The status of HIV testing and counseling in Kenya: results from a nationally representative population-based survey.

BACKGROUND: HIV testing and counseling (HTC) is essential for successful HIV prevention and treatment programs. The national target for HTC is 80% of the adult population in Kenya. Population-based data to measure progress towards this HTC target are needed to assess the countrys changing needs for HIV prevention and treatment. METHODS: In 2012-2013 we conducted a national HIV survey among Kenyans aged 18 months to 64 years. Respondents aged 15-64 years were administered a questionnaire that collected information on demographics HIV testing behavior and self-reported HIV status. Blood samples were collected for HIV testing in a central laboratory. Participants were offered home-based testing and counseling to learn their HIV status in the home and point-of-care CD4 testing if they tested HIV-positive. RESULTS: Of 13720 adults who were interviewed 71.6% [95% confidence interval (CI): 70.2 to 73.1] had been tested for HIV. Among those 56.1% (95% CI: 52.8 to 59.4) had been tested in the past year 69.4% (95% CI: 68.0 to 70.8) had been tested more than once and 37.2% (95% CI: 35.7 to 38.8) had been tested with a partner. Fifty-three percent (95% CI: 47.6 to 58.7) of HIV-infected persons were unaware of their infection. Overall 9874 (72.0%) of participants accepted home-based HIV testing and counseling; 4.1% (95% CI: 3.3 to 4.9) tested HIV-positive and of those 42.5% (95% CI 31.4 to 53.6) were in need of immediate treatment for their HIV infection but not receiving it. CONCLUSIONS: HIV testing rates have nearly reached the national target for HTC in Kenya. However knowledge of HIV status among HIV-infected persons remains low. HTC needs to be expanded to reach more men and couples and strategies are needed to increase repeat testing for persons at risk for HIV infection.