title: The status of HIV testing and counseling in Kenya: results from a nationally representative population-based survey.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: *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.
authors.forename: Anne
authors.initials: A
authors.lastname: Ng'ang'a
authors.forename: Wanjiru
authors.initials: W
authors.lastname: Waruiru
authors.forename: Carol
authors.initials: C
authors.lastname: Ngare
authors.forename: Victor
authors.initials: V
authors.lastname: Ssempijja
authors.forename: Thomas
authors.initials: T
authors.lastname: Gachuki
authors.forename: Inviolata
authors.initials: I
authors.lastname: Njoroge
authors.forename: Patricia
authors.initials: P
authors.lastname: Oluoch
authors.forename: Davies O
authors.initials: DO
authors.lastname: Kimanga
authors.forename: William K
authors.initials: WK
authors.lastname: Maina
authors.forename: Rex
authors.initials: R
authors.lastname: Mpazanje
authors.forename: Andrea A
authors.initials: AA
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D018791:CD4 Lymphocyte Count / Q000706:statistics & numerical data*; D003376:Counseling / Q000706:statistics & numerical data*; D005260:Female; D006679:HIV Seropositivity / Q000175:diagnosis* / Q000628:therapy; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006699:Home Care Services; D006801:Humans; D007407:Interviews as Topic; D007630:Kenya; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D012424:Rural Population / Q000706:statistics & numerical data; D012737:Sex Factors; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult
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