Determinants of Hiv Self-testing Utilization Among Health Sciences Undergraduate Students; a Binary Logistic Regression Approach

Abstract

Background. In 2016, the WHO issued guidance on HIV self-testing as a measure to improve the access and uptake of HIV diagnosis towards curbing the increasingly growing HIV incidences and progression to AIDS. The Kenya HIV Impact Assessment released in January 2020 estimated HIV prevalence of 4.9 percent and 36,000 annual infections (KENPHIA, 2018). The prevalence of HIV by sex and age showed higher rates among women and those aged 20 to 34 years. Numerous studies have applied logistic regression approach to enhance the knowledge and statistics on HIV/AIDS among college-going students (Shahzad et al., 2021). The present study sought to advance knowledge of HIV among faculty of health sciences undergraduate students by assessing determinants affecting the utility of HIV self-testing kits. Contrary to previous studies, this study applied a multilevel model approach to generate both fixed (overall average) estimates and investigate the random (course and year-of-study specific estimates) effects. Broad Objective. To assess the determinants of HIV self-testing utilization among undergraduate students in the Faculty of Health Science, University of Nairobi. Methodology. Study design – The study was a cross-sectional analytical study. It was conducted at the UoN Chiromo and KNH campuses, which are 2 and 3 kilometers north & southwest of Nairobi, the capital city of Kenya. The study participants included undergraduate medical students from the University of Nairobi, Faculty of Health Sciences undertaking bachelor’s degree in MBChB, Pharmacy, Nursing, Dentistry and Medical Laboratory Sciences. Data collection was done using self-administered questionnaires. The variables to be assessed included HIVST uptake (dependent variable), socio-demographic factors (age, sex, marital status, religion, residence) individual factors (knowledge about HIV, sexual behavior factors, stigma, media exposure, affordability of self-test kits) and institutional factors (accessibility to healthcare facilities, availability of HIVST). Data analysis was performed using R software version 4.2.3 (2022-10-31 UCRT) Significance of the study. The research provided useful information about predictors of HIV self-testing utilization, including its barriers and facilitators. It also demonstrated the levels of self-awareness of HIV serological status amongst the youthful population. Results The study revealed an overall HIVST utilization rate of 30.5% among participants. Marital status was found to be a significant determinant, with married students being 9.22 times more likely to use HIVST compared to their single counterparts (p-value = 0.049). Conversely, practicing safe sex, longer time since the last HIV test, and concerns about potential reactions were associated with lower odds of HIVST utilization. Conclusion The study revealed an overall HIVST utilization rate of 30.5% among participants. Marital status was found to be a significant determinant, with married students being 9.22 times more likely to use HIVST compared to their single counterparts (p-value = 0.049). Conversely, practicing safe sex, longer time since the last HIV test, and concerns about potential reactions were associated with lower odds of HIVST utilization.