Correlates pf Prevalent HIV Infection among Adults & Adolescents in Kisumu, Kenya

We estimated HIV prevalence and identified correlates of HIV infection among 1106 men and women aged 16–34 years residing in Kisumu, Kenya. Demographic, sexual, and other behavioural data were collected using audio computer-assisted self-interview in conjunction with a medical examination, real-time parallel rapid HIV testing, and laboratory testing for pregnancy, gonorrhoea, chlamydia, syphilis, and herpes simplex virus type 2. Multivariate logistic regression was used to identify variables associated with prevalent HIV infection by gender. 

• Overall HIV prevalence was 12.1%. 
• HIV prevalence among women (17.1%) was approximately two and one half times the prevalence among men (6.6%). 
• Odds of HIV infection in men 
• increased with age and 
• were greater among those who were uncircumcised 
• and those who had an herpes simplex virus type 2 positive test result. 
• Odds of prevalent HIV infection among women also 
• increased with age. 
• Women who tested herpes simplex virus type 2 positive had more than three times the odds of prevalent HIV infection compared with those who tested herpes simplex virus type 2 negative. 

Tailored sexual health interventions and programs may help mitigate HIV age and gender disparities.

Correlates of HIV infection among men, Kisumu Incidence Cohort Study, Kenya, 2007–2010.

	HIV Prevalence at Screening		Bivariate		Multiple Regression
	N	%	OR (95% CI)	p-value	aOR** (95% CI)	p-value
Age*			1.20 (1.11, 1.29)	<.0001	1.21 (1.07, 1.35)	.0017
Marital status				.0373		.2976
Single/never married	21	5.3	Ref		Ref
Married/living as married	12	9.8	1.95 (0.93, 4.08)		0.47 (0.14, 1.57)
Separated/divorced/widowed	2	25.0	6.00 (1.14, 31.54)		2.08 (0.24, 18.07)
Religion				.5776
Roman Catholic	11	5.2	Ref
Protestant or other Christian	15	6.8	1.32 (0.59, 2.94)
Muslim/Nomiya/Other	7	8.1	1.58 (0.59, 4.23)
No religion	2	13.3	2.78 (0.56, 13.90)
Highest education level				.0030		.2421
Never attended school	6	27.3	9.25 (2.67, 32.08)		4.47 (0.95, 21.06)
Primary school	12	7.6	2.01 (0.74, 5.51)		1.41 (0.42, 4.74)
Secondary school	11	5.7	1.48 (0.54, 4.10)		1.15 (0.38, 3.50)
Post-secondary schoola	6	3.9	Ref		Ref
Currently working				.8029
Yes	16	6.9	1.09 (0.55, 2.17)
No	19	6.4	ref
Lifetime number of sexual partnersb				.3646
1–2	2	4.4	Ref
3–4	7	4.7	1.09 (0.22, 5.41)
5 or more	25	7.9	1.88 (0.43, 8.20)
Ever had anal sex				.2108		.1577
Yes	3	3.4	0.46 (0.14, 1.55)		0.37 (0.09, 1.48)
No	31	7.0	Ref		Ref
Ever had oral sex				.9831
Yes	9	6.6	1.01 (0.46, 2.21)
No	26	6.6	Ref
Ever been forced into sex				.5502
Yes	6	8.2	1.32 (0.53, 3.30)
No	29	6.4	Ref
Number of sexual partners in the past three monthsb				.9009		.4761
0	5	14.3	Ref		Ref
1	5	4.4	0.27 (0.07, 1.00)		0.31 (0.06, 1.59)
2–3	13	6.1	0.39 (0.13, 1.18)		0.34 (0.08, 1.39)
4 or more	12	7.3	0.47 (0.16, 1.44)		0.42 (0.10, 1.74)
Any unprotected vaginal or anal sex in the past three months				.6114
Yes	3	4.4	1.38 (0.40, 4.70)
No	24	6.0	Ref
Sex during special occasions in the past three months				.6831
Yes	10	5.5	0.85 (0.39, 1.86)
No	20	6.4	Ref
STI history				<.0001		.0966
Never	19	4.3	Ref		Ref
Not recent	10	15.4	4.03 (1.78, 9.12)		2.09 (0.76, 5.78)
Recent (past three months)	6	24.0	7.00 (2.51, 19.53)		3.40 (0.99, 11.65)
HSV-2 results				<.0001		.0489
Positive	12	20.7	6.82 (3.04, 15.29)		3.13 (1.12, 8.73)
Indeterminate	7	16.7	5.23 (2.02, 13.55)		3.04 (0.95, 9.71)
Negative	16	3.7	Ref		Ref
Circumcision as confirmed by physical examination (men)				.0070		.0109
Uncircumcised	31	8.9	4.29 (1.49, 12.35)		4.42 (1.41, 13.89)
Circumcised	4	2.2	Ref		Ref

aPost-secondary education includes technical/vocational training, college, or university.

bPersons with whom the participant had vaginal or anal sex.

*Continuous variable.

**Odds ratios and confidence intervals adjusted for all variables listed in the column (i.e. all variables with p <.25 in bivariate models).

Correlates of HIV infection among women, Kisumu Incidence Cohort Study, Kenya, 2007–2010.

