TY - JOUR
T1 - Trends and predictors of HIV positivity and time since last test at voluntary counselling and testing encounters among adults in Kilifi, Kenya, 2006-2017
AU - Mugo, Peter M.
AU - Agutu, Clara A.
AU - Wahome, Elizabeth
AU - Juma, Margaret
AU - Nzioka, Joseph
AU - Mohamed, Khamisi
AU - Mumba, Teresia
AU - Shally, Mahmoud
AU - Fauz, Ibrahim
AU - Omar, Anisa
AU - Rinke de Wit, Tobias F.
AU - van der Elst, Elise M.
AU - Graham, Susan M.
AU - Sanders, Eduard J.
N1 - Funding Information: We acknowledge the KWTRP counsellors who provided testing and counselling services at the three VCTs during the period under study, data entry staff, and Christopher Nyundo for the map of study area. This manuscript was submitted for publication with permission from the Director of the Kenya Medical Research Institute (KEMRI). Publisher Copyright: © 2021 Mugo PM et al.
PY - 2021
Y1 - 2021
N2 - Background: Little is known about HIV retesting uptake among key populations (KP) and general populations (GP) in Kenya. We assessed trends and predictors of first-time testing (FTT), late retesting (previous test more than one year ago for GP or three months for KP), and test positivity at three voluntary counselling and testing (VCT) centres in coastal Kenya. Methods: Routine VCT data covering 2006-2017 was collected from three VCT centres in Kilifi County. We analysed HIV testing history and test results from encounters among adults 18-39 years, categorized as GP men, GP women, men who have sex with men (MSM), and female sex workers (FSW). Results: Based on 24,728 test encounters (32% FTT), we observed declines in HIV positivity (proportion of encounters where the result was positive) among GP men, GP women, first-time testers and MSM but not among FSW. The proportion of encounters for FTT and late retesting decreased for both GP and KP but remained much higher in KP than GP. HIV positivity was higher at FTT and late retesting encounters; at FSW and MSM encounters; and at encounters with clients reporting lower educational attainment and sexually transmitted infection (STI) symptoms. HIV positivity was lower in GP men, never married clients and those less than 35 years of age. FTT was associated with town, risk group, age 18-24 years, never-married status, low educational attainment, and STI symptoms. Late retesting was less common among encounters with GP individuals who were never married, had Muslim or no religious affiliation, had lower educational attainment, or reported STI symptoms. Conclusions: HIV positive test results were most common at encounters with first-time testers and late re-testers. While the proportion of encounters at which late retesting was reported decreased steadily over the period reviewed, efforts are needed to increase retesting among the most at-risk populations.
AB - Background: Little is known about HIV retesting uptake among key populations (KP) and general populations (GP) in Kenya. We assessed trends and predictors of first-time testing (FTT), late retesting (previous test more than one year ago for GP or three months for KP), and test positivity at three voluntary counselling and testing (VCT) centres in coastal Kenya. Methods: Routine VCT data covering 2006-2017 was collected from three VCT centres in Kilifi County. We analysed HIV testing history and test results from encounters among adults 18-39 years, categorized as GP men, GP women, men who have sex with men (MSM), and female sex workers (FSW). Results: Based on 24,728 test encounters (32% FTT), we observed declines in HIV positivity (proportion of encounters where the result was positive) among GP men, GP women, first-time testers and MSM but not among FSW. The proportion of encounters for FTT and late retesting decreased for both GP and KP but remained much higher in KP than GP. HIV positivity was higher at FTT and late retesting encounters; at FSW and MSM encounters; and at encounters with clients reporting lower educational attainment and sexually transmitted infection (STI) symptoms. HIV positivity was lower in GP men, never married clients and those less than 35 years of age. FTT was associated with town, risk group, age 18-24 years, never-married status, low educational attainment, and STI symptoms. Late retesting was less common among encounters with GP individuals who were never married, had Muslim or no religious affiliation, had lower educational attainment, or reported STI symptoms. Conclusions: HIV positive test results were most common at encounters with first-time testers and late re-testers. While the proportion of encounters at which late retesting was reported decreased steadily over the period reviewed, efforts are needed to increase retesting among the most at-risk populations.
KW - HIV diagnosis
KW - HIV retesting
KW - Kenya
KW - Kilifi County
KW - Voluntary counselling and testing
UR - http://www.scopus.com/inward/record.url?scp=85104250511&partnerID=8YFLogxK
U2 - https://doi.org/10.12688/wellcomeopenres.15401.2
DO - https://doi.org/10.12688/wellcomeopenres.15401.2
M3 - Article
C2 - 33884308
SN - 2398-502X
VL - 4
JO - Wellcome open research
JF - Wellcome open research
M1 - 127
ER -