The Association of HIV Counseling and Testing with HIV Risk Behaviors in a Random Population-based Survey in Kisumu, Kenya

AIDS Behav (2011) 15:718724 DOI 10.1007/s10461-009-9649-4

ORIGINAL PAPER

The Association of HIV Counseling and Testingwith HIV Risk Behaviors in a Random Population-based Survey in Kisumu, Kenya

Megan J. Huchko Michele Montandon

Rosemary Nguti Elizabeth A. Bukusi

Craig R. Cohen

Published online: 11 December 2009 The Author(s) 2009. This article is published with open access at Springerlink.com

Abstract HIV testing has been promoted as a key HIV prevention strategy in low-resource settings, despite studies showing variable impact on risk behavior. We sought to examine rates of HIV testing and the association between testing and sexual risk behaviors in Kisumu, Kenya. Participants were interviewed about HIV testing and sexual risk behaviors. They then underwent HIV serologic testing. We found that 47% of women and 36% of men reported prior testing. Two-thirds of participants who tested HIV-positive in this study reported no prior HIV test. Women who had undergone recent testing were less likely to report high-risk behaviors than women who had never been tested; this was not seen among men. Although rates of HIV testing were higher than seen in previous studies, the majority of HIV-infected people were unaware of their status. Efforts should be made to increase HIV testing among this population.

Keywords HIV-1 Voluntary counseling and testing

HIV risk behaviors HIV prevention Kenya

Introduction

Voluntary counseling and testing (VCT) traditionally involves an individual actively seeking out HIV testing at a specic testing facility and includes targeted pre- and post-test counseling. This model of VCT has played an essential role in the public health response to HIV in both resource-rich and resource-limited countries. In Kenya, VCT has been promoted as a cost-effective prevention tool, with the potential to stimulate behavior change in individuals who learn their HIV status. With the increasing availability of anti-retroviral therapy (ART) in Kenya over the past 5 years, VCT has taken on the additional role as a point of entry into care. Despite increased access to treatment, the number of HIV-infected people still far outstrips the countrys resources, with ART reaching less than 25% of eligible adults [1]. Effective prevention measures remain crucial to controlling the epidemic.

VCT efcacy data has shown variable effects on HIV risk behavior, with signicant behavior changes seen mainly in HIV-infected individuals [2]. However, there have...