	HIV Prevalence at Screening		Bivariate		Multiple Regression
	N	%	OR** (95% CI)	p-value	aOR** (95% CI)	p-value
Age*			1.17 (1.11, 1.23)	<.0001	1.16 (1.04, 1.29)	.0085
Marital status				<.0001		.9456
Single/never married	36	10.3	Ref		Ref
Married/living as married	44	24.2	2.76 (1.70, 4.48)		1.00 (0.34, 2.97)
Separated/divorced/widowed	16	41.0	6.03 (2.92, 12.45)		1.26 (0.29, 5.52)
Religion				.8482
Roman Catholic	48	17.3	Ref
Protestant or other Christian	28	15.3	0.87 (0.52, 1.44)
Muslim/Nomiya/Other	17	19.5	1.16 (0.63, 2.15)
No religion	4	18.2	1.07 (0.35, 3.29)
Highest education level				.0096		.3554
Never attended school	8	33.3	4.21 (1.53, 11.61)		4.77 (0.49, 46.07)
Primary school	48	21.2	2.26 (1.19, 4.28)		3.05 (0.84, 11.08)
Secondary school	27	14.4	1.42 (0.72, 2.83)		2.31 (0.66, 8.08)
Post-secondary schoola	14	10.6	Ref		Ref
Currently working				.0038		.6743
Yes	47	23.3	1.92 (1.24, 2.99)		0.83 (0.35, 1.96)
No	50	13.6	Ref		Ref
Lifetime number of sexual partnersb*				.0010		.2903
1–2	11	7.8	Ref		Ref
3–4	40	17.5	2.53 (1.25, 5.12)		2.52 (0.75, 8.47)
≥5	41	24.3	3.81 (1.88, 7.74)		1.68 (0.46, 6.16)
Ever had anal sex				.0940		.5813
Yes	19	12.5	0.63 (0.37, 1.08)		0.73 (0.24, 2.21)
No	76	18.5	Ref		Ref
Ever had oral sex				.5928
Yes	17	15.2	0.86 (0.48, 1.52)
No	78	17.3	Ref
Ever been forced into sex				.3499
Yes	29	19.5	1.26 (0.78, 2.04)
No	68	16.1	Ref
Number of sexual partners in the past three monthsb				.6828
0	6	17.1	Ref
1	51	15.6	0.89 (0.35, 2.27)Ref
2–3	28	18.0	1.06 (0.40, 2.79)
4 or more	14	19.4	1.17 (0.41, 3.35)
Any unprotected vaginal or anal sex in the past three months				.0725		.5167
Yes	70	18.1	1.96 (0.94, 4.10)		0.70 (0.24, 2.06)
No	9	10.1	Ref		Ref
Sex during special occasions in the past three months				.7423
Yes	19	17.9	1.10 (0.63, 1.92)
No	71	16.6	Ref
STI history				<.0001		.9115
Not recent	10	15.4	4.03 (1.78, 9.11)		1.38 (0.32, 5.90)
Recent (past three months)	6	24.0	7.00 (2.51, 19.53)		1.00 (0.08, 11.81)
Never	19	4.3	Ref		Ref
HSV-2 results				<.0001		.0114
Positive	76	35.5	12.92 (6.94, 24.06)		3.85 (1.38, 10.71)
Indeterminate	9	23.1	7.04 (2.78, 17.82)		0.88 (0.14, 5.59)
Negative	13	4.1	Ref		Ref
Pregnant as confirmed by lab test (women)				.0963		.9837
Yes	8	28.6	2.06 (0.88, 4.82)		0.98 (0.09, 10.66)
No	88	16.3	Ref		Ref
Used birth control pills to delay or avoid pregnancy in the past three months (women)				.0484		.5334
Yes	33	23.1	1.96 (1.01, 3.82)		1.38 (0.51, 3.74)
No	15	13.3	Ref		Ref
Used injections to delay or avoid pregnancy in the past three months (women)				.0355		.9940
Yes	33	24.1	2.02 (1.05, 3.90)		1.00 (0.38, 2.67)
No	16	13.6	Ref		Ref

aPost-secondary education includes technical/vocational training, college, or university.

bPersons with whom the participant had vaginal or anal sex.

*Continuous variable.

**Odds ratios and confidence intervals adjusted for all variables listed in the column (i.e. all variables with p <.25 in bivariate models).

Full article at:   http://goo.gl/NFjq0f

By:  Anne Gumbe,1 Eleanor McLellan-Lemal,2 Deborah A Gust,2 Sherri L Pals,2 Kristen Mahle Gray,2 Richard Ndivo,1Robert T Chen,2 Lisa A Mills,3 and Timothy K Thomas3, for the KICoS Study Team1

¹Kenya Medical Research Institute, Kisumu, Kenya

²Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, GA, USA

³Centers for Disease Control and Prevention, HIV-Research Branch, Kisumu, Kenya

Corresponding author: Anne Gumbe, International AIDS Vaccine Initiative, ABC Place (Building 2,3rd Fl) Waiyaki Way, PO Box 340 KNH, Nairobi, Kenya. Email: gro.ivai@ebmuga

Int J STD AIDS. 2015 Nov; 26(13): 929–940.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health