Introduction: HIV remains a significant global health challenge, disproportionately affecting adolescent girls and young women (AGYW). HIV testing is crucial in controlling the infection and reducing its prevalence. Understanding risky sexual behaviors among AGYW is pivotal in aligning prevention interventions. Despite global prevention efforts, testing gaps persist among AGYW, linked to risky sexual behavior (RSB). This study explores the association between these behaviors 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 analyzed using Chi-square tests and logistic regression. Data was collected between June to July 2023.

Results: 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. Participants engaging in risky behaviors such as lack of condom use (3.96 times more likely), experiencing gender-based violence (4.65 times more likely), or contracting STIs (2.85 times more likely) had higher odds of seeking HIV testing services.

Conclusion: This study establishes a clear link between risky sexual behaviors and HIV testing among AGYW, with a 60.7% testing prevalence; however, gaps still exist. 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.

Materials and Methods  

Design

A community-based cross-sectional analytical study design, using quantitative techniques, was employed.

Study site and population

Kibra is one of the 17 sub counties in Nairobi County, it is located southwest of Nairobi County approximately 5 kilometers from CBD and projected to have a population of 206,064 persons, 21.5% of this population constitutes the AYPs aged between 15-24 years. Majority of the residents are in informal settlements [17]. The sample size of 379 adolescent girls and young women (AGYW) aged 15-24 was calculated using the Cochran formula [18]. Employing a multistage sampling technique, three out of five Wards were randomly selected. Then random walk sampling method was used, starting from common meeting points (markets, hospitals, or schools) in selected wards. A local guide assisted in choosing a random route, with data collection continuing until the minimum sample size was reached. In households with multiple AGYW, random selection using yes/no indicators determined the participant. To be eligible participant must have been a resident for at least one year before time of study, consent/assent to participate and aged between 15-24 years.

Data Collection

Standardized structured interviewer-administered questionnaires were used, covering sociodemographic details, risky sexual behaviors, and HIV testing service utilization. Sociodemographic factors (age, sex, education level, marital status, average monthly income, religion) and indicators of risky sexual behaviors were assessed. Risky behaviors included sexual activity, age at first encounter, condom use, pregnancy prevention methods, transactional sex, multiple sexual partners, sex under the influence, and STI diagnosis in the past 12 months. HIV testing history was also assessed. Data was collected between June and July 2023.

Data Analysis

Completed questionnaires were cross-checked for accuracy and completeness, then analyzed using SPSS version 25. Descriptive statistics on sociodemographic characteristics such as age, sex, education level, marital status, average monthly income, religion, and risky sexual behaviors included sexual activity, age at first encounter, condom use, pregnancy prevention methods, transactional sex, multiple sexual partners, sex under the influence, and STI diagnosis in the past 12 months. Inferential statistics were employed. Regression analyses were performed to assess the association between the explanatory variables and each variable. Variables with a univariable p-value < 0.1 were included in multivariate logistic regression. Adjusted odds ratios, 95% confidence intervals, and p-values were reported, with significance set at p < 0.05.

Ethical Considerations

Ethical clearance was obtained from Jomo Kenyatta University of Agriculture and Technology Research Committee. Research permits were secured from the National Commission for Science Technology and Innovations (NACOSTI) and Nairobi County Ethical and Research Committee. Informed consent and assent were obtained from participants, ensuring full disclosure of study purpose, risks, and benefits. Strict confidentiality measures, including identity code usage and password protection, were implemented. Access to data was restricted, and anonymity was maintained during data