Factors Influencing the Use of Multiple HIV Prevention Services among Men in the General Population of Kenya: An analysis of the 2022 KDHS
Asiimwe, J. B.; Nuwabaine, L. M.; Betunga, B.; Sserwanja, Q.; Kawuki, J.
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BackgroundThe use of multiple HIV prevention strategies is more effective in preventing HIV than single-method approaches. This study, therefore, aimed to examine the factors influencing the utilization of multiple HIV prevention methods among Kenyan men. MethodsSecondary data from the 2022 Kenya Demographic and Health Survey (KDHS) involving 14,453 participants selected by multistage stratified sampling were analysed. Multivariable logistic regression was conducted using SPSS (version 29) to identify associated factors. ResultsAbout 75.4% of men used at least two HIV prevention methods. Most were circumcised (94.2%), followed by HIV testing (73.5%) and condom use at last sexual intercourse (30.2%). Concerning the use of multiple HIV prevention services, the findings indicated that a relatively low proportion of the men who had tested for HIV, were circumcised and then used condoms (22.7%), followed by men who had tested for HIV, and then used condoms (23.9%), and those who were circumcised and then used condoms (28.7%). Factors associated with utilization of multiple HIV prevention services included HIV knowledge (aOR=4.64 (95%CI: 1.34-16.11), age at first sex (aOR=0.25 (95%CI: 0.08-0.79), age at first child (aOR=10.37 (95%CI: 1.26-85.60), number of lifetime partners (aOR=0.44 (95%CI: 0.24-0.80), access to newspapers (aOR=2.77 (95%CI: 1.42-5.43)), tribe (Taita/Taveta= aOR=0.02 (95%CI: 0.003-0.16), Meru (aOR=0.20 (95%CI: 0.06-0.70), and Luo= aOR=0.05 (95%CI: 0.01-0.18)) and justified refusing of sex by their partners (aOR=2.03 (95%CI:1.12-3.66), North Easten religion (aOR=0.10(95%CI:0.02-0.56), Eastern (aOR=0.23(95%CI:0.07-0.77), Central (aOR=0.16(95%CI:0.04-0.62), Rift valley (aOR=0.06(95%CI:0.02.0.18) ConclusionUtilization of multiple HIV prevention services among Kenyan men is above average, but sociodemographic and community factors influenced the use of multiple HIV prevention services among men. Innovative targeted awareness campaigns about the HIV risk and benefits of multiple HIV prevention services are needed for older men, those from certain tribes, regions, and with multiple sex partners. However, stakeholders need to involve and incorporate cultural and religious leaders to raise awareness about the benefits of prevention services and ensure their accessibility. There is a need to incorporate gender-transformative messaging in HIV outreach programs and mass media to promote HIV service use among men. The government of Kenya should implement region-specific interventions, including mobile clinics and culturally sensitive health promotion, to strengthen community health systems in underserved regions.
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