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

Abstract

PurposeThe 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.MethodsA 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.ResultsOf 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.ConclusionsStreet-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.

Preliminary Study of Fourteen AIDS-Associated Lung Complications from Imaging,Pathology and Microbiology

“…A high-incidence of herpes infection is observed in the AIDS patients, 26.4% occurred in the stage of HIV infection, 73.6% of them in the AIDS stage [32]. Noteworthy, culture of microbe is a key measure to identify infection of herpes virus.…”

Implementing intensified tuberculosis case-finding among street-connected youth and young adults in Kenya

“…It is not clear whether we can extrapolate these findings to this SCY population, as all the HIV-positive patients in that cohort were female. 8 FIGURE TB sensitization talk and screening at one of the 'barracks' in Eldoret, Kenya. TB = tuberculosis.…”

“…7 In a recent prevalence study in Eldoret, 6% of SCY were HIV-infected. 8 Another local study revealed cough as the most common symptom of SCY and upper respiratory tract infection one of the most common health problems. 2 In low-and middle-income countries (LMICs) such as Kenya, tuberculosis (TB) is among the top 10 causes of mortality, and is the leading cause of death in HIV-infected individuals.…”

“…While there are fewer females living on the street than males, females have a significantly higher HIV burden, underscoring the importance of ICF for TB in females. 4,8 Other studies in the region had greater female participation by implementing targeted programming for girls. Our program might have had more success in screening females if we had created a girls-only activity.…”

Highlights from this issue

“…Winston et al describe high rates of STI and HIV in Kenyan street-connected youth, a situation affecting millions of vulnerable young people across the globe,10 while a Stoltey et al in the USA describe a strong correlation between incarceration rates and diagnosed chlamydia incidence 9. A US report by Mansergh et al 12 reports that internalised homophobia is associated with increased sexual risk among black MSM but not Latinos.…”