HIV Prevalence and Associated Risk Factors among Individuals Aged 1334 Years in Rural Western Kenya

Objectives: To estimate HIV prevalence and characterize risk factors among young adults in Asembo, rural western Kenya. Design: Community-based cross-sectional survey. Methods: From a demographic surveillance system, we selected a random sample of residents aged 13-34 years, who were contacted at home and invited to a nearby mobile study site. Consent procedures for non-emancipated minors required assent and parental consent. From October 2003 April 2004, consenting participants were interviewed on risk behavior and tested for HIV and HSV-2. HIV voluntary counseling and testing was offered. Results: Of 2606 eligible residents, 1822 (70%) enrolled. Primary reasons for refusal included not wanting blood taken, not wanting to learn HIV status, and partner/parental objection. Females comprised 53% of 1762 participants providing blood. Adjusted HIV prevalence was 15.4% overall: 20.5% among females and 10.2% among males. HIV prevalence was highest in women aged 25-29 years (36.5%) and men aged 30-34 years (41.1%). HSV-2 prevalence was 40.0% overall: 53% among females, 25.8% among males. In multivariate models stratified by gender and marital status, HIV infection was strongly associated with age, higher number of sex partners, widowhood, and HSV-2 seropositivity. Conclusions: Asembo has extremely high HIV and HSV-2 prevalence, and probable high incidence, among young adults. Further research on circumstances around HIV acquisition in young women and novel prevention strategies (vaccines, microbicides, pre-exposure prophylaxis, HSV-2 prevention, etc.) are urgently needed. Citation: Amornkul PN, Vandenhoudt H, Nasokho P, Odhiambo F, Mwaengo D, et al. (2009) HIV Prevalence and Associated Risk Factors among Individuals Aged 13-34 Years in Rural Western Kenya. PLoS ONE 4(7): e6470. doi:10.1371/journal.pone.0006470 Editor: Adrian V. Hernandez, Lerner Research Institute, Cleveland Clinic, United States of America Received April 1, 2009; Accepted June 11, 2009; Published July 31, 2009 This is an open-access article distributed under the terms of the Creative Commons Public Domain declaration which stipulates that, once placed in the public domain, this work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. Funding: The study was funded entirely by the U.S. Government through the U.S. Centers for Disease Control and Prevention (CDC), Division of HIV/AIDS Prevention Surveillance and Epidemiology. The study design, data collection instruments, data analysis, decision to publish, and preparation of the manuscript were led by medical epidemiologists and statisticians at the CDC and stationed in Kenya. Data collection was done by Kenyan staff working at the CDC-funded research station in Kisumu, Kenya. Competing Interests: The authors have declared that no competing interests exist. * E-mail: pamornkul@iavi.org ¤a Current address: International AIDS Vaccine Initiative, San Francisco, California, United States of America ¤b Current address: Belgian Institute of Tropical Medicine, Antwerp, Belgium ¤c Current address: Management Sciences for Health, Nairobi, Kenya ¤d Current address: University of Nairobi, Nairobi, Kenya ¤e Current address: Program for Appropriate Technology in Health (PATH), Kisumu, Kenya ¤f Current address: George Washington University, Washington, D.C., United States of America ¤g Current address: World Health Organization, Geneva, Switzerland