Awareness of and willingness to use oral HIV self-test kits among Kenyan young adults living in informal urban settlements: a cross-sectional survey

Figures & data

Table 1. Crude and RDS-weighted estimates of demographic characteristics, sexual risk behaviors, and awareness of and willingness to use oral HIV self-test kits in Kenyan young adults (N = 350).

Demographic characteristics	Crude		RDS-weighted
	N	%^a	%^a	(95% CI)
Gender
Male	196	56	50	(43, 57)
Female	154	44	50	(43, 57)
Age (in years)
18–19	209	60	61	(54, 67)
20–22	106	40	38	(31, 45)
Highest level of education
Primary	175	50	53	(46, 60)
Secondary or higher	174	50	47	(40, 54)
Marital status
Married/Cohabiting	19	5	6	(3, 10)
Single^b	330	94	94	(90, 97)
Monthly Income^c
< KSh 5,000	165	47	48	(42, 55)
KSh 5,000–9,999	69	20	19	(14, 24)
≥ KSh 10,000	78	22	20	(15, 26)
Tribal Ethnicity
Luo	22	6	5	(3, 9)
Luhya	43	12	13	(9, 19)
Kikuyu	163	47	45	(38, 52)
Garre	40	11	14	(9, 20)
Borana	18	5	5	(3, 9)
Mixed/Other	62	18	18	(13, 24)
Sexual behaviors
Ever had sex (n = 350)	231	66	60	(53, 67)
Recent high-risk sexual behavior^d (n = 231)	180	78	76	(68, 83)
HIV self- testing
Awareness of oral HIV self-testing (n = 350)	67	19	19	(14, 25)
Willing to use oral HIV self-test (n = 349)	263	75	74	(67, 79)
Willing to ask a sexual partner to use oral HIV self-test (n = 299)	231	77	75	(68, 81)

[a] Percentages may not add up to 100% due to rounding and/or missing or don’t know responses; [b] Includes widowed, divorced, or separated; [c] 1 US Dollar (USD) ≈103 Kenyan Shillings (KSh); [d] Includes report of one or more of the following in the last six months among respondents who reported having had sex: unprotected sex, sex while high/drunk, sex exchange, and sex with three or more partners.

Table 2. Bivariate logistic regression analyses of demographic and sexual risk behaviors associated with awareness of oral HIV self-testing (HIVST), willingness to use oral HIVST, and willingness to ask a sexual partner to use oral HIVST before sex in Kenyan young adults (N = 350)

Characteristics	Awareness of oral HIV self-test	Willingness to use oral HIV self-test	Willingness to ask a sexual partner to use oral HIV self-test before sex
	OR (95%CI)	OR (95%CI)	OR (95%CI)
Gender
Male	1.0	1.0	1.0
Female	1.29 (0.76, 2.22)	1.80 (1.11, 2.92)*	1.55 (0.91, 2.64)
Age (in years)
18–19	1.0	1.0	1.0
20–22	1.05 (0.61, 1.82)	2.57 (1.48, 4.46)**	2.66 (1.47, 4.83)**
Highest level of education
Primary	1.0	1.0	1.0
Secondary or higher	0.60 (0.34, 1.04)	2.25 (1.36, 3.70)**	1.63 (0.95, 2.82)
Marital status
Married/Cohabiting	1.0	1.0	1.0
Single^a	0.52 (0.19, 1.44)	0.04 (<0.01, 1.41)	0.40 (0.10, 1.60)
Monthly Income^b
< KSh 5,000	1.0	1.0	1.0
KSh 5,000–9,999	0.93 (0.45,1.94)	1.37 (0.68, 2.79)	0.93 (0.43, 1.99)
≥ KSh 10,000	0.76 (0.36, 1.60)	0.80 (0.43, 1.48)	0.47 (0.25, 0.89)*
Tribal Ethnicity
Luo	1.0	1.0	1.0
Luhya	2.58 (0.47, 14.14)	0.26 (0.05, 1.32)	0.20 (0.03, 1.52)
Kikuyu	2.65 (0.54, 13.08)	0.35 (0.07, 1.63)	0.21 (0.03, 1.45)
Garre	0.54 (0.08, 3.90)	0.23 (0.05, 1.15)	0.14 (0.02, 1.03)
Borana	0.77 (0.06, 7.92)	0.12 (0.02, 0.73)*	0.09 (0.01, 0.93)*
Mixed/Other	2.66 (0.51, 13.98)	0.55 (0.11, 2.82)	0.39 (0.05, 2.97)
Ever had sex
No	1.0	1.0	1.0
Yes	1.70 (0.94, 3.06)	1.48 (0.91, 2.40)	1.04 (0.58, 1.84)
Recent high-risk sexual behavior^c
No	1.0	1.0	1.0
Yes	0.82 (0.39, 1.76)	0.34 (0.13, 0.86)*	0.54 (0.23, 1.27)
Awareness of oral HIV self-test
No	N/A	1.0	1.0
Yes		0.58 (0.32, 1.02)	1.14 (0.58, 2.25)
Willingness to use oral HIV self-test
No	N/A	N/A	1.0
Yes			21.19 (10.91, 41.17)***

[a] Includes widowed, divorced, or separated; [b] 1 US Dollar (USD) ≈103 Kenyan Shillings (KSh); [c] Includes report of one or more of the following in the last six months among respondents who reported having had sex: unprotected sex, sex while high/drunk, sex exchange, and sex with three or more partners; * p < 0.05; ** p < 0.01; ***p < 0.001. Statistically significant findings are starred and bolded to facilitate identification.

