HIV, Syphilis, and Gonorrhea in Rural Kenya: Prevalence and Risk Factors Public

Abstract

Abstract

HIV, Syphilis, and Gonorrhea in Rural Kenya: Prevalence and Risk Factors
Two baseline cross sectional surveys in rural western Kenya were performed in a largely anti-retroviral
naïve population to determine the prevalence and risk factors of seroprevalent infection of HIV, syphilis
and gonorrhea infection. Higher prevalence of infection was found in women compared to men for HIV,
syphilis and gonorrhea infection. Risk factors that were found to be associated with higher odds of HIV
infection were being widowed compared with being married, having a higher number of lifetime sexual
partners, being older, and having an occupation that is usually associated with a higher socio-economic
status. Lower odds of HIV infection were found to be associated with being single, being younger, being
Catholic, and being unemployed or having an occupation usually associated with a lower socio-economic
status. The risk factors associated with syphilis were generally the same as those associated with HIV,
but the association was often reversed for gonorrhea infection compared to HIV infection. The risk
factors determined by these models can be used to target high risk behaviors and groups for
interventions.

Table of Contents

Table of Contents


BACKGROUND .......................................................................................................................................... 1
HIV ........................................................................................................................................................... 1
Other Sexually Transmitted Diseases ....................................................................................................... 3
Health and Demographic Surveillance System in western Kenya ............................................................ 7
METHODS ................................................................................................................................................... 9
Hypotheses ................................................................................................................................................ 9
Data collection ........................................................................................................................................ 10
Secondary Data Analysis ........................................................................................................................ 12
RESULTS ................................................................................................................................................... 14
Prevalence ............................................................................................................................................... 15
HIV risk factors ...................................................................................................................................... 15
Bivariate Analysis ............................................................................................................................... 15
Multivariate Analysis .......................................................................................................................... 18
Syphilis risk factors................................................................................................................................. 19
Bivariate Analysis ............................................................................................................................... 19
Multivariate Analysis .......................................................................................................................... 20
Gonorrhea risk factors............................................................................................................................. 21
Bivariate Analysis ............................................................................................................................... 21
Multivariate Analysis .......................................................................................................................... 22
DISCUSSION ............................................................................................................................................. 24
Strengths ................................................................................................................................................. 31
Weaknesses ............................................................................................................................................. 32
FUTURE DIRECTIONS ............................................................................................................................ 32
REFERENCES ........................................................................................................................................... 34
TABLES......................................................................................................................................................... 41
Table 1: Age Distribution of Sample ...................................................................................................... 41
Table 2: Prevalence of Sexually Transmitted Infections and Co-infections ........................................... 41

Table 3: Summary Table of Risk Factors: Overall ................................................................................. 42
Table 4: Summary Table of Risk Factors: Females ................................................................................ 44
Table 5: Summary Table of Significant Risk Factors: Males ................................................................. 46
Table 6: Risk factors for HIV infection .................................................................................................. 48
Table 7: Risk factors for Syphilis ........................................................................................................... 56
Table 8: Risk factors for Gonorrhea ....................................................................................................... 64
APPENDIX: IRB APPROVAL LETTER .................................................................................................. 72

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Mot-clé	HIV syphilis gonorrhea
Committee Chair / Thesis Advisor	McGowan Jr., John E, Emory University
Committee Members	Chen, Robert, CDC
Partnering Agencies	CDC

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