PLoS ONE (Jul 2009)

HIV prevalence and associated risk factors among individuals aged 13-34 years in Rural Western Kenya.

  • Pauli N Amornkul,
  • Hilde Vandenhoudt,
  • Peter Nasokho,
  • Frank Odhiambo,
  • Dufton Mwaengo,
  • Allen Hightower,
  • Anne Buvé,
  • Ambrose Misore,
  • John Vulule,
  • Charles Vitek,
  • Judith Glynn,
  • Alan Greenberg,
  • Laurence Slutsker,
  • Kevin M De Cock

DOI
https://doi.org/10.1371/journal.pone.0006470
Journal volume & issue
Vol. 4, no. 7
p. e6470

Abstract

Read online

OBJECTIVES:To estimate HIV prevalence and characterize risk factors among young adults in Asembo, rural western Kenya. DESIGN:Community-based cross-sectional survey. METHODS:From a demographic surveillance system, we selected a random sample of residents aged 13-34 years, who were contacted at home and invited to a nearby mobile study site. Consent procedures for non-emancipated minors required assent and parental consent. From October 2003 - April 2004, consenting participants were interviewed on risk behavior and tested for HIV and HSV-2. HIV voluntary counseling and testing was offered. RESULTS:Of 2606 eligible residents, 1822 (70%) enrolled. Primary reasons for refusal included not wanting blood taken, not wanting to learn HIV status, and partner/parental objection. Females comprised 53% of 1762 participants providing blood. Adjusted HIV prevalence was 15.4% overall: 20.5% among females and 10.2% among males. HIV prevalence was highest in women aged 25-29 years (36.5%) and men aged 30-34 years (41.1%). HSV-2 prevalence was 40.0% overall: 53% among females, 25.8% among males. In multivariate models stratified by gender and marital status, HIV infection was strongly associated with age, higher number of sex partners, widowhood, and HSV-2 seropositivity. CONCLUSIONS:Asembo has extremely high HIV and HSV-2 prevalence, and probable high incidence, among young adults. Further research on circumstances around HIV acquisition in young women and novel prevention strategies (vaccines, microbicides, pre-exposure prophylaxis, HSV-2 prevention, etc.) are urgently needed.