| Joshua N. Maina |
| Department of Medicine, Moi University |
| December, 2009 |
Abstract |
| Background: Ensuring timely access to care for persons with HIV/AIDS has important individual and public health benefits. Mechanisms to provide free diagnosis and treatment of patients with HIV/AIDS have been put in place in Kenya. However, many patients test and present late for medical care. This indicates that there are other factors that limit patients' access to HIV testing and medical care. Identification of factors associated with delayed testing and presentation for care is important to target interventions aimed at encouraging early testing and entrance into HIV care. This study reports on the prevalence of delayed presentation for HIV care, prevalance of delayed HIV testing and identifying factors associated with delayed testing and presentation. Design: A cross-sectional study. Qualitative and quantitative components. Setting: Tenwek Mission Hospital, Bomet. Study population: HIV positive patients presenting for initial care at Tenwek comprehensive care clinic and VCT counselors. Methods: Interviewer administered questionnaires were used for patients' data collection and qualitative data collected from VCT counselors. Data on patients' socio-demographic characteristics, perception of HIV risks, time, place, and circumstances of testing and presentation for care were sought. The chi-square test was used to test associations between independent variables and the outcomes. Multivariate logistic regression was used to identify factors that significantly predict the outcomes. Qualitative data from VCT counselors were summarized and presented. Results: A total of 186 subjects were interviewed. 110 (59.1%) were females. The mean age was 35.5(0.715) years. Seventy-four (40.4%) were at WHO stage 3 and 112(60.2.%) were married. Of those interviewed (64%) were late testers and (13%) were later presenters. Multivariate analysis showed that being in a marriage union was a significant predictor of late testing (p smaller than 60;0.017). Despite the free HIV/AIDS program in Kenya, there is a high prevalence of late HIV testing. This was associated by low risk perception, being in a marriage union and failure by health workers to suggest HIV testing. Poor referral systems and lack of counseling during HIV testing are important risks for delayed presentation for care. |
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