Delaying sexual debut as a strategy for reducing HIV epidemic in Kenya

Elijah O. Onsomu, James K. Kimani, Benta A. Abuya, Ahmed A. Arif, DaKysha Moore, Vanessa Duren-Winfield, George Harwell

Abstract

The study purpose was to determine the association between sexual debut and HIV sero-status, and factors contributing to a positive HIV sero-status.  Retrospective cross-sectional data from the Kenya Demographic and Health Survey-2003 were used.  Data on women aged 15-49 (n=3,273) and men aged 15-54 (n=2,917) accepting HIV testing were retained from three datasets.  Stata version 10.1 was used for analyses, p<0.05.  Nine percent of women and 5% of men tested positive for HIV, of whom 46% and 49%, p<0.001 were aged 16-21 respectively.  After adjusting for confounding, women and men who had sexual debut aged 16-21 were 2.31 (95% CI: 1.52-3.51), p<0.001 and 1.83 (95% CI: 1.07-3.13), p<0.05 times more likely to test positive for HIV compared to those who never had sex respectively.  Early sexual debut continues to be a major risk factor for acquiring HIV infection later in life, suggesting earlier interventions could have a major impact towards fighting the disease.  (Afr J Reprod Health 2013; 17[2]: 46-57).

Résumé

Le but de l'étude était de déterminer l'association entre l'activité sexuelle et situation sérologique du VIH et les facteurs qui contribuent à un effet positif de la situation  sérologique du VIH.   Nous nous sommes servis  des données transversales rétrospectives de l'Enquête démographique et de santé au Kenya -2003.  Les données sur les femmes âgées de 15-49 ans (n = 3273) et les hommes âges de 15-54 ans (n = 2917) qui ont accepte le dépistage du VIH ont été retenus à partir de trois ensembles de données. La version Stata 10.1 a été utilisé pour les analyses, p <0,05.  Les analyses ont révélé la présence du VIH chez neuf pour cent des femmes et 5% des hommes,  dont 46% et 49%, p <0,001 étaient âgés de 16 à 21 ans respectivement. Après l’ajustement pour les facteurs confondants, les femmes et les hommes qui ont eu leurs premiers rapports sexuels a l’âge de 16 à 21 ans  étaient 2,31 (IC à 95%: 1,52 à 3,51), p <0,001 et 1,83 (IC à 95%: 1.7 à 3.13), p <0,05 fois plus susceptibles d’avoir le résultat positif dans les analyses pour déterminer la présence du VIH par rapport à ceux qui n'ont jamais eu des rapports sexuels, respectivement. L'initiation au rapport sexuel précoce continue d'être un facteur de risque majeur de contracter l'infection du VIH plus tard dans la vie, ce qui suggère que les interventions antérieures pourraient avoir un impact majeur vers  la lutte contre la maladie. (Afr J Reprod Health 2013; 17[2]: 46-57).

 

Keywords: HIV/AIDS, HIV sero-status, Risk factors, Education, Kenya 

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References

National AIDS Control Council (NACC). HIV/AIDS data booklet; 2006.

Buvé A, Caraël M, Hayes RJ, Auvert B, Ferry B, Robinson NJ, et al. The multicenter study on factors determining the differential spread of HIV in four African cities: summary and conclusions. AIDS. 2001; 15(Suppl 4):S127-S31.

Central Bureau of Statistics (CBS) [Kenya], Ministry of Health (MOH) [Kenya], and ORC Macro. 2004. Kenya Demographic and Health Survey 2003. Calverton, Maryland: CBS, MOH, and ORC Macro. Available at: http://www.measuredhs.com/pubs/pdf/FR151/FR151. pdf. Accessed 10 February 2008.

Glynn JR, Caraël M, Auvert B, Kahindo M, Chege J, Musonda R, et al. Why do young women have a much higher prevalence of HIV than young men? A study in Kisumu, Kenya and Ndola, Zambia. AIDS. 2001; 15(sup 4):S51-S60.

Njue C, Nzioka C, Ahlberg B, Pertet AM, Voeten HA. If you don’t abstain, you will die of Aids: AIDS education in Kenyan public schools. AIDS Educ Prev. 2009; 21(2):169-79.

Maticka-Tyndale E. Sustainability of gains made in a primary school HIV prevention programme in Kenya into secondary school years. J Adolesc. 2010; 33(4):563-73.

Ministry of Education (MOE). Sector Strategic Plan 20032007. Nairobi, Kenya: Government Printer; 2003.

Mwebi BM. One teacher’s practice in a Kenyan classroom: overcoming barriers to teaching of HIV/AIDS curriculum, in Barbara Slater Stern (Editor) Curriculum and Teaching Dialogue: v. 9, Pt. 1 &2, Publisher: Information Age Publishing, Charlotte, NC, 2008; 79-95.

