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

Abstract

BackgroundWe analyzed HIV testing rates, prevalence of undiagnosed HIV, and predictors of testing in the Kenya AIDS Indicator Survey (KAIS) 2007.MethodsKAIS 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.ResultsOf 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.ConclusionsThe 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.

Factors associated with HIV testing and receiving results during antenatal care in Tanzania

“…Similar relationships are reported in Kenya in a study on knowledge of HIV status a major barrier to HIV prevention, care and treatment efforts where one can overcome stigma and discrimination (Cherutich, Kaiser et al 2012). It could also be an effect of ongoing community based interventions where older women have undergone longer exposures to HIV education leading to increased skills to overcome discrimination and stigma.…”

“…Additional factors influencing counseling, testing and collection of results includes social demographic characteristics, age, marital status, gender relations, place of residence, wellbeing and wealth (Cherutich, Kaiser et al 2012) (Ettenger, Barnighausen et al 2013). Thus knowing which factors negatively affect access to PMTCT would facilitate adoption of interventions that will increase access to PMTCT in a given geographical cultural context which will facilitate achieving the PMTCT goals.…”

Teste de HIV solicitado e espontâneo: um estudo de base populacional com mulheres de uma cidade do Sul do Brasil

“…Diversos estudos de base populacional realizados em diferentes países investigaram a prevalência de realização de teste para HIV e fatores associados 9,10,11,12,13,14,15,16,17,18,19,20,21 . É importante salientar que existe, na literatura, uma ampla variação na definição operacional de teste solicitado e teste espontâneo, o que prejudica a comparação dos resultados e pode explicar a discrepância entre os resultados deste estudo e outros achados da literatura.…”

Características en hombres que tienen sexo con hombres VIH+ en Cali-Colombia 2012-2015

“…Frente a este panorama la literatura es variable; algunos estudios reportan cómo personas infectadas por el vih que desconocen su infección no reducen los comportamientos de riesgo [17,18]. Por otra parte, estudios previos han demostrado que muchas personas infectadas cambian los comportamientos para reducir la transmisión sexual o a través de agujas, una vez son conscientes de su caso [18][19][20][21].…”