Health care utilization and access to human immunodeficiency virus (HIV) testing and care and treatment services in a rural area with high HIV prevalence, Nyanza Province, Kenya, 2007

We present health and demographic surveillance system data to assess associations with health care utilization and human immunodeficiency virus (HIV) service receipt in a high HIV prevalence area of western Kenya. Eighty-six percent of 15,302 residents indicated a facility/clinician for routine medi...

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Bibliographic Details
Published in:The American journal of tropical medicine and hygiene 2014-02, Vol.90 (2), p.224-233
Main Authors: Ackers, Marta-Louise, Hightower, Allen, Obor, David, Ofware, Peter, Ngere, Lilian, Kubaje, Adazu, Laserson, Kayla F
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Cross-Sectional Studies
Female
Health Services Accessibility
HIV Infections - diagnosis
HIV Infections - drug therapy
HIV Infections - epidemiology
Human immunodeficiency virus
Humans
Kenya - epidemiology
Male
Mass Screening
Middle Aged
Population Surveillance
Prevalence
Rural Population
Socioeconomic Factors
Young Adult
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Summary:We present health and demographic surveillance system data to assess associations with health care utilization and human immunodeficiency virus (HIV) service receipt in a high HIV prevalence area of western Kenya. Eighty-six percent of 15,302 residents indicated a facility/clinician for routine medical services; 60% reported active (within the past year) attendance. Only 34% reported a previous HIV test, and self-reported HIV prevalence was 6%. Active attendees lived only slightly closer to their reported service site (2.8 versus 3.1 km; P < 0.001) compared with inactive attendees. Multivariate analysis showed that younger respondents (< 30 years of age) and active and inactive attendees were more likely to report an HIV test compared with non-attendees; men were less likely to report HIV testing. Despite traveling farther for HIV services (median distance = 4.4 km), 77% of those disclosing HIV infection reported HIV care enrollment. Men and younger respondents were less likely to enroll in HIV care. Socioeconomic status was not associated with HIV service use. Distance did not appear to be the major barrier to service receipt. The health and demographic surveillance system data identified patterns of service use that are useful for future program planning.
ISSN:0002-9637
1476-1645
DOI:10.4269/ajtmh.13-0181