title: Factors associated with HIV testing among men who have sex with men in Western Kenya: a cross-sectional study.
abstract: HIV diagnosis is an important step in the HIV cascade of prevention and treatment. However, men who have sex with men in low- and middle-income countries have limited access to HIV care services. We examined factors associated with prior HIV testing among men who have sex with men in western Kenya. We recruited 95 men who have sex with men aged 18 years and older, and who reported at least one sexual contact with a man in the past 6 months; however, this analysis is restricted to 89 participants who completed questions on HIV testing. Logistic regression model was used to determine factors associated with HIV testing in the past one year. Results indicate that 23 (26%) had not been tested in the past 12 months. Bivariate analyses demonstrated that condomless anal sex (odds ratio = 3.29, 95% confidence interval = 1.18-9.17) and comfort with healthcare providers (odds ratio = 1.15, 95 % CI = 1.05-1.26) were associated with higher odds of HIV testing in the past 12 months. Experiencing social stigma was associated with lower odds of HIV testing in the last 12 months (odds ratio = 0.91, 95% confidence interval = 0.84-0.94). In multivariable models, social stigma remained significantly associated with lower odds of HIV testing in the last 12 months odds ratio = 0.90, 95% confidence interval = 0.82-0.99) after inclusion of sexual risk and individual level variables. Development of men who have sex with men-sensitive HIV-testing services, addressing stigma, and training healthcare workers to provide culturally sensitive services may assist in effectively engaging men who have sex with men in the HIV treatment cascade.
authors.affiliation: 1 Department of Behavioral and Social Sciences, School of Public Health, Brown University, Rhode Island, United States.|2 School of Public Health, Moi University, Eldoret, Kenya.|3 Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Shangani
authors.affiliation: 3 Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.|4 Department of Behavioral Science, College of Health Sciences, School of Medicine, Moi University, Eldoret, Kenya.
authors.forename: Violet
authors.initials: V
authors.lastname: Naanyu
authors.affiliation: 3 Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.|4 Department of Behavioral Science, College of Health Sciences, School of Medicine, Moi University, Eldoret, Kenya.
authors.forename: Ann
authors.initials: A
authors.lastname: Mwangi
authors.affiliation: 5 International Centre for Reproductive Health, University of Ghent, Belgium.
authors.forename: Heleen
authors.initials: H
authors.lastname: Vermandere
authors.affiliation: 1 Department of Behavioral and Social Sciences, School of Public Health, Brown University, Rhode Island, United States.
authors.forename: Ethan
authors.initials: E
authors.lastname: Mereish
authors.affiliation: 6 School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya.
authors.forename: Andrew
authors.initials: A
authors.lastname: Obala
authors.affiliation: 5 International Centre for Reproductive Health, University of Ghent, Belgium.
authors.forename: Davy
authors.initials: D
authors.lastname: Vanden Broeck
authors.affiliation: 3 Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.|6 School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya.|7 Department of Medicine, School of Medicine, Indiana University, Indianapolis, United States.
authors.forename: John
authors.initials: J
authors.lastname: Sidle
authors.affiliation: 1 Department of Behavioral and Social Sciences, School of Public Health, Brown University, Rhode Island, United States.
authors.forename: Don
authors.initials: D
authors.lastname: Operario
mesh_terms: D000328:Adult; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D007630:Kenya; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D016017:Odds Ratio; D012725:Sexual Behavior / Q000706:statistics & numerical data; D057545:Social Stigma
keywords: HIV testing; Kenya; men who have sex with men; stigma