The authors note that convenience sampling was not designed to represent the general population. The large difference in HBsAg positivity between independently recruited rounds, alongside the use of screening tests, means the pooled estimate should be interpreted cautiously. They call for representative sampling and confirmatory testing, and highlight vaccination, screening and youth-friendly SRH services as prevention priorities.