Barriers and Facilitators to Human Immunodeficiency Virus Self Testing among Undergraduate Students in Kenyatta University, Kenya
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Date
2024-10
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Kenyatta University
Abstract
Over 36.9 million people worldwide live with HIV, with 21.7 million receiving ART.
In Africa, 1.5 million individuals aged 15-24 are affected, with teenage girls and young
women being disproportionately affected. KENPHIA Preliminary Report revealed a
nationwide HIV prevalence rate of 4.9%, with women having a higher rate of 6.6%
compared to men at 3.1%. HIVST aims to increase accessibility to testing services for
at-risk populations. The WHO has preapproved three HIV self-testing kits for Kenya,
including OraQuick®, Atomo®, and INSTI®. However, only 62% of young
individuals are aware of their HIV-positive status, with university students at a higher
risk due to risky sexual behaviors and cross-generational relationships. The UNAIDS
aims to achieve 95% HIV status awareness by 2030, but current conventional HIV
testing has not effectively ensured widespread availability of HIV prevention,
treatment, and care. This cross-sectional analytical study targeted undergraduate
students, utilizing multi-stage cluster sampling and self-administered questionnaires to
collect comprehensive data on their demographic characteristics, HIV testing practices,
and factors influencing HIVST uptake. The results revealed that 24.4% of participants
had ever used HIVST, with 65.3% having tested for HIV overall. Among those who
had tested, 44.6% had last done so more than a year ago, with facility-based testing
being the most common method (71.2%). Age and gender were significant
determinants of HIVST uptake; females (50.8%) and older students aged 22-25 years
had higher odds of using HIVST. Awareness of HIV prevention methods like PrEP was
a particularly strong facilitator, with participants aware of PrEP being 2.4 times more
likely to use HIVST. Additionally, 69.1% of participants found HIVST kits affordable,
though 57.7% reported difficulty accessing them. Social media emerged as the primary
source of information for 56.7% of participants, while 86.6% found the instructions on
the kits easy to understand. Despite these barriers, 78.4% of participants were confident
in interpreting their HIV status at home, and 88.7% agreed that HIVST kits should be
made available free of charge in public health facilities. The study underscored the
importance of addressing persistent barriers such as stigma, cost, and accessibility to
significantly increase HIVST uptake. Key recommendations include enhancing HIV
prevention education, leveraging successful media campaigns like "Chukua Selfie,"
integrating HIVST into campus health services, and tailoring interventions to specific
demographic groups such as young adults. The study provided a nuanced understanding
of the determinants affecting HIVST uptake and offered actionable strategies to
enhance HIV prevention and control efforts among young adults in Kenya
Description
Thesis Submitted in Partial Fulfillment of the Requirement for the Award of the Degree of Masters in Medicine (Family Medicine) in the School of Health Sciences of Kenyatta University, October, 2024
Supervisors:
1. Joseph Thigi
2. Osborn Tembu