PUBLICATION: BMC Public Health
Ziraba, A.K., Madise, N.J., Kimani, J.K., Oti, S.O., Mgomella, G.S., Matilu, M. & Ezeh, A.C.
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
Ziraba is an Epidemiologist and a Medical Doctor. His research interests include reproductive, maternal, newborn and child health, HIV/AIDS, health systems research, health and demographic surveillance, estimation of mortality in environments with poor or no...
Alex joined APHRC in 1998 (then a program of the Population Council in Nairobi) as a Senior Research Fellow. In 2000, he was appointed APHRC’s Interim Director and charged with the responsibility of leading its...