Knowledge, attitudes, stigma perceptions, and practices towards HIV testing among youths aged 18-35 years in Kumba, Cameroon: a community-based cross-sectional study.

backgroundDespite national efforts to scale up the human immunodeficiency virus (HIV) testing in Cameroon, many youths still remain untested. Understanding their knowledge, attitudes, stigma perceptions, and practices (KASP) towards HIV testing is vital for improving uptake. This study aimed to assess HIV-related KASP and identify barriers and facilitators to among youths aged 18-35 years in Kumba, Cameroon.

methodsA community-based cross-sectional study was conducted from February to April 2025 among 632 youths selected through a multistage sampling technique, stratified by municipalities and neighbourhoods across Kumba. Data were collected using a structured, pre-tested questionnaire. Descriptive statistics were used to summarise the sociodemographic data and KASP scores. Binary and ordinal logistic regression analyses were used to identify factors associated with HIV testing.

resultsOut of the 632 participants, 528 (83.5%) demonstrated moderate knowledge of HIV testing, while 33 (3.6%) had high knowledge. Positive attitudes toward HIV testing were observed in 128 (20.3%) participants. Fear of receiving a positive result 222 (35.1%) and anticipated stigma 107 (16.9%) were cited as barriers to testing. Youths with no sexual partners were significantly more likely to have good knowledge (OR 2.98, 95% CI: 1.53-5.78, p = 0.001), positive attitudes (OR 3.15, 95% CI: 1.81-5.47, p < 0.001), and testing practices (OR 7.62, 95% CI: 4.05-14.32, p < 0.001). While stigma was associated with lower testing uptake, sociodemographic factors such as gender, education, and religion were not significantly associated with testing behaviour.

conclusionsAlthough knowledge and attitudes towards HIV were generally positive, substantial gaps remain in testing uptake. Fear of a positive result and stigma were key barriers cited by one-third and one-sixth of the participants, respectively. This highlights the need for targeted community-based interventions, including peer-led education programmes, stigma-reduction campaigns, and youth-friendly testing services. Integration of HIV education into youth outreach and health programmes is recommended. As a cross-sectional study, causal relationships could not be established.. HIGHLIGHTS: - This study assessed HIV-related knowledge, attitudes, and testing practices among youths aged 18-35 years in Kumba, Cameroon. - Although general knowledge about HIV was high, misconceptions remained, and nearly one-third of the participants had never been tested for HIV. - HIV-related stigma, fear of positive results, and lack of youth-friendly services were major barriers to testing, underscoring the need for targeted awareness, improved counselling, and community-level interventions to promote regular voluntary HIV testing among youths in similar urban-rural communities.