Kenya AIDS Indicator Survey (KAIS). Final report – September 2009; 2007. Available at:

http://www.aidskenya.org/Knowledge-

Centre/Publications. Accessed 08 January 2011.

World Health Organization (WHO). Preventing HIV/AIDS in young people: A systematic review of the evidence from developing countries; 2006. Available at whqlibdoc.who.int/trs/WHO_TRS_938_eng.pdf. Accessed 22 February 2011.

Bakilana A. Age at sexual debut in South Africa. Afr J AIDS Res. 2005; 4(1):1-5.

Konde-Lule JK, Wawer MJ, Sewankambo NK, Serwadda D, Kelly R, Li C, et al. Adolescents, sexual behavior and HIV-1 in rural Rakai District, Uganda. AIDS. 1997; 11(6):791-9.

Pettifor AE, Rees HV, Kleinschmidt I, Steffenson AE, MacPhail C, Hlongwa-Madikizela L, et al. Young people’s sexual health in South Africa: HIV prevalence and sexual behaviors from a nationally representative household survey. AIDS. 2005; 19(14):1525-34.

Pettifor AE, van der Straten A, Dunbar MS, Shiboski SC, Padian NS. Early age of first sex: a risk factor for HIV infection among women in Zimbabwe. AIDS. 2004; 18(10):1435-42.

Maticka-Tyndale E, Gallant M, Brouillard-Coyle C, Holland D, Metcalfe K, Wildish J, et al. The sexual scripts of Kenyan young people and HIV prevention. Cult Health Sex. 2005; 7(1):27-41.

Tenkorang EY, Maticka-Tyndale E. Factors influencing the timing of first sexual intercourse among young people in Nyanza, Kenya. Int Fam Plan Perspect. 2008; 34(4):177-88.

White R, Cleland J, Carael W. Links between premarital sexual behavior and extramarital intercourse: a multisite analysis. AIDS. 2000; 14(15):2323-31.

Lugalla JLP, Emmelin MAC, Mutembei AK, Comoro CJ, Killewo JZJ, Kwesigabo G, et al. The social and cultural contexts of HIV/AIDS transmission in the Kagera region, Tanzania. J Asian Afr Stud. 1999; 34(4):377-402.

National AIDS Control Council (NACC). Mainstreaming gender into the Kenya national HIV/AIDS strategic plan, 2000-2005 / the Gender and HIV/AIDS Technical Sub-Committee of the National AIDS Control Council; 2002.

Lumley T. Analysis of complex survey samples. Journal of Statistical Software. 2004; 9(1):1-19.

StataCorp. Stata Statistical Software: Release 10. College Station, Texas, StataCorp LP; 2007.

Wears RL. Advanced statistics: statistical methods for analyzing cluster and cluster-randomized data. Acad Emerge Med. 2002; 9:330-41.

Hosmer DW, Lemeshow S. Applied logistic regression. New York, NY: John Wiley & Sons, Inc.; 1989.

Carpenter LM, Kamali A, Ruberantwari A, Malamba SS, Whitworth JAG. Rates of HIV-1 transmission within marriage in rural Uganda in relation to the HIV serostatus of the partners. AIDS. 1999; 13(9):1083-89.

Agot KE, Ndinya-Achola JO, Kreiss JK, Weiss NS. Risk of HIV-1 in rural Kenya: a comparison of circumcised and uncircumcised men. Epidemiology. 2004;

(2):157-63.

Bailey RC, Moses S, Parker CB, Agot K, Maclean I, Krieger JN, et al. Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomized controlled trial. Lancet, 2007; 369(9562):643-56.

Gregson S, Nyamukapa CA, Garnett GP, Mason PR, Zhuwau T, Caraël M, et al. Sexual mixing patterns and sex-differentials in teenage exposure to HIV infection in rural Zimbabwe. Lancet. 2002;359 (9321):1896-903.

Awusabo-Asare K, Annim SK. Wealth status and risky sexual behaviour in Ghana and Kenya. Appl Health Econ Health Policy. 2008; 6(1):27-39.

Agbemenu K, Schlenk EA. An integrative review of comprehensive sex education for adolescent girls in Kenya. J Nurs Scholarsh. 2011; 43(1):54-63.

Alford S, Cheetham N, Hauser D. Science and success in developing countries: holistic programs that work to prevent teen pregnancy, HIV &sexually transmitted infections. Washington, DC: Advocates for Youth. 2005; Available at: http://www.advocatesforyouth.org /programsthatwork/developing/index.htm. Accessed 15 January 2011.

Berry S, Noble R. HIV and AIDS in Uganda. 2007; Available at: http://www.avert.org/aidssuganda.htm. Accessed 20 December 2010.

Kiragu SW. Exploring sexuality education and the burdened teacher: a participatory approach in rural primary school in Kenya. Pastoral Care in Education. 2007; 25(3):5-15.

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