Lack of Knowledge of HIV Status a Major Barrier to HIV Prevention, Care and Treatment Efforts in Kenya: Results from a Nationally Representative Study

Details

• Alternative Title:
  PLoS One
• Personal Author:
  Cherutich, Peter ; Kaiser, Reinhard ; Galbraith, Jennifer ; Williamson, John ; Shiraishi, Ray W. ; Ngare, Carol ; Mermin, Jonathan ; Marum, Elizabeth ; Bunnell, Rebecca
• Corporate Authors:
  KAIS Study Group
• Description:
  Background
  
  We analyzed HIV testing rates, prevalence of undiagnosed HIV, and predictors of testing in the Kenya AIDS Indicator Survey (KAIS) 2007.
  
  Methods
  
  KAIS was a nationally representative sero-survey that included demographic and behavioral indicators and testing for HIV, HSV-2, syphilis, and CD4 cell counts in the population aged 15–64 years. We used gender-specific multivariable regression models to identify factors independently associated with HIV testing in sexually active persons.
  
  Results
  
  Of 19,840 eligible persons, 80% consented to interviews and blood specimen collection. National HIV prevalence was 7.1% (95% CI 6.5–7.7). Among ever sexually active persons, 27.4% (95% CI 25.6–29.2) of men and 44.2% (95% CI 42.5–46.0) of women reported previous HIV testing. Among HIV-infected persons, 83.6% (95% CI 76.2–91.0) were unaware of their HIV infection. Among sexually active women aged 15–49 years, 48.7% (95% CI 46.8–50.6) had their last HIV test during antenatal care (ANC). In multivariable analyses, the adjusted odds ratio (AOR) for ever HIV testing in women ≥35 versus 15–19 years was 0.2 (95% CI: 0.1–0.3; p<0.0001). Other independent associations with ever HIV testing included urban residence (AOR 1.6, 95% CI: 1.2–2.0; p = 0.0005, women only), highest wealth index versus the four lower quintiles combined (AOR 1.8, 95% CI: 1.3–2.5; p = 0.0006, men only), and an increasing testing trend with higher levels of education. Missed opportunities for testing were identified during general or pregnancy-specific contacts with health facilities; 89% of adults said they would participate in home-based HIV testing.
  
  Conclusions
  
  The vast majority of HIV-infected persons in Kenya are unaware of their HIV status, posing a major barrier to HIV prevention, care and treatment efforts. New approaches to HIV testing provision and education, including home-based testing, may increase coverage. Targeted interventions should involve sexually active men, sexually active women without access to ANC, and rural and disadvantaged populations.
  
  
• Subjects:
  Adolescent Adult AIDS Serodiagnosis Data Collection Demography Female Health Knowledge, Attitudes, Practice Health Planning HIV Infections Humans Laboratories Male Middle Aged Pregnancy Public Health Research Article Self Report Sexual Behavior Young Adult

  More +
• Source:
  PLoS One. 2012; 7(5).
• Document Type:
  Journal Article
• Place as Subject:
  Kenya
• Volume:
  7
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:61a1531d427a92336616916a7ce7b56c987d8d50d9f371df0fd565537ca16dd3
• Download URL:
  https://stacks.cdc.gov/view/cdc/8190/cdc_8190_DS1.pdf
• File Type:
  [PDF - 210.10 KB ]