HEALTH SERVICE PROVISION FACTORS INFLUENCING UTILIZATION OF HIV TESTING SERVICES AMONG PASTORALISTS (A CROSS-SECTIONAL DESCRIPTIVE STUDY UNDERTAKEN IN KAJIADO EAST SUB-COUNTY, KAJIADO COUNTY -KENYA)

Abstract

Background: HIV Testing Services (HTS) are essential for HIV prevention, detection, treatment, and care. Despite progress in Kenya, factors influencing HTS utilization among pastoralists remain underexplored.
Objective: This study assessed health service provision factors influencing HTS utilization among pastoralists in Kajiado East Sub-County, Kajiado County in Kenya.
Methodology: A cross-sectional mixed-methods study was conducted. Quantitative data were collected via questionnaire and analyzed using SPSS version 25. Odds ratios and binary logistic regression were used to determine associations (p≤0.05). Qualitative data from 8 key informant interviews and 4 focus group discussions were analyzed thematically using NVivo.
Results: A total of 395 respondents were enrolled but those who consented to the study was 384 respondents among pastoralists (response rate 97%). HTS utilization was low at 39.4% (149 out of 378); factors attributed to this included HTS counselor sex (p=0.005), counsellor age (p=0.044), availability of HTS centre, as well as presence of community health promoters (CHP). A good percentage 33.5% (n=129) of respondents preferred community health promoters as HTS counsellor. Respondents recommended more staff diversity, mobile HTS units as well as integration of HTS services in primary health care. Upon adjusting; Recommendation of HTS services to others: Respondents who would not recommend HTS had 96.3% lower odds of utilization (AOR = 0.037, 95% CI: 0.0073–0.1894, p < 0.001). Availability of HTS services: Lack of availability remained significantly associated with reduced odds of utilization (AOR = 0.21, 95% CI: 0.05–0.78, p = 0.02). Community health promoter: Having a community health promoter was strongly associated with nearly eight times higher odds of utilization (AOR = 7.93, 95% CI: 1.30–48.55, p = 0.025) were independently associated with HTS utilization among pastoralists.
Conclusion: The independent predictors of HTS utilization were willingness to recommend HTS, availability of HTS services, and presence of community health promoters among pastoralist communities. There is need to develop frameworks aimed towards the unique context of pastoralist communities including provision of mobile HTS services in order to improve service uptake.