Assessment of factors associated with HIV self-testing among long-distance truck drivers along Uganda road in Uasin Gishu county, Kenya

Abstract

HIV self-test refers to a process where individuals perform their own HIV test by taking an oral or blood-based test. HIV self-testing was introduced to increase the number of HIV testing rates among hard-to-reach populations such as long-distance truck drivers. However, little is known about its uptake in Kenya where it has been available since 2017, and the factors influencing its utilisation. The purpose of this study was to assess the sociodemographic and behavioural characteristics associated with HIVST among long-distance truck drivers along Uganda Road in Uasin Gishu County. It also sought to determine HIVST uptake and testing preferences. This cross-sectional study utilized proportionate stratified sampling and simple random sampling to recruit a total of 287 truck drivers. A questionnaire uploaded to Kobo Toolbox was used to collect data. A research license from MKU IREC and a permit from NACOSTI were granted. Downloaded data in an Excel sheet was imported to SPSS version 28 for coding and cleaning. Means, frequencies, and percentages were used for descriptive analysis of quantitative data. Association between variables was established by bivariate analysis/chi-square tests with a significant p-value of <0.05. To adjust for the impact of other variables, all statistically significant variables from bivariable analysis were subjected to multivariate logistic regression analysis using a generalized linear model. All logistic regression factors with a p-value of <0.05 were identified as true predictors of HIVST among long-distance truck drivers. A total of 287 truck drivers took part in the study, the majority being males (98.6%) compared to females (1.4%) with an average age of 38.66 years. HIVST uptake was 35.5%. Factors associated with HIVST testing included the duration of driving specifically 6-10 years (OR=3.0, 95% CI =1.3-6.9, p=0.008); moderate and high perceived risk of HIV infection (OR=4.1, 95% CI=1.9-9.1, p=<0.001 and OR=3.7, 95% CI=1.3-10.8, p=0.012); average and excellent HIV knowledge (OR=11.7, 95% CI =2.2-217.4, p=0.021 and OR=28.3, 95% CI =5.1-536, p=0.002). The majority of truck drivers (84.3%) preferred blood based kits compared to 8.8% who preferred oral-based kits. Couple testing was preferred by over two-thirds of truck drivers compared to testing alone. HIV self-testing uptake is still low. There is a need to create targeted educational campaigns through peer-led programs and workplace sensitization, reinforcing HIV risk perception and knowledge and interventions tailored to meet the needs of drivers of varying degrees of experience. It’s imperative to prioritize the availability and promotion of blood-based kits, considering their overwhelming preference. Despite their preference for blood-based kits, oral kit use should be encouraged by giving education and information about the advantages of oral testing.