Abstract
Abstract Background HIV remains a major global health challenge, with 39 million people living with the virus in 2023. Adolescent girls and young women face disproportionate risk, yet evidence on HIV screening uptake is often country‑specific. Comparative data across African and Asian contexts are limited, leaving a gap in understanding the broader determinants of screening. This study assessed the prevalence of HIV screening and identified sociodemographic, behavioral, and contextual factors associated with uptake among adolescent girls and young women. Methods A cross-sectional analysis of Demographic and Health Survey data (2022–2024) from 15 countries in sub-Saharan Africa and Asia included 106,367 women aged 15–24. Multilevel logistic regression was used to examine individual, community, and health system factors linked to HIV screening. Results Less than one in three participants had ever been screened for HIV. Uptake was significantly associated with older age, higher education, wealth, sexual activity, pregnancy, contraceptive use, health facility visits, media exposure, and mobile phone ownership. Regional differences were pronounced, with substantially higher screening in sub-Saharan Africa compared to Asia. Conclusions HIV screening among adolescent girls and young women remains unacceptably low. Strengthening youth‑friendly services, integrating testing into reproductive health programs, and leveraging digital health and media platforms are critical strategies. Equity‑focused outreach targeting poorer households and urban populations is essential to close gaps and advance global HIV prevention goals.