Risk Factors for HIV Infection in a National Adult Population: Evidence From the 2003 Kenya Demographic and Health Survey

The authors of the current study sought to examine demographic, social, and behavioral variables as HIV risk factors among men and women in Kenya.

Data from the 2003 Kenya Demographic and Health Survey, a cross-sectional, population-based survey, were used. Survey fieldwork produced 3,273 women ages 15-49 and 2,941 men ages 15-54 years who gave consent for anonymous blood testing. HIV serostatus data for male and female participants were analyzed for their relationships to key characteristics using bivariate and multivariate techniques to asses factors associated with being HIV-positive.

Kenya's national HIV prevalence was found to be 6.7 percent. In the study sample analysis, uncircumcised men were four times more likely to be HIV-positive than those who were not. Compared to nonpolygynously married women, women who were widowed (odds ratio [OR] = 10.9), divorced (OR = 2.3), or were one of three or more wives (OR = 3.4) were at higher risk for being HIV-positive. Both men and women from Nyanza province were found to be at a particularly high risk for HIV infection (OR = 2.9 and 2.3, respectively), compared to men and women from Nairobi. Males ages 35-44 had the highest HIV risk, whereas the ages of highest risk for women were 25-29. Increased wealth was a predictor for HIV risk: the wealthiest women were 2.6 times more likely than the poorest women to be HIV-positive. Both men and women who considered themselves to be at low HIV risk were, in fact, the most likely to be HIV-positive.

"This analysis demonstrates that HIV is a multidimensional epidemic, with demographic, residential, social, biological, and behavioral factors all exerting influence on individual probability of becoming infected with HIV," the authors concluded. "Although all of these factors contribute to the risk profile for a given individual, the results suggest that differences in biological factors such as circumcision and sexually transmitted infections may be more important in assessing risk for HIV than differences in sexual behavior."

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