Abstract
BACKGROUND: 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. METHODS: 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 a manual stepwise procedure was used to enter variables with p-values <0.1 in the bivariate model analysis into the multivariate logistic regression model at 95% Confidence Interval. Data was collected between June to July 2023. RESULTS: Majority (80.7%) of the respondents were single, married (18.2%) or separated (1.1%). Almost two-thirds (64.6%) were educated to secondary school level, while tertiary and primary levels accounted for 23.5% and 11.6% respectively. 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. Respondents who failed to use condoms in their last sexual encounter demonstrated a higher probability of testing for HIV (OR 3.96,955 CI:2.12,7.58, p<0.001). those who experienced gender-based violence were had a higher likelihood of testing (OR: 4.65, 95% CI: 1.93,13.87, p-0.002)Participants engaging in risky behaviours such as lack of condom had higher odds of testing for HIV (AOR: 4.27, 95% CI: 2.25, 8.30, p-<0.001) relative to those who used protection. CONCLUSIONS: This study establishes a clear link between risky sexual behaviours and HIV testing among AGYW Utilization of HIV testing among this population is still low. Efforts to enhance testing rates are vital. Interventions should align with acceptable methods, focusing on this high-risk group to ensure effective HIV care and prevention. The Ministry of Health should consider integration of HIV services in various service delivery points, upscale the uptake of HIV-self testing for both oral and blood blood based and support social protective measures for AGYW to ensure effective HIV care and prevention.