Table 3. Adjusted logistic regression analyses of demographic and sexual risk behaviors associated with awareness of oral HIVST, willingness to use oral HIVST, and willingness to ask a sexual partner to use oral HIVST before sex in Kenyan young adults (N = 350).

Characteristics	Awareness of oral HIV self-test	Willingness to use oral HIV self-test	Willingness to ask a sexual partner to use oral HIV self-test before sex
	AOR^a (95%CI)	AOR^a (95%CI)	AOR^a (95%CI)
Gender
Male	1.0	1.0	1.0
Female	1.21 (0.69, 2.11)	1.99 (1.18, 3.33)**	1.55 (0.88, 2.74)
Age (in years)
18–19	1.0	1.0	1.0
20–22	1.13 (0.63, 2.03)	2.00 (1.13, 3.56)*	2.28 (1.22, 4.25)**
Highest level of education
Primary	1.0	1.0	1.0
Secondary or higher	0.59 (0.33, 1.05)	2.02 (1.18, 3.45)*	1.45 (0.80, 2.63)
Marital status
Married/Cohabiting	1.0	1.0	1.0
Single^b	0.58 (0.20, 1.71)	0.07 (<0.01, 2.43)	0.67 (0.16, 2.90)
Monthly Income^c
< KSh 5,000	1.0	1.0	1.0
KSh 5,000–9,999	1.00 (0.47, 2.13)	1.38 (0.65, 2.93)	0.88 (0.39, 1.95)
≥ KSh 10,000	0.94 (0.42, 2.11)	0.67 (0.33, 1.36)	0.38 (0.18, 0.81)*
Tribal ethnicity
Luo	1.0	1.0	1.0
Luhya	2.18 (0.39, 12.25)	0.27 (0.06, 1.50)	0.21 (0.03, 1.62)
Kikuyu	2.73 (0.54, 13.70)	0.48 (0.10, 2.34)	0.27 (0.04, 1.92)
Garre	0.52 (0.07, 3.87)	0.36 (0.07, 1.91)	0.20 (0.03, 1.59)
Borana	0.58 (0.05, 6.73)	0.21 (0.03, 1.28)	0.13 (0.01, 1.35)
Mixed/Other	2.71 (0.51, 14.38)	0.64 (0.12, 3.39)	0.40 (0.05, 3.11)
Ever had sex
No	1.0	1.0	1.0
Yes	1.86 (0.97, 3.54)	1.19 (0.69, 2.04)	0.78 (0.41, 1.47)
Recent high-risk sexual behaviors^d
No	1.0	1.0	1.0
Yes	0.93 (0.43, 2.05)	0.33 (0.12, 0.90)*	0.55 (0.22, 1.34)
Awareness of oral HIV self-test
No	N/A	1.0	1.0
Yes		0.53 (0.29, 0.97)*	1.16 (0.58, 2.34)
Willingness to use oral HIV self-test
No	N/A	N/A	1.0
Yes			21.70 (10.57, 44.55)***

[a] Adjusts for age, gender, and education; [b] Adjusts for age, gender, and education; [b] Includes widowed, divorced, or separated; [c] 1 US Dollar (USD) ≈103 Kenyan Shillings (KSh); [d] Includes report of one or more of the following in the last six months among respondents who reported having had sex: unprotected sex, sex while high/drunk, sex exchange, and sex with three or more partners; * p < 0.05; ** p < 0.01; ***p < 0.001. Statistically significant findings are starred and bolded to facilitate identification.

Table 4. Crude and RDS-weighted estimates of reported reasons among Kenyan Young adults for willingness to use or not to use an oral HIV self-test kit (N = 350).

Reasons for willingness to use an oral HIVST kit (n = 262)^a	Crude		RDS-weighted
	N	%	%	(95% CI)
Knowledge of HIV status	198	76	74	(67, 80)
Increased confidentiality	99	38	38	(30, 46)
Increased convenience	56	21	23	(17, 31)
Autonomy or ability to do it one’s self	15	6	4	(2, 8)
Less stigma	22	8	10	(6, 17)
Less risk of status disclosure	21	8	11	(7, 17)
Saves time	55	21	23	(16, 31)
Saves money	12	5	6	(3, 12)
Easier to repeat	26	10	9	(6, 14)
Accessed through more outlets	1	0	0	(0, 3)
Other reasons	6	2	2	(1, 5)
Reasons for non-willingness to use an ornal HIVST kit (n = 79)^a	N	%	%	%
Too costly or expensive	1	1	5	(1, 27)
Possible inaccurate results	42	53	59	(45, 72)
Lack of counselling	13	17	24	(13, 41)
Difficulty with referral to care and treatment	1	1	2	(0, 14)
Facility-based HIV testing is free	3	4	4	(1, 13)
Unsafe disposal	3	4	3	(1, 12)
Possible self-harm	18	23	27	(16, 42)
Used with coercion	1	1	1	(0, 7)
Ill-omened use of money	0	0	0	(0, 0)
Encourages unprotected sex	2	3	3	(1, 14)
Other reasons	29	37	25	(16, 38)

[a] Excludes participants who reported no reason (n = 9).

Table 5. Crude and RDS-weighted estimates of reported most preferred point-of-access to acquire oral HIV self-test kits among Kenyan young adults who were willing to use HIVST (N = 263).

Most preferred point-of-access (N-263)	Crude		RDS-weighted
	N^a	%	%	(95% CI)
General hospital	152	59	59	(51, 66)
Specialized HIV clinic	48	19	19	(13, 26)
Pharmacy or laboratory	31	12	13	(9, 19)
Community center	10	4	4	(2, 8)
School or university	4	2	1	(0, 4)
Other place	13	5	4	(2, 7)

[a] Excludes participants (n = 5) with erred multiple responses.