Gender differentials in factors associated with HIV testing intentions in Kenya: An application of the health belief model

Abstract

Demand for HIV testing and counseling has been growing with intensified efforts to scale up antiretroviral treatment globally. In Kenya, HIV testing and counselling programs have been expanding at an unprecedented pace. Knowledge of levels and associates of testing intentions is of essence. To obtain such knowledge, a recent nationally representative sample of reproductive-aged women and men was analyzed applying the health belief model. Among 5,441 women and 2,407 men studied, 68 and 70% expressed interests to be tested. After adjusting for socio-demographic variables, perceived severity (women: adjusted odds ratio (AOR)=1.16, [95% confidence interval (CI)=0.99-1.36]; men: AOR=1.29 [1.01-1.66]), perceived benefits (women: AOR=1.10 [1.05-1.15]; men: AOR=1.14 [1.05-1.24]) and perceived barriers (women: AOR=0.94 [0.88-1.01]; men: AOR=0.85 [0.79-0.93]) were associated with intentions to test among both sexes. Among women, perceived susceptibility, as measured by having sexually transmitted infections (AOR=1.58 [1.12-2.24]) and self-reported risk of HIV infection (moderate risk (vs. no risk): AOR=1.36 [1.10-1.69]; great risk or has AIDS: AOR=1.65 [1.25-2.17]), also correlated with desire for testing; whereas among men cues to action was significantly yet negatively associated with testing intentions (AOR=0.69 [0.56-0.87]). When scaling up HIV testing and counseling, a gendered approach is recommended in Kenya. Key words: HIV testing intentions, Kenya, the health belief model, gendered approach.