*National AIDS and Sexually Transmitted Infection (STI) Control Programme, Ministry of Health, Nairobi, Kenya; †Global Health Sciences, University of California, San Francisco, San Francisco, CA; ‡Division of Global HIV/AIDS, Center for Global Health, US Centers for Disease Control and Prevention, Nairobi, Kenya; §National Public Health Laboratory Services, Ministry of Health, Kenya; ‖Liverpool Voluntary Counselling and Testing, Nairobi, Kenya; ¶National Public Health Laboratory Services, Ministry of Health, Nairobi, Kenya; and ¶World Health Organization, Nairobi, Kenya.
J Acquir Immune Defic Syndr. 2014 May 1;66 Suppl 1(Suppl 1):S27-36. doi: 10.1097/QAI.0000000000000102.
HIV testing and counseling (HTC) is essential for successful HIV prevention and treatment programs. The national target for HTC is 80% of the adult population in Kenya. Population-based data to measure progress towards this HTC target are needed to assess the country's changing needs for HIV prevention and treatment.
In 2012-2013, we conducted a national HIV survey among Kenyans aged 18 months to 64 years. Respondents aged 15-64 years were administered a questionnaire that collected information on demographics, HIV testing behavior, and self-reported HIV status. Blood samples were collected for HIV testing in a central laboratory. Participants were offered home-based testing and counseling to learn their HIV status in the home and point-of-care CD4 testing if they tested HIV-positive.
Of 13,720 adults who were interviewed, 71.6% [95% confidence interval (CI): 70.2 to 73.1] had been tested for HIV. Among those, 56.1% (95% CI: 52.8 to 59.4) had been tested in the past year, 69.4% (95% CI: 68.0 to 70.8) had been tested more than once, and 37.2% (95% CI: 35.7 to 38.8) had been tested with a partner. Fifty-three percent (95% CI: 47.6 to 58.7) of HIV-infected persons were unaware of their infection. Overall 9874 (72.0%) of participants accepted home-based HIV testing and counseling; 4.1% (95% CI: 3.3 to 4.9) tested HIV-positive, and of those, 42.5% (95% CI 31.4 to 53.6) were in need of immediate treatment for their HIV infection but not receiving it.
HIV testing rates have nearly reached the national target for HTC in Kenya. However, knowledge of HIV status among HIV-infected persons remains low. HTC needs to be expanded to reach more men and couples, and strategies are needed to increase repeat testing for persons at risk for HIV infection.
艾滋病毒检测和咨询（HTC）对于成功的艾滋病毒预防和治疗计划至关重要。肯尼亚全国 HTC 的目标是成年人口的 80%。需要基于人群的数据来衡量实现这一 HTC 目标的进展情况，以评估该国对艾滋病毒预防和治疗需求的变化。
2012-2013 年，我们在肯尼亚年龄在 18 个月至 64 岁的人群中开展了全国艾滋病毒调查。年龄在 15-64 岁的受访者接受了一份问卷，该问卷收集了人口统计学、艾滋病毒检测行为和自我报告的艾滋病毒状况信息。在中央实验室采集血液样本进行艾滋病毒检测。参与者可以选择在家接受检测和咨询，以了解自己的艾滋病毒状况，如果艾滋病毒检测呈阳性，还可以在现场进行 CD4 检测。
在接受访谈的 13720 名成年人中，71.6%[95%置信区间（CI）：70.2-73.1]接受过艾滋病毒检测。其中，56.1%（95%CI：52.8-59.4）在过去一年中接受过检测，69.4%（95%CI：68.0-70.8）接受过多次检测，37.2%（95%CI：35.7-38.8）与伴侣一起接受过检测。53%（95%CI：47.6-58.7）的艾滋病毒感染者不知道自己的感染状况。共有 9874 人（72.0%）接受了家庭艾滋病毒检测和咨询；4.1%（95%CI：3.3-4.9）检测结果呈阳性，其中 42.5%（95%CI 31.4-53.6）需要立即接受艾滋病毒感染治疗但未得到治疗。
肯尼亚的艾滋病毒检测率已接近全国 HTC 目标。然而，艾滋病毒感染者对自身艾滋病毒状况的了解仍然很低。需要扩大 HTC 服务，以覆盖更多的男性和夫妇，并需要制定战略，增加艾滋病毒感染风险人群的重复检测。
