The Status of HIV Testing and Counseling in Kenya

Abstract

Background HIV testing and counseling (HTC) is essential for successful HIV prevention and treatment programs. The national target for HTC is 80% of the adult population in Kenya. Population-based data to measure progress towards this HTC target are needed to assess the country’s changing needs for HIV prevention and treatment. Methods In 2012–2013, we conducted a national HIV survey among Kenyans aged 18 months to 64 years. Respondents aged 15–64 years were administered a questionnaire that collected information on demographics, HIV testing behavior, and self-reported HIV status. Blood samples were collected for HIV testing in a central laboratory. Participants were offered home-based testing and counseling to learn their HIV status in the home and point-of-care CD4 testing if they tested HIV-positive. Results Of 13,720 adults who were interviewed, 71.6% [95% confidence interval (CI): 70.2 to 73.1] had been tested for HIV. Among those, 56.1% (95% CI: 52.8 to 59.4) had been tested in the past year, 69.4% (95% CI: 68.0 to 70.8) had been tested more than once, and 37.2% (95% CI: 35.7 to 38.8) had been tested with a partner. Fifty-three percent (95% CI: 47.6 to 58.7) of HIV-infected persons were unaware of their infection. Overall 9874 (72.0%) of participants accepted home-based HIV testing and counseling; 4.1% (95% CI: 3.3 to 4.9) tested HIV-positive, and of those, 42.5% (95% CI 31.4 to 53.6) were in need of immediate treatment for their HIV infection but not receiving it. Conclusions HIV testing rates have nearly reached the national target for HTC in Kenya. However, knowledge of HIV status among HIV-infected persons remains low. HTC needs to be expanded to reach more men and couples, and strategies are needed to increase repeat testing for persons at risk for HIV infection.

Systematic review and meta-analysis of community and facility-based HIV testing to address linkage to care gaps in sub-Saharan Africa

“…The percentage of testers who were young adults testers <age 25 or <30 years) was reported in 17 home HTC studies 5,18,29–31,35,37,38,45,63,64,68–70,73,74,90,117 , one home with self-testing 11 , 13 mobile 10,12,13,68,91,93,95–97,103,107,114 , two index partner 48,88 , two campaign 47,77 , 20 facility VCT 12,51,52,54,64,88,89,91–93,95,104–107,114,118–120 , and six facility PITC 58,82,86,88,110,113 . Results varied considerably by study (Supplementary Figures S29–S35).…”

“…Uptake was reported in 31 home HTC studies 5,14,15,18,27,29–38,40–45,53,62–74 , two home with self-testing 11,75 , two mobile 10,68 , three index partner or family member 48–50 , four campaign 46,47,76,77 , three workplace 78–80 , three facility VCT 54,56,81 , and 11 facility PITC studies 56,57,59,60,81–87 . Overall, community modalities had high uptake (Fig.…”

“…The percentage of men out of total persons tested was reported in 25 home HTC studies 5,14,18,29,31,32,37,38,41–45,63,64,66,68–72,88–90 , two home with self-testing 11,75 , 10 mobile 10,13,68,72,91–99 , 3 index partner 47,49,88 , 3 campaign 46,47,76 , 2 workplace 100,101 , 20 facility VCT 52,54,61,64,81,88,89,92,93,95,96,98,102–107 , and 13 facility PITC 58,60,82–84,86,99,108–113 (Fig. 2).…”

“…Percentage of participants reporting testing for the first time was included in 20 home HTC studies 5,14,18,29,31,32,38,41–44,63,65,66,68–72,88 , 11 mobile 10,12,68,93–95,97,103,114 , 3 campaign 46,47,77 , 3 key populations 25,115,116 , and 7 facility VCT 12,54,91,93,95,106 , and 5 facility PITC 58,86,88,111,112 . Pooled percentages of first-time testers were higher for community than facility modalities (Fig.…”

Understanding HIV Testing Behaviors of Minority Adolescents: A Health Behavior Model Analysis

“…When properly used, HIV testing is the gateway to treatment, care, and prevention (Ng’ang’a et al, 2014). Late diagnosis of HIV results in increased transmission and missed opportunities for treatment, making early HIV testing a critical public health priority.…”