title: HIV testing uptake and prevalence among adolescents and adults in a large home-based HIV testing program in Western Kenya.
abstract: OBJECTIVE
  To describe HIV testing uptake and prevalence among adolescents and adults in a home-based HIV counseling and testing program in western Kenya.
  
  
  METHODS
  Since 2007, the Academic Model Providing Access to Healthcare program has implemented home-based HIV counseling and testing on a large scale. All individuals aged ≥13 years were eligible for testing. Data from 5 of 8 catchments were included in this analysis. We used descriptive statistics and multivariate logistic regression to examine testing uptake and HIV prevalence among adolescents (13-18 years), younger adults (19-24 years), and older adults (≥25 years).
  
  
  RESULTS
  There were 154,463 individuals eligible for analyses as follows: 22% adolescents, 19% younger adults, and 59% older adults. Overall mean age was 32.8 years and 56% were female. HIV testing was high (96%) across the following 3 groups: 99% in adolescents, 98% in younger adults, and 94% in older adults (P < 0.001). HIV prevalence was higher (11.0%) among older adults compared with younger adults (4.8%) and adolescents (0.8%) (P < 0.001). Those who had ever previously tested for HIV were less likely to accept HIV testing (adjusted odds ratio: 0.06, 95% confidence interval: 0.05 to 0.07) but more likely to newly test HIV positive (adjusted odds ratio: 1.30, 95% confidence interval: 1.21 to 1.40). Age group differences were evident in the sociodemographic and socioeconomic factors associated with testing uptake and HIV prevalence, particularly, gender, relationship status, and HIV testing history.
  
  
  CONCLUSIONS
  Sociodemographic and socioeconomic factors were independently associated with HIV testing and prevalence among the age groups. Community-based treatment and prevention strategies will need to consider these factors.
authors.affiliation: *USAID-Academic Model Providing Access to Healthcare (AMPATHPlus) Partnership, Eldoret, Kenya; †Department of Epidemiology, School of Public Health, College of Health Sciences, Moi University, Eldoret, Kenya; ‡Children's Health Services Research, Indiana University School of Medicine, Indianapolis, IN; §Department of Medicine, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya; ‖Department of Medicine, School of Medicine, Indiana University, Indianapolis, IN; ¶Regenstrief Institute, Inc, Indianapolis, IN; and #Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
authors.forename: Juddy
authors.initials: J
authors.lastname: Wachira
authors.forename: Samson
authors.initials: S
authors.lastname: Ndege
authors.forename: Julius
authors.initials: J
authors.lastname: Koech
authors.forename: Rachel C
authors.initials: RC
authors.lastname: Vreeman
authors.forename: Paul
authors.initials: P
authors.lastname: Ayuo
authors.forename: Paula
authors.initials: P
authors.lastname: Braitstein
mesh_terms: D000293:Adolescent; D000328:Adult; D003710:Demography; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D055815:Young Adult