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.
Unawareness of HIV Infection Among HIV-Infected Persons Aged 15–64 Years by Select Characteristics, Kenya AIDS Indicator Survey 2012
| Unaware of HIV | |||
|---|---|---|---|
| Select Characteristics Weighted % (95% CI) | Unweighted, N | Infection Unweighted, n | |
| Total | 648 | 343 | 53.1 (47.6 to 58.7) |
| Sex | |||
| Male | 193 | 120 | 62.0 (53.4 to 70.5) |
| Female | 455 | 223 | 47.8 (42.1 to 53.4) |
| Age category, yrs | |||
| 15–24 | 75 | 59 | 82.0 (72.3 to 91.7) |
| 25–34 | 209 | 121 | 58.9 (50.5 to 67.4) |
| 35–44 | 198 | 89 | 42.2 (33.4 to 51.0) |
| 45–54 | 126 | 53 | 45.1 (34.6 to 55.6) |
| 55–64* | 40 | 21 | 48.5 (31.2 to 65.8) |
| Marital status | |||
| Never married/never cohabited | 58 | 44 | 77.7 (66.4 to 88.9) |
| Ever widowed | 165 | 52 | 31.5 (24.1 to 39.0) |
| Divorced/separated | 83 | 53 | 64.6 (51.8 to 77.4) |
| Married/cohabiting | 342 | 194 | 56.1 (47.9 to 64.3) |
| Highest educational attainment | |||
| No primary* | 43 | 26 | 61.1 (44.1 to 78.2) |
| Incomplete primary* | 46 | 23 | 49.1 (32.9 to 65.4) |
| Complete primary | 223 | 123 | 56.0 (47.2 to 64.7) |
| Secondary or higher | 335 | 170 | 51.2 (44.5 to 57.9) |
| Wealth index | |||
| Poorest | 97 | 51 | 49.1 (36.8 to 61.5) |
| Second | 153 | 75 | 49.8 (37.4 to 62.2) |
| Middle | 137 | 68 | 46.8 (36.0 to 57.5) |
| Fourth | 158 | 84 | 55.7 (46.0 to 65.3) |
| Richest | 102 | 64 | 65.2 (54.9 to 75.4) |
| Residence | |||
| Rural | 373 | 192 | 51.0 (43.6 to 58.3) |
| Urban | 275 | 151 | 56.0 (47.5 to 64.5) |
| Region | |||
| Nairobi | 67 | 40 | 60.0 (47.5 to 72.4) |
| Central | 60 | 32 | 56.3 (41.2 to 71.4) |
| Coast | 66 | 40 | 59.1 (44.2 to 74.0) |
| Eastern | 75 | 41 | 53.6 (37.6 to 69.7) |
| Nyanza | 242 | 116 | 49.7 (40.1 to 59.3) |
| Rift Valley | 79 | 47 | 56.0 (40.1 to 72.0) |
| Western | 59 | 27 | 46.7 (31.2 to 62.2) |
| Ever pregnant† | |||
| No* | 32 | 26 | 82.5 (70.1 to 95.0) |
| Yes | 400 | 186 | 45.7 (39.7 to 51.7) |
| Currently pregnant† | |||
| No | 374 | 191 | 49.9 (43.6 to 56.2) |
| Yes‡ | 21 | 10 | — |
| Lifetime number of partners | |||
| 1 | 128 | 71 | 51.0 (40.3 to 61.6) |
| 2–3 | 236 | 125 | 54.8 (47.9 to 61.6) |
| 4–5 | 105 | 48 | 49.1 (37.8 to 60.4) |
| 6–9* | 45 | 24 | 53.7 (36.4 to 71.0) |
| 10 or more | 58 | 29 | 50.7 (36.7 to 64.8) |
| Do not know | 62 | 34 | 51.2 (36.4 to 66.0) |
| Condom use with most recent sexual partner in the past 12 mo§ | |||
| No | 291 | 202 | 67.7 (60.3 to 75.1) |
| Yes | 179 | 61 | 37.1 (29.1 to 45.2) |
| Symptoms of sexually transmitted infections in past 12 mo | |||
| No | 574 | 313 | 54.4 (48.6 to 60.3) |
| Yes | 74 | 30 | 42.9 (30.0 to 55.9) |
| Ever been tested for HIV | |||
| No | 72 | 72 | 100 |
| Yes | 574 | 269 | 46.3 (40.5 to 52.1) |
| When was the last HIV test? | |||
| <3 mo ago | 136 | 56 | 39.0 (28.9 to 49.2) |
| 3–5 mo ago | 91 | 48 | 50.5 (37.5 to 63.5) |
| 6–11 mo ago | 78 | 44 | 58.0 (44.1 to 71.9) |
| 1–2 yrs ago | 115 | 62 | 53.7 (42.9 to 64.4) |
| >2 yrs ago | 144 | 52 | 36.8 (27.2 to 46.4) |
Participants with missing values were removed from this analysis.
*Denominator between 25 and 49 observations; estimates may be unreliable.
†Among women only.
‡Due to small denominator (<25 observations), estimates are unreliable and have been suppressed.
§Among persons who had sex in the past 12 months.
Full article at: http://goo.gl/hkWmIh
By:
*National AIDS and Sexually Transmitted
Infection (STI) Control Programme, Ministry of Health, Nairobi, Kenya
†Global Health Sciences, University of
California, San Francisco, San Francisco, CA
‡Division of Global HIV/AIDS, Center for
Global Health, US Centers for Disease Control and Prevention, Nairobi, Kenya
§National Public Health Laboratory
Services, Ministry of Health, Kenya
||Liverpool Voluntary Counselling and
Testing, Nairobi, Kenya
¶National Public Health Laboratory
Services, Ministry of Health, Nairobi, Kenya
¶World Health Organization, Nairobi, Kenya
Correspondence to: Anne Ng’ang’a, BDS, MSc, National AIDS
and Sexually Transmitted Infection Control Programme, Ministry of Health,
Kenyatta National Hospital Grounds, 19361-00202 Nairobi, Kenya
More at: https://twitter.com/hiv insight
No comments:
Post a Comment