Utilization of sexual and reproductive health services among young people living with HIV and attending selected HIV clinics in selected sub-counties of Nairobi, Kenya.

Background: Young people living with HIV in Sub-Saharan Africa account for the largest proportion of the vulnerable population in the world. Kenya has little evidence to showcase the utilization of sexual and reproductive health services among young people living with HIV. Nairobi County has one of the highest HIV burdens among adolescents and youth in the country. Consequently, this study aimed to assess factors associated with the utilization of sexual and reproductive health services among young people aged 15-24 years living with HIV.

Methods: A health facility-based cross-sectional study design with convergent parallel mixed methods technique was used. Purposive sampling with predetermined criteria was used to select six high-volume public health facilities in six high-burden sub-counties of Nairobi. A total of 253 participants completed the semi-structured questionnaires on utilization and associated factors.12 healthcare workers were purposively selected as key informant sessions in individual key informant sessions on their perception of young people's utilization.

Results: 4Stepwise multivariable binary logistic regression was used to analyse the quantitative data using Stata version 14. NVivo software was used to code and thematically analyse the data. Results 47 % of the participants had utilized the services. Collection of condoms (45.7%) was the most utilized while treatment of sexually transmitted infections (8.2%) was the least utilized services. Female sex (AOR--adjusted odds ratio : 3.60 95%, Cl: 1.67-6.40), increase in age (AOR: 2.27 95%, Cl: 1.1C-4.65), HIV status disclosure to a sexual partner (AOR: 2.00 95%, Cl: 1.11-3.80) and privacy for sexual and reproductive health services at a health facility (AOR: 3.27 95%Cl: 1.42-7.60) were factors significantly associated with utilization.

Conclusions: Given higher utilization rates of sexual reproductive services were demonstrated among females and those who disclosed their HIV status to sexual partner , strengthening behavioral interventions to engage young men and disclosure support strategies can address the existing disparities.