Reaching the Urban Poor with Health Interventions: The Case of Hiv Testing In Nairobi Urban Informal Settlements, Kenya

Abstract

HIV testing and counseling (HCT) is an entry point to HIV prevention, treatment, and care. In Kenya, national-level data show an astronomical growth in testing. However, national estimates blur sub-group testing differentials and fail to reflect the situation of the most vulnerable groups. We draw on data from 6,035 women and men of reproductive age interviewed in the 2012 Nairobi Cross-sectional Slum Survey and 11,909 women and men interviewed in the 2008/09 Kenya Demographic and Health Survey to compare the levels of HIV testing among residents of Nairobi slums and the rest of Nairobi and Kenya. We found that a greater proportion of Nairobi slum dwellers had been tested for HIV compared with residents in other parts of Nairobi and Kenya as a whole. This counter-intuitive finding may be explained by the specific advantage of slum dwellers over the rest of the country in accessing HIV testing services through mobile clinics and research studies. Relatively disadvantaged sub-groups such as women aged 15-19 years and the never married were most likely to be tested in mobile clinics or research studies. Our findings underscore the importance of targeted interventions to reduce inequities in access to HTC services.