PUBLICATION: BMC Public Health
Kabiru, C.W., Luke, N., Izugbara, C., Zulu, E.
Background: HIV counseling and testing is considered an important component of HIV prevention and treatment.
This paper examines the characteristics of young males and females at the time of first reported HIV test, including the
influence of recent sexual partnerships, and investigates how HIV testing and the cumulative number of tests are
associated with sexual behaviors within six months of testing.
Methods: The study uses data from a random sample of youth aged 18-24 years living in Kisumu, Kenya, who were
interviewed using a 10-year retrospective life history calendar. Cox regression models were used to examine the
correlates of the timing of first HIV test. Variance-correction models for unordered repeated events were employed to
examine whether having an HIV test in the previous six months and the cumulative number of tests predict unsafe
sexual practices in a given month.
Results: Sixty-four percent of females and 55% of males reported at least one HIV test in the last 10 years and 40% of
females were pregnant the month of first test. Significant correlates of first HIV test included marital aspirations among
non-pregnant females, unprotected sex in the previous six months among pregnant females, and concurrency in the
previous six months among males. Having a recent HIV test was associated with a decreased likelihood of unprotected
sex among ever-pregnant females, an increased likelihood of unprotected sex and “risky” sexual partnerships among
never-pregnant females, and an increased likelihood of concurrency among males. Repeated HIV testing was
associated with a lower likelihood of concurrency among males and involvement in “risky” sexual partnerships among
males and never-pregnant females.
Conclusions: The high rate of pregnancy at first test suggests that promotion of HIV testing as part of prevention of
mother-to-child transmission is gaining success. Further research is warranted to examine how and why behavior
change is influenced by client- versus provider-initiated testing. The influence of different sexual partnership variables
for males and females suggests that interventions to assess risk and promote testing should be gender- and
relationship-specific. The findings also suggest that encouraging repeat or routine testing could potentially increase
the uptake of safer sexual behaviors.
Caroline is a research scientist in APHRC’s Population Dynamics and Reproductive Health program. She holds a PhD in Health Promotion and Behavior (2005) from the University of Georgia, Athens (USA), a Masters degree in Public...
Chimaraoke joined APHRC in 2006 as a Sabbatical Fellow and was appointed to the position of Associate Research Scientist in August 2007. Prior to this, he worked with universities in Nigeria as a lecturer and researcher,...