Introduction Women in Sub -Saharan africa continue to be dispropotionately affectced by the HIV epidemic. Correlates of HIV infection need to be better understood, and prevention strategies adapted, to account for risk patterns linked to particular settings or situations.

Methods We assessed prevalence and correlates of HIV infection among women 18–34 years of age screened for a contraceptive vaginal ring study.Women provided socio-demographic, medical information, and underwent real-time parallel rapid HIV testing and medical evaluation and sexually transmitted infections (STI) testing.

Results Of the 459 women screened, the median age was 25 (IQR: 21–28). Majority of whom were married (69%), and more than a half (69%) had primary or less level of education. Overall, HIV prevalence was 14.5%, with the married and widowed recording a significantly higher burden of HIV (25% and 50%) respectively. Slightly more than a half (55%) of HIV positive women perceived their health to be good. Women who tested positive for herpes simplex and gonorrhoea had significantly higher prevalence of HIV ((6% vs. 21%, p<0.001% and 14% vs. 39%; p=0.003) respectively. Women ages 25–29 years old had a 3 fold increased odds of HIV acquisition compared to 18–24 year olds (aOR=3.61; 95% CI:1.23–10.49, p=0.019), while those aged 30–34 had a 5 fold increased risk (aOR=5.36; 95% CI:1.23–19.60, p=0.011). Widowed had nearly 6 times risk of HIV acquisition compared to single women ((aOR=5.85; 95% CI:1.39–24.51, p=0.016), whereas women reporting to have to have had sexual intercourse with partners of unknown HIV status in the last 3 months were four times more likely to test positive for HIV than those who did not (OR 4.10 95% CI: 1.47–11.41).

Conclusion Behavioural, biological and structural factors continue to put women at risk of HIV.There is need for multipronged prevention strategies including female controlled multipurpose technologies to reduce their HIV burden.