Lack of Knowledge of HIV Status a Major Barrier to HIV Prevention, Care and Treatment Efforts in Kenya: Results from a Nationally Representative Study

Background: We analyzed HIV testing rates, prevalence of undiagnosed HIV, and predictors of testing in the Kenya AIDS Indicator Survey (KAIS) 2007. Methods: KAIS was a nationally representative sero-survey that included demographic and behavioral indicators and testing for HIV, HSV-2, syphilis, and CD4 cell counts in the population aged 15–64 years. We used gender-specific multivariable regression models to identify factors independently associated with HIV testing in sexually active persons. Results: Of 19,840 eligible persons, 80 % consented to interviews and blood specimen collection. National HIV prevalence was 7.1 % (95 % CI 6.5–7.7). Among ever sexually active persons, 27.4 % (95 % CI 25.6–29.2) of men and 44.2 % (95 % CI 42.5– 46.0) of women reported previous HIV testing. Among HIV-infected persons, 83.6 % (95 % CI 76.2–91.0) were unaware of their HIV infection. Among sexually active women aged 15–49 years, 48.7 % (95 % CI 46.8–50.6) had their last HIV test during antenatal care (ANC). In multivariable analyses, the adjusted odds ratio (AOR) for ever HIV testing in women $35 versus 15– 19 years was 0.2 (95 % CI: 0.1–0.3; p,0.0001). Other independent associations with ever HIV testing included urba