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Epidemiology
Original article
Prevalence of sexually transmitted infections including HIV in street-connected adolescents in western Kenya
  1. Susanna E Winston1,
  2. Amon K Chirchir2,
  3. Lauryn N Muthoni2,3,
  4. David Ayuku4,
  5. Julius Koech5,
  6. Winstone Nyandiko5,6,
  7. E Jane Carter7,8,
  8. Paula Braitstein5,8,9,10,11
  1. 1Division of Pediatric Infectious Diseases, Rhode Island Hospital/Hasbro Children's Hospital, Warren Alpert Medical School at Brown University, Providence, Rhode Island, USA
  2. 2Moi Teaching and Referral Hospital, Eldoret, Kenya
  3. 3Aga Khan University Hospital, Nairobi, Kenya
  4. 4Department of Behavioral Sciences, Moi University, School of Medicine, College of Health Sciences, Eldoret, Kenya
  5. 5Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
  6. 6Department Child Health and Pediatrics, Moi University, School of Medicine, Eldoret, Kenya
  7. 7Department of Pulmonary and Critical Care, The Miriam Hospital, Warren Alpert Medical School at Brown University, Providence, Rhode Island, USA
  8. 8Department of Medicine, Moi University, School of Medicine, College of Health Sciences, Eldoret, Kenya
  9. 9Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
  10. 10Division of Epidemiology, University of Toronto, Dalla Lana School of Public Health, Toronto, Canada
  11. 11Regenstrief Institute, Inc., Indianapolis, Indiana, USA
  1. Correspondence to Dr Paula Braitstein, Department of Medicine, Indiana University, 720 Eskenazi Avenue, Fifth Third Faculty Office Building, Suite E2132, Indianapolis, IN 46202, USA; pbraitst{at}iupui.edu

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.

  • ADOLESCENT
  • AFRICA
  • HIV
  • SCREENING
  • EPIDEMIOLOGY (GENERAL)

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/sextrans-2014-051797

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