African Population and Health Research Center, Kirawa Road, off Peponi Road P O Box 10787, 00100, Nairobi, Kenya.
BMC Public Health. 2011 Aug 23;11:663. doi: 10.1186/1471-2458-11-663.
BACKGROUND: Counselling and testing is important in HIV prevention and care. Majority of people in sub-Saharan Africa do not know their HIV status and are therefore unable to take steps to prevent infection or take up life prolonging anti-retroviral drugs in time if infected. This study aimed at exploring determinants of HIV testing and counselling in two Nairobi informal settlements. METHODS: Data are derived from a cross-sectional survey nested in an ongoing demographic surveillance system. A total of 3,162 individuals responded to the interview and out of these, 82% provided a blood sample which was tested using rapid test kits. The outcome of interest in this paper was HIV testing status in the past categorised as "never tested"; "client-initiated testing and counselling (CITC)" and provider-initiated testing and counselling (PITC). Multinomial logistic regression was used to identify determinants of HIV testing. RESULTS: Approximately 31% of all respondents had ever been tested for HIV through CITC, 22% through PITC and 42% had never been tested but indicated willingness to test. Overall, 62% of females and 38% of males had ever been tested for HIV. Males were less likely to have had CITC (OR = 0.47; p value < 0.001) and also less likely to have had PITC (OR = 0.16; p value < 0.001) compared to females. Individuals aged 20-24 years were more likely to have had either CITC or PITC compared to the other age groups. The divorced/separated/widowed were more likely (OR = 1.65; p value < 0.01) to have had CITC than their married counterparts, while the never married were less likely to have had either CITC or PITC. HIV positive individuals (OR = 1.60; p value < 0.01) and those who refused testing in the survey (OR = 1.39; p value < 0.05) were more likely to have had CITC compared to their HIV negative counterparts. CONCLUSION: Although the proportion of individuals ever tested in the informal settlements is similar to the national average, it remains low compared to that of Nairobi province especially among men. Key determinants of HIV testing and counselling include; gender, age, education level, HIV status and marital status. These factors need to be considered in efforts aimed at increasing participation in HIV testing.
背景：咨询和检测在艾滋病毒预防和护理中很重要。撒哈拉以南非洲的大多数人不知道自己的艾滋病毒状况，因此无法采取措施预防感染，或者在感染后及时服用延长生命的抗逆转录病毒药物。本研究旨在探讨内罗毕两个非正规住区的艾滋病毒检测和咨询的决定因素。
方法：数据来自于一项嵌套在正在进行的人口监测系统中的横断面调查。共有 3162 人接受了访谈，其中 82%的人提供了血样，并用快速检测试剂盒进行了检测。本文的研究结果是过去的艾滋病毒检测状况，分为“从未检测过”、“客户发起的检测和咨询（CITC）”和“提供者发起的检测和咨询（PITC）”。采用多变量逻辑回归来确定艾滋病毒检测的决定因素。
结果：大约 31%的受访者曾通过 CITC 接受过艾滋病毒检测，22%的受访者曾通过 PITC 接受过艾滋病毒检测，42%的受访者从未接受过检测，但表示愿意接受检测。总的来说，62%的女性和 38%的男性曾接受过艾滋病毒检测。与女性相比，男性接受 CITC 的可能性较低（OR = 0.47；p 值<0.001），接受 PITC 的可能性也较低（OR = 0.16；p 值<0.001）。20-24 岁的人比其他年龄组更有可能接受 CITC 或 PITC。离异/分居/丧偶者比已婚者更有可能接受 CITC（OR = 1.65；p 值<0.01），而未婚者接受 CITC 或 PITC 的可能性较小。艾滋病毒阳性者（OR = 1.60；p 值<0.01）和在调查中拒绝检测者（OR = 1.39；p 值<0.05）比艾滋病毒阴性者更有可能接受 CITC。
结论：尽管非正规住区的检测比例与全国平均水平相似，但与内罗毕省相比，这一比例仍然较低，尤其是在男性中。艾滋病毒检测和咨询的关键决定因素包括：性别、年龄、教育程度、艾滋病毒状况和婚姻状况。在努力增加艾滋病毒检测参与度时，需要考虑这些因素。
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