Assessment of factors associated with the uptake of Provider initiated HIV counselling and

testing (PITC) among clients at Kenyatta National Hospital Accident and Emergency
Department, Nairobi, Kenya.
1, 2
Cherutich R.K., 2, 3 Dr. Wanzala P., 2 Prof. Makokha A. O.
1
Kenyatta National Hospital, National Referral and Teaching Hospital, Nairobi Kenya.
2
Jomo Kenyatta University of Agriculture & Technology, Institute of Tropical Medicine and
Infectious Diseases, Nairobi, Kenya

3
Kenya Medical Research Institute, Centre for Public Health Research and The Epidemiology,
Public Health & Health Systems Research Programme, Nairobi, Kenya

Abstract

HIV/AIDS has caused great morbidity and mortality to people around the globe. Without proper
care and treatment many more people will continue to perish. To curb this, proper preventive
measure needs to be put in place. HIV testing and counseling is one of the measures and is the
critical entry-point for engagement into treatment and care as well as for primary and secondary
prevention efforts. Despite the importance of this step, most HIV-infected patients globally, and
particularly in resource-poor settings, are unaware of their HIV status. To improve the HIV
status awareness, provider-initiated HIV testing and counseling (PITC) was introduced. The
primary objective of this study was therefore to assess factors associated with the uptake of
provider initiated HIV counseling and testing (PITC) among clients with possible clinical signs
of HIV infection in Kenyatta National Hospital, Accident and Emergency Department (A&E). A
cross sectional hospital-based survey was carried out, where a structured questionnaire was
administered to 340 subjects selected to participate in the study. The results from this study
showed that there was a significant association between uptake of provider initiated HIV testing
and counseling (PITC) and employment (P = 0.006), high risk sexual behaviors (p = 0.007),
decision to allow ones children play with children who are HIV positive (p = 0.018), and not
fearing to take an HIV test (P < 0.001). The odds of accepting to test HIV through PITC strategy
was 1.1 among clients who were generally young in age. Using fear as the reference category for
whether one would fear to take an HIV test or not, the odds of not fearing to test compared to
fearing to test was 10.0. A high proportion (96.2%) of the clients accepted to test for HIV
through the PITC strategy at KNH Accident and Emergency Department. The findings of this
study shows that offering provider initiated HIV testing and counseling is feasible and may
increase linkage to HIV care and treatment for many individuals with HIV infections. There is
need to increase the impact and feasibility of provider initiated HIV testing and counseling in
high HIV prevalence and resource-constrained settings because the results of this current study
show that there is high uptake. More studies need to be carried out to identify barriers to provider
initiated HIV testing and counseling among clients who declined in this study.