Juddy Wachira1, Samson Ndege, Julius Koech, Rachel C Vreeman, Paul Ayuo, Paula Braitstein. 1. *USAID-Academic Model Providing Access to Healthcare (AMPATHPlus) Partnership, Eldoret, Kenya; †Department of Epidemiology, School of Public Health, College of Health Sciences, Moi University, Eldoret, Kenya; ‡Children's Health Services Research, Indiana University School of Medicine, Indianapolis, IN; §Department of Medicine, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya; ‖Department of Medicine, School of Medicine, Indiana University, Indianapolis, IN; ¶Regenstrief Institute, Inc, Indianapolis, IN; and #Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Abstract
OBJECTIVE: To describe HIV testing uptake and prevalence among adolescents and adults in a home-based HIV counseling and testing program in western Kenya. METHODS: Since 2007, the Academic Model Providing Access to Healthcare program has implemented home-based HIV counseling and testing on a large scale. All individuals aged ≥13 years were eligible for testing. Data from 5 of 8 catchments were included in this analysis. We used descriptive statistics and multivariate logistic regression to examine testing uptake and HIV prevalence among adolescents (13-18 years), younger adults (19-24 years), and older adults (≥25 years). RESULTS: There were 154,463 individuals eligible for analyses as follows: 22% adolescents, 19% younger adults, and 59% older adults. Overall mean age was 32.8 years and 56% were female. HIV testing was high (96%) across the following 3 groups: 99% in adolescents, 98% in younger adults, and 94% in older adults (P < 0.001). HIV prevalence was higher (11.0%) among older adults compared with younger adults (4.8%) and adolescents (0.8%) (P < 0.001). Those who had ever previously tested for HIV were less likely to accept HIV testing (adjusted odds ratio: 0.06, 95% confidence interval: 0.05 to 0.07) but more likely to newly test HIV positive (adjusted odds ratio: 1.30, 95% confidence interval: 1.21 to 1.40). Age group differences were evident in the sociodemographic and socioeconomic factors associated with testing uptake and HIV prevalence, particularly, gender, relationship status, and HIV testing history. CONCLUSIONS: Sociodemographic and socioeconomic factors were independently associated with HIV testing and prevalence among the age groups. Community-based treatment and prevention strategies will need to consider these factors.
OBJECTIVE: To describe HIV testing uptake and prevalence among adolescents and adults in a home-based HIV counseling and testing program in western Kenya. METHODS: Since 2007, the Academic Model Providing Access to Healthcare program has implemented home-based HIV counseling and testing on a large scale. All individuals aged ≥13 years were eligible for testing. Data from 5 of 8 catchments were included in this analysis. We used descriptive statistics and multivariate logistic regression to examine testing uptake and HIV prevalence among adolescents (13-18 years), younger adults (19-24 years), and older adults (≥25 years). RESULTS: There were 154,463 individuals eligible for analyses as follows: 22% adolescents, 19% younger adults, and 59% older adults. Overall mean age was 32.8 years and 56% were female. HIV testing was high (96%) across the following 3 groups: 99% in adolescents, 98% in younger adults, and 94% in older adults (P < 0.001). HIV prevalence was higher (11.0%) among older adults compared with younger adults (4.8%) and adolescents (0.8%) (P < 0.001). Those who had ever previously tested for HIV were less likely to accept HIV testing (adjusted odds ratio: 0.06, 95% confidence interval: 0.05 to 0.07) but more likely to newly test HIV positive (adjusted odds ratio: 1.30, 95% confidence interval: 1.21 to 1.40). Age group differences were evident in the sociodemographic and socioeconomic factors associated with testing uptake and HIV prevalence, particularly, gender, relationship status, and HIV testing history. CONCLUSIONS: Sociodemographic and socioeconomic factors were independently associated with HIV testing and prevalence among the age groups. Community-based treatment and prevention strategies will need to consider these factors.
Authors: Anjuli D Wagner; Kate S Wilson; Joseph B Babigumira; Cyrus Mugo; Peter M Mutiti; Jillian Neary; Dalton C Wamalwa; David Bukusi; Grace C John-Stewart; Pamela K Kohler; Jennifer A Slyker Journal: J Assoc Nurses AIDS Care Date: 2020 Jul-Aug Impact factor: 1.354
Authors: Brianna Osetinsky; Jan A C Hontelez; Mark N Lurie; Stephen T McGarvey; Gerald S Bloomfield; Sonak D Pastakia; Richard Wamai; Till Bärnighausen; Sake J de Vlas; Omar Galárraga Journal: Health Aff (Millwood) Date: 2019-07 Impact factor: 6.301
Authors: Lonnie Embleton; Carmen H Logie; Kenneth Ngure; LaRon Nelson; Liza Kimbo; David Ayuku; Janet M Turan; Paula Braitstein Journal: AIDS Behav Date: 2022-07-30
Authors: Jiayu Wang; Cyrus Mugo; Vincent O Omondi; Irene N Njuguna; Elizabeth Maleche-Obimbo; Irene Inwani; James P Hughes; Jennifer A Slyker; Grace John-Stewart; Dalton Wamalwa; Anjuli D Wagner Journal: AIDS Behav Date: 2022-03-19
Authors: Matthew J Akiyama; Charles M Cleland; John A Lizcano; Peter Cherutich; Ann E Kurth Journal: Lancet Infect Dis Date: 2019-09-17 Impact factor: 25.071
Authors: Wendy P O'Meara; Joshua A Mott; Jeremiah Laktabai; Kabura Wamburu; Barry Fields; Janice Armstrong; Steve M Taylor; Charles MacIntyre; Reeshi Sen; Diana Menya; William Pan; Bradly P Nicholson; Christopher W Woods; Thomas L Holland Journal: Am J Trop Med Hyg Date: 2015-03-09 Impact factor: 2.345
Authors: Lindsey K Reif; Vanessa Rivera; Bianca Louis; Rachel Bertrand; Mireille Peck; Benedict Anglade; Grace Seo; Elaine J Abrams; Jean W Pape; Daniel W Fitzgerald; Margaret L McNairy Journal: AIDS Patient Care STDS Date: 2016-08 Impact factor: 5.078
Authors: Kevin Kadede; Theodore Ruel; Jane Kabami; Emmanuel Ssemmondo; Norton Sang; Dalsone Kwarisiima; Elizabeth Bukusi; Craig R Cohen; Teri Liegler; Tamara D Clark; Edwin D Charlebois; Maya L Petersen; Moses R Kamya; Diane V Havlir; Gabriel Chamie Journal: AIDS Date: 2016-09-10 Impact factor: 4.177
Authors: Susanna E Winston; Amon K Chirchir; Lauryn N Muthoni; David Ayuku; Julius Koech; Winstone Nyandiko; E Jane Carter; Paula Braitstein Journal: Sex Transm Infect Date: 2015-02-24 Impact factor: 3.519