HIV infection and sexual partnerships and behaviour among adolescent girls in Nairobi, Kenya

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
International Journal of STD & AIDS (Impact Factor: 1.04). 07/2012; 23(7):468-74. DOI: 10.1258/ijsa.2012.011361
Source: PubMed

ABSTRACT Early sexual partnerships place young women in sub-Saharan Africa at high risk for HIV. Few studies have examined both individual- and partnership-level characteristics of sexual relationships among adolescent girls. A cross-sectional survey of sexual history and partnerships was conducted among 761 adolescent girls aged 15-19 years in Nairobi, Kenya. Rapid HIV testing was conducted and correlates of HIV infection were determined using multivariate logistic regression. The HIV prevalence was 7% and seropositive adolescents had a younger age at sexual debut (P < 0.01), more sexual partners in 12 months (P = 0.03), and were more likely to report transactional or non-consensual sex (P < 0.01). Girls who reported not knowing their partner's HIV status were 14 times as likely to be HIV-seropositive than girls who knew their partner's status (adjusted odds ratio: 14.2 [1.8, 109.3]). Public health messages to promote HIV testing and disclosure within partnerships could reduce sexual risk behaviours and HIV transmission among adolescents.

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    ABSTRACT: Populations with higher risks for HIV exposure contribute to the HIV epidemic in Kenya. We present data from the second Kenya AIDS Indicator Survey to estimate the size and HIV prevalence of populations with high-risk characteristics. The Kenya AIDS Indicator Survey 2012 was a national survey of Kenyans aged 18 months to 64 years which linked demographic and behavioral information with HIV results. Data were weighted to account for sampling probability. This analysis was restricted to adults aged 18 years and older. Of 5088 men and 6745 women, 0.1% [95% confidence interval (CI): 0.03 to 0.14] were persons who inject drugs (PWID). Among men, 0.6% (CI: 0.3 to 0.8) had ever had sex with other men, and 3.1% (CI: 2.4 to 3.7) were males who had ever engaged in transactional sex work (MTSW). Among women, 1.9% (CI: 1.3 to 2.5) had ever had anal sex, and 4.1% (CI: 3.5 to 4.8) were women who had ever engaged in transactional sex work (FTSW). Among men, 17.6% (CI: 15.7 to 19.6) had been male clients of transactional sex workers (TSW). HIV prevalence was 0% among men who have sex with men, 6.3% (CI: 0 to 18.1) among persons who injected drugs, 7.1% (CI: 4.8 to 9.4) among male clients of TSW, 7.6% (CI: 1.8 to 13.4) among MTSW, 12.1% (CI: 7.1 to 17.1) among FTSW, and 12.1% (CI: 5.0 to 19.2) among females who ever had engaged in anal sex. Population-based data on high-risk populations can be used to set realistic targets for HIV prevention, care, and treatment for these groups. These data should inform priorities for high-risk populations in the upcoming Kenyan strategic plan on HIV/AIDS.
    JAIDS Journal of Acquired Immune Deficiency Syndromes 05/2014; 66 Suppl 1:S46-56. DOI:10.1097/QAI.0000000000000137 · 4.39 Impact Factor
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    ABSTRACT: HIV infection in adolescents is promoted by sexual risky behaviours and nonconsensual sex. Nonconsensual sex ranges from forced sex/rape, unwanted touch and inducement by gifts. This study was designed to determine the prevalence of nonconsensual sex (NCS) and HIV infection in adolescents. Eight hundred and eighty three adolescents from 10 secondary schools were randomly selected and given a questionnaire to fill. All had group pre-test counseling had HIV screening. HIV positive subjects had a confirmatory test done after individual post-test counseling. Ethical clearance was received from the relevant authorities and persons. Of the 883 students, 169 (19.2%) were sexually experienced. Of which 101/169 (59.8%) were males and 40.2% females. Mean age at first sexual debut was 14.4±2.6 years; males 13.3±2.7 years and females 14.6±3.2 years, P=0.006. Seventy three of 127 respondents (57.5%) indicated consensual sex and 42.5% (54/127) indicated NCS. Of the 54 subjects, 74% were females and 22% males. Mean age at first sex in NCS was 13.5 + 3.4 yrs; males, 12.5±2.9 yr in NCS and 14±2.6 in consensual, P=0.045; females 14±3.5 in NCS and 16.5±1.2 in consensual P=0.02. Circumstances of sex showed 59.3% were forced sex or rape, 7.4% was following gifts. Over 70% of NCS group use no form of protection. In the population studied 9/883 (1.02%) were HIV positive. Among the sexually experienced HIV prevalence was 2.4% (4/169), and 3.7% (2/54) among NCS. Prevalence of NCS is high, occurring at an earlier age and associated with lack of condom use as well as a higher HIV prevalence.
    Journal of the Nigeria Medical Association 10/2012; 53(4):210-2. DOI:10.4103/0300-1652.107555
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    ABSTRACT: In Tanzania, approximately 25% of adolescents give birth and 50% more become sexually active during adolescence. We hypothesised that reproductive health education and services for young females are inaccessible and conducted this study to gain insights into their perceptions of sexually-transmitted infections (STIs) and barriers to reproductive health service utilisation in rural Mwanza, Tanzania. We conducted nine focus group among pregnant adolescents aged 15 -20 years. Data was transcribed, translated, and coded for relevant themes using NVivo10 software for qualitative data analysis. Most participants were aware of the dangers of STIs to themselves and their unborn babies, but did not perceive themselves as at risk of acquiring STIs. They viewed condoms as ineffective for preventing STIs and pregnancies and unnecessary for those in committed relationships. Stigma, and long waiting times and lack of privacy in the clinics discouraged young females from seeking reproductive healthcare. Reproductive healthcare for young females who are not pregnant is practically nonexistent in Tanzania. Healthcare access for pregnant young women is also limited. Targeted changes to increase clinic accessibility and to provide reproductive health education to all rather than only pregnant women have the potential to address these gaps. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Acta paediatrica (Oslo, Norway: 1992). Supplement 12/2014; DOI:10.1111/apa.12886

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