Gender differentials in factors associated with HIV testing intentions in Kenya: An application of the health belief model

Abstract

Demand for HIV testing and counseling has been growing with intensified efforts to scale up 
antiretroviral treatment globally. In Kenya, HIV testing and counseling programs have been expanding 
at an unprecedented pace. Knowledge of levels and associates of testing intentions is of essence. To 
obtain such knowledge, a recent nationally representative sample of reproductive-aged women and 
men was analyzed applying the health belief model. Among 5,441 women and 2,407 men studied, 68 and 
70% expressed interests to be tested. After adjusting for socio-demographic variables, perceived 
severity (women: adjusted odds ratio (AOR)=1.16, [95% confidence interval (CI)=0.99-1.36]; men: 
AOR=1.29 [1.01-1.66]), perceived benefits (women: AOR=1.10 [1.05-1.15]; men: AOR=1.14 [1.05-1.24]) 
and perceived barriers (women: AOR=0.94 [0.88-1.01]; men: AOR=0.85 [0.79-0.93]) were associated with 
intentions to test among both sexes. Among women, perceived susceptibility, as measured by having 
sexually transmitted infections (AOR=1.58 [1.12-2.24]) and self-reported risk of HIV infection (moderate 
risk (vs. no risk): AOR=1.36 [1.10-1.69]; great risk or has AIDS: AOR=1.65 [1.25-2.17]), also correlated 
with desire for testing; whereas among men cues to action was significantly yet negatively associated 
with testing intentions (AOR=0.69 [0.56-0.87]). When scaling up HIV testing and counseling, a gendered 
approach is recommended in Kenya.