title: Health care utilization and access to human immunodeficiency virus (HIV) testing and care and treatment services in a rural area with high HIV prevalence, Nyanza Province, Kenya, 2007.
abstract: We present health and demographic surveillance system data to assess associations with health care utilization and human immunodeficiency virus (HIV) service receipt in a high HIV prevalence area of western Kenya. Eighty-six percent of 15,302 residents indicated a facility/clinician for routine medical services; 60% reported active (within the past year) attendance. Only 34% reported a previous HIV test, and self-reported HIV prevalence was 6%. Active attendees lived only slightly closer to their reported service site (2.8 versus 3.1 km; P < 0.001) compared with inactive attendees. Multivariate analysis showed that younger respondents (< 30 years of age) and active and inactive attendees were more likely to report an HIV test compared with non-attendees; men were less likely to report HIV testing. Despite traveling farther for HIV services (median distance = 4.4 km), 77% of those disclosing HIV infection reported HIV care enrollment. Men and younger respondents were less likely to enroll in HIV care. Socioeconomic status was not associated with HIV service use. Distance did not appear to be the major barrier to service receipt. The health and demographic surveillance system data identified patterns of service use that are useful for future program planning.
authors: Global HIV/AIDS Program and Division of Parasitic Diseases, Centers for Disease Control and Prevention, Nairobi, Kenya; Kenya Medical Research Institute/Centers for Disease Control and Prevention Research and Public Health Collaboration, Kisumu, Kenya, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors: Marta-Louise
authors: ML
authors: Ackers
authors: Allen
authors: A
authors: Hightower
authors: David
authors: D
authors: Obor
authors: Peter
authors: P
authors: Ofware
authors: Lilian
authors: L
authors: Ngere
authors: Adazu
authors: A
authors: Kubaje
authors: Kayla F
authors: KF
authors: Laserson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D006297:Health Services Accessibility; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D012424:Rural Population; D012959:Socioeconomic Factors; D055815:Young Adult