Determinants of HIV self-testing utilization among health sciences undergraduate students in Kenya

Abstract

Background

HIV self-testing (HIVST) was endorsed by WHO in 2016 to expand access to HIV diagnosis, especially for young people. Kenyan youths, including university students, remain vulnerable to HIV, yet uptake of free HIVST kits is inconsistent. This study assessed determinants of HIVST utilization among health sciences undergraduates at the University of Nairobi.

Methods

We conducted a cross-sectional analytical study at the Chiromo and Faculty of Health Sciences campuses. Multi-stage cluster sampling yielded 412 students from Medicine, Pharmacy, Nursing, Dentistry and Medical Laboratory Science. Data on socio-demographics, sexual behaviour, stigma, and institutional access were collected via self-administered questionnaires and analysed in R. Associations were examined using χ²/Fisher’s exact tests and Wilcoxon tests; variables with p < .05 entered a multivariable mixed-effects logistic regression model to account for clustering by course and year of study.

Results

Overall, 30.5% reported prior HIVST use. Uptake was higher among older students and those in advanced years. Being in a relationship and consistently using condoms were associated with lower HIVST uptake. Recency of the last HIV test strongly predicted use, with students tested within the preceding 3–6 months more likely to self-test. Residence and gender were not independent predictors after adjustment.

Conclusions

HIVST uptake among Kenyan health sciences undergraduates is moderate but uneven. Age, academic seniority and recent HIV testing history increase uptake, whereas perceived low risk (e.g. condom use) reduces it. Universities and the Ministry of Health should pair easy kit access with messaging that encourages routine testing regardless of perceived risk to accelerate progress toward UNAIDS 95-95-95 targets.