# Risky sexual behaviours and utilization of HIV testing services among the adolescent girls and young women aged between 15-24 years in Kibra Sub County, Nairobi County, Kenya

## TL;DR

This study examines how risky sexual behaviors and sociodemographic factors influence HIV testing among young women in Nairobi, Kenya.

## Contribution

The study provides localized insights into HIV testing disparities and behavioral factors among adolescent girls and young women in Kibra Sub County.

## Key findings

- 60.7% of AGYW aged 15–24 had undergone HIV testing.
- Risky behaviors like lack of condom use and gender-based violence were strongly associated with higher odds of HIV testing.
- Sociodemographic factors such as education and marital status significantly influenced testing rates.

## Abstract

HIV remains a significant global health challenge, disproportionately affecting adolescent girls and young women (AGYW). HIV testing is crucial in controlling transmission and reducing its prevalence. Understanding risky sexual behaviours among AGYW is pivotal in aligning prevention interventions. Despite global prevention efforts, testing gaps persist among AGYW, linked to risky sexual behaviour (RSB). This study explores the association between these behaviours and HIV testing utilization among AGYW (aged 15–24) in Kibra Sub County, Nairobi.

A cross-sectional study sampled 379 AGYW from three wards in Kibra Sub County in Nairobi County. To be an eligible participant, one must have been a resident for at least one year before the time of the study and aged between 15–24 years, employing standardized structured interviewer-administered questionnaires and statistical analyses. Results were analysed using Chi-square tests and logistic regression. Data was collected between June to July 2023.

Overall, HIV testing prevalence was 60.7% (n=230). Those aged 20–24 were 71.3% (n=164), with secondary education were 63.5% (n=146) and married 28.7% (66) were more likely to undergo testing. Participants engaging in risky behaviours such as lack of condom use (3.96 times more likely), experiencing gender-based violence (4.65 times more likely), or contracting STIs (2.85 times more likely) had higher odds of seeking HIV testing services.

This study establishes a clear link between risky sexual behaviours and HIV testing among AGYW, with a 60.7% testing prevalence; however, gaps still exist. Efforts to enhance testing rates are vital. Interventions should align with acceptable methods, focusing on this affected community to ensure effective HIV care and prevention.

Localized insights into testing disparities: This study provides localized insights into HIV testing disparities within specific communities, shedding light on differences in testing rates among various wards. Understanding these community-specific variations is essential for tailoring targeted interventions and healthcare resources effectively.

Comprehensive analysis of sociodemographic factors: Unlike some previous studies, this research comprehensively examines a range of sociodemographic factors, including education, employment status, income, and marital status, to identify nuanced influences on HIV testing among Adolescent Girls and Young Women (AGYW). By analysing these multifaceted factors, this study enriches the understanding of the complex interplay between sociodemographic variables and HIV testing behaviour in this vulnerable population.

Behavioural contextualization of HIV testing: This study goes beyond numerical analysis by delving into the behavioural context surrounding HIV testing among AGYW. By exploring risky sexual behaviours in detail, such as transactional sex, alcohol-induced encounters, and STI diagnoses, this research offers a nuanced understanding of the psychosocial factors influencing HIV testing decisions. These insights are pivotal for developing targeted behavioural interventions that address the specific challenges faced by AGYW, thus contributing significantly to the design of more effective public health strategies.