Often present before sexual debut, contextual conditions enhance STI risk by increasing sexual risk behaviors and likelihood of exposure to infection. These findings suggest that upstream conditions such as housing and safety contribute to the burden of STIs and are appropriate targets for future intervention.
The aim of this study was to assess prevalence and risk factors for sexually transmitted infections (STIs) among fishermen along Lake Victoria, Kenya. This cross-sectional study surveyed 250 fishermen from beaches in Kisumu District using proportional-to-size sampling based on the number of registered boats per beach. Participants provided demographic and sexual behaviour information, blood for HIV-1 herpes simplex virus type 2 (HSV-2) and syphilis serological tests urine for transcription-mediated amplification assays for Neisseria gonorrhoeae and Chlamydia trachomatis and penile and scrotal swabs for human papillomavirus (HPV) DNA assay. Consistent condom use with the three most recent sexual partners was reported by 30%; 38% reported concurrent sexual partnerships and 65% reported ever having transactional sex. HIV seroprevalence was 26%, HSV-2 seroprevalence by Western blot assay was 58% and 9.5% were rapid plasma reagin and Treponema pallidum particle agglutination assay positive. Genital HPV DNA of any type was detected in 57.2% with 74% of these having two or more HPV types. C. trachomatis and N. gonorrhoeae were detected in 3.2% and 1.2% respectively. Risk factors for syphilis seropositivity included working on multiple beaches during the past year (adjusted odds ratio [AOR] 3.81; 95% confidence interval [CI] 1.29-11.28). HPV infection was associated with owning a radio which is a marker for higher socioeconomic status (AOR 6.33; 95% CI 2.94-7.14) and reporting transactional sex with the most recent sexual partner (AOR 3.03; 95% CI 1.23-7.69). In conclusion, 90% of fishermen had evidence of one or more STIs. This exceptionally high-risk occupational group represents a high priority for preventive interventions.
Studies of venue shopping have typically analyzed the case of an individual advocacy group or issue campaign rather than comparing venue strategies across multiple groups. Moreover, this literature focuses on interest groups and advocacy coalitions whose principal mandate is to influence public policy. Using original data, we test theories of venue selection among nonprofit organizations that report engaging in policy processes but the majority of which do not self‐identify as an advocacy group. Our analyses explore the “where” of nonprofit advocacy across three different venue types: branch (executive, legislative), domain (bureaucracy, elected officials), and level of government (local, state, federal). Like interest groups, we find that nonprofits shop among both executive and legislative branches and among elected and bureaucratic domains; however, they tend to specialize in one level of government. Geographic scope and revenue source predicted venue targeting, but most other organizational characteristics including age, capacity, and structure did not.
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