Background

HIV remains a significant global health challenge, disproportionately

affecting adolescent girls and young women (AGYW). HIV testing is

crucial in controlling transmission and reducing its prevalence.

Understanding risky sexual behaviours among AGYW is pivotal in

aligning prevention interventions. Despite global prevention efforts,

testing gaps persist among AGYW, linked to risky sexual behaviour

(RSB). This study explores the association between these behaviours

and HIV testing utilization among AGYW (aged 15–24) in Kibra Sub

County, Nairobi.

Methods

A cross-sectional study sampled 379 AGYW from three wards in Kibra

Sub County in Nairobi County. To be an eligible participant, one must

have been a resident for at least one year before the time of the study

and aged between 15–24 years, employing standardized structured

interviewer-administered questionnaires and statistical analyses.

Results were analysed using Chi-square tests and a manual stepwise

procedure was used to enter variables with p-values <0.1 in the

bivariate model analysis into the multivariate logistic regression model at 95% Confidence Interval. Data was collected between June to

July 2023.

Results

Majority (80.7%) of the respondents were single, married (18.2%) or

separated (1.1%). Almost two-thirds (64.6%) were educated to

secondary school level, while tertiary and primary levels accounted for

23.5% and 11.6% respectively. Overall, HIV testing prevalence was

60.7% (n=230). Those aged 20–24 were 71.3% (n=164), with secondary

education were 63.5% (n=146) and married 28.7% (66) were more

likely to undergo testing. Respondents who failed to use condoms in

their last sexual encounter demonstrated a higher probability of

testing for HIV (OR 3.96,955 CI:2.12,7.58, p<0.001). those who

experienced gender-based violence were had a higher likelihood of

testing (OR: 4.65, 95% CI: 1.93,13.87, p-0.002)

Participants engaging in risky behaviours such as lack of condom had

higher odds of testing for HIV (AOR: 4.27, 95% CI: 2.25, 8.30, p-<0.001)

relative to those who used protection.

Conclusions

This study establishes a clear link between risky sexual behaviours

and HIV testing among AGYW Utilization of HIV testing among this

population is still low. Efforts to enhance testing rates are vital.

Interventions should align with acceptable methods, focusing on this

high-risk group to ensure effective HIV care and prevention. The

Ministry of Health should consider integration of HIV services in

various service delivery points, upscale the uptake of HIV-self testing

for both oral and blood blood based and support social protective

measures for AGYW to ensure effective HIV care and prevention.