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Observational Study
. 2015 Aug;91(5):353-9.
doi: 10.1136/sextrans-2014-051797. Epub 2015 Feb 24.

Prevalence of sexually transmitted infections including HIV in street-connected adolescents in western Kenya

Susanna E Winston  1 , Amon K Chirchir  2 , Lauryn N Muthoni  3 , David Ayuku  4 , Julius Koech  5 , Winstone Nyandiko  6 , E Jane Carter  7 , Paula Braitstein  8
Affiliations
Observational Study

Prevalence of sexually transmitted infections including HIV in street-connected adolescents in western Kenya

Susanna E Winston et al. Sex Transm Infect. 2015 Aug.

Abstract

Purpose: The objectives of this study were to characterise the sexual health of street-connected adolescents in Eldoret, Kenya, analyse gender disparity of risks, estimate the prevalence of sexually transmitted infections (STIs), and identify factors associated with STIs.

Methods: A cross-sectional study of street-connected adolescents ages 12-21 years was conducted in Eldoret, Kenya. Participants were interviewed and screened for Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, herpes simplex virus-2, syphilis and HIV. Descriptive statistics and logistic regression were used to identify factors associated with having any STI.

Results: Of the 200 participants, 81 (41%) were female. 70.4% of females and 60.5% of males reported sexual activity. Of those that participated in at least one STI test, 28% (55/194) had ≥1 positive test, including 56% of females; 14% (28/194) had >1 positive test. Twelve females and zero males (6% overall, 14.8% of females) were HIV positive. Among females, those with HIV infection more frequently reported transactional sex (66.7% vs. 26.1%, p=0.01), drug use (91.7% vs. 56.5%, p=0.02), and reported a prior STI (50.0% vs. 14.7%, p<0.01). Having an adult caregiver was less likely among those with HIV infection (33.3% vs. 71.0%, p=0.04). Transactional sex (AOR 3.02, 95% CI (1.05 to 8.73)), a previous STI (AOR 3.46 95% CI (1.05 to 11.46)) and ≥2 sexual partners (AOR 5.62 95% (1.67 to 18.87)) were associated with having any STI.

Conclusions: Street-connected adolescents in Eldoret, Kenya are engaged in high-risk sexual behaviours and females in particular have a substantial burden of STIs and HIV. There is a need for STI interventions targeted to street-connected youth.

Keywords: ADOLESCENT; AFRICA; EPIDEMIOLOGY (GENERAL); HIV; SCREENING.

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Figures

Figure 1
Figure 1
STI prevalence by gender. CT, Chlamydia trachomatis; HSV-2, herpes simplex virus-2; NG, Neisseria gonorrhoeae; STI, sexually transmitted infection; TV, Trichomonas vaginalis.
See this image and copyright information in PMC

References

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    1. United Nations Integrated Regional Informing Network. Youth in crisis: coming of age in the 21st century. Nairobi, Kenya: United Nations Integrated Regional Informing Network, 2007.
    1. Commission on revenue allocation. Kenya: County Fact Sheets, 2011. https://www.opendata.go.ke/Counties/Kenya-County-Fact-Sheets-Dec-2011/zn... (accessed 25 Jun 2014).
    1. National AIDS Control Council (NACC) and National AIDS and STIs Control Programme (NASCOP). Kenya AIDS Epidemic update 2011. Nairobi, Kenya: NACC and NASCOP, 2012. http://www.unaids.org/en/dataanalysis/knowyourresponse/countryprogressre... (accessed 25 Jun 2014).
    1. Kenya National Bureau of Statistics (KNBS) and ICF Macro. Kenya demographic and health survey 2008–09. Calverton, Maryland: KNBS and ICF Macro, 2010.

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