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. 2025 Oct 23;16(1):1401.
doi: 10.4102/jphia.v16i1.1401. eCollection 2025.

Knowledge, attitudes and practices related to SARS-CoV-2 prevention in Kenya

Brennan R Cebula  1 , Roger Ying  1   2 , Tyler Hamby  1   2 , Julius Tonzel  1   2 , Josphat Kosgei  3   4 , Deborah Langat  3   4 , Rael Bor  3   4 , Britt Gayle  1   2 , Matthew L Romo  1   2 , Glenna Schluck  1   2 , Christine Akoth  3   4 , Fred Sawe  3   4 , Margaret Yacovone  5 , Julie A Ake  1 , Trevor A Crowell  1   2
Affiliations

Knowledge, attitudes and practices related to SARS-CoV-2 prevention in Kenya

Brennan R Cebula et al. J Public Health Afr. .

Abstract

Background: Knowledge, attitudes, and practices (KAPs) regarding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) non-pharmaceutical interventions (NPIs) may differ among populations with health vulnerabilities.

Aim: To examine COVID-19 KAPs among Kenyan adolescents and adults with behavioural vulnerability to HIV.

Setting: This study was conducted in Kericho and Homa Bay, Kenya.

Methods: From December 2021 to April 2023, we enrolled participants without HIV aged 14-55 years who reported recent sexually transmitted infection, injection drug use, transactional sex, condomless sex, and/or anal sex with males. A self-administered questionnaire captured sociodemographic data and KAPs. Multivariable robust Poisson regression with purposeful variable selection was used to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for factors associated with NPI practices.

Results: Among 399 participants (median age 22 years [interquartile range 19-24]), 317 (79.4%) were female. Participants during the Omicron-variant wave were less likely to meet outdoors (PR = 0.85 [95% CI: 0.73-0.98]), reduce shopping (PR = 0.83 [95% CI: 0.73-0.96], and avoid crowds (PR = 0.81 [95% CI: 0.71-0.93]). Believing that mask-wearing prevents SARS-CoV-2 was associated with less meeting outdoors (PR = 0.44 [95% CI: 0.27-0.73]) and reducing shopping (PR = 0.48 [95% CI: 0.31-0.76]), while believing that handwashing prevents SARS-CoV-2 was associated with less crowd avoidance (PR = 0.73 [95% CI: 0.60-0.89]). Perceiving widespread community face mask use was associated with reduced shopping (PR = 1.12 [95% CI: 1.02-1.23]).

Conclusion: Belief in personal NPIs (mask-wearing and handwashing) was associated with decreased practice of social NPIs (meeting outdoors, reducing shopping, and avoiding crowds).

Contribution: Future public health strategies for pandemic response should anticipate risk compensation.

Keywords: COVID-19; HIV; SARS-CoV-2; attitudes and practices; knowledge; non-pharmaceutical intervention.

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Conflict of interest statement

The authors reported that they received funding from the US National Institute of Allergy and Infectious Diseases and National Institute of Mental Health, which may be affected by the research reported in the enclosed publication. The author has disclosed those interests fully and has implemented an approved plan for managing any potential conflicts arising from their involvement. The terms of these funding arrangements have been reviewed and approved by the affiliated university in accordance with its policy on objectivity in research.

Figures

FIGURE 1
FIGURE 1
Distribution of responses to questions regarding knowledge of SARS-CoV-2 non-pharmaceutical interventions to prevent COVID-19 (a) and transmission (b) among participants with behavioural vulnerability to HIV in Kenya.
FIGURE 2
FIGURE 2
Attitudes regarding COVID-19 risk (a) and perceptions of community practices (b) among participants with behavioural vulnerability to HIV in Kenya.
FIGURE 3
FIGURE 3
Practice of non-pharmaceutical interventions to prevent COVID-19 among participants with behavioural vulnerability to HIV in Kenya.
FIGURE 1-A1
FIGURE 1-A1
Timeline of COVID-19 waves in Kenya and the corresponding predominant SARS-CoV-2 variant.
See this image and copyright information in PMC

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