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

Abstract

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.