Publication:

Effectiveness of community post interventions in human immunodeficiency virus testing services among men compared to facility-based testing in Kericho County

Background Men have lower human immunodeficiency virus (HIV) testing uptake than women globally, especially in sub-Saharan Africa. In Kenya’s Kericho County, structural, cultural, and behavioral barriers limit male engagement. Community posts (CPs) have been introduced to improve access, but their effectiveness is insufficiently documented.

Methods An analytical cross-sectional study compared HIV testing services (HTS) uptake among men (≥18 years) at two CPs and two health facilities with comprehensive care centers. Mixed methods were used. Quantitative data came from self-administered questionnaires and HTS registers, analyzed in SPSS v29 using descriptive statistics, odds ratios, paired t tests, and cluster-level analysis. Qualitative data from key informant interviews and focus group discussions were analyzed thematically in NVivo.

Results Overall, 68.8% of men had utilized HTS. Uptake was higher at CPs (85.7%) than facilities (52.2%). Mean uptake was significantly greater in CPs (84) than facilities (52.5) (t=-9.0, p=0.012). Contributing factors included convenience (81.1%), supportive environments (69.6%), free services (66.4%), confidentiality (63.1%), and perceived superior quality (90.3%).

Conclusions CP interventions significantly improve male HTS uptake compared with facility-based services. Scaling up CPs, extending flexible hours, strengthening privacy, and implementing male-focused outreach and behavior-change strategies could further enhance testing. Provider training, respectful care, confidentiality, and service integration remain essential for sustaining engagement.