Gender Differences in Psychosocial Predictors of Sexual Activity and HIV Testing Among Youth in Kenya

Abstract

Sub-Saharan Africa (SSA) carries a disproportionate burden of HIV in the world relativeto its population. Youth are at particular risk. Understanding HIV risk factors, as wellas factors affecting HIV testing among SSA youth, is important given that HIV testing,linkage to care, and viral suppression are part of the global strategy to end HIV. Becauseyoung women face disparate sexual and reproductive health outcomes, exploring genderdifferences related to HIV risk, and testing is vital. Using existing program evaluationdata from a larger project, the purpose of this study was to explore gender differencesrelated to sexual activity and HIV testing among youth in SSA. Participant data from581 youth ages 13–24 in Kenya was analyzed using descriptive statistics, analysis ofcovariance, and binomial logistic regression. Findings revealed that young men weremore likely to report sexual activity than young women. Age was a predictor of sexualactivity for all youth. However, among psychosocial variables, depression predictedsexual activity for young women while stress predicted sexual activity for young men.Although there were no gender differences in HIV testing after controlling for demographicand psychosocial variables, there were some differences between young women andyoung men with regard to predictors of HIV testing. Age and full-time self-employmentpredicted HIV testing among young women, while part-time self-employment, education,and substance abuse risk predicted HIV testing among young men. Findings suggest aneed for gender and youth friendly strategies for addressing the HIV treatment cascadeand care continuum.