Identifying At-Risk Populations in Kenya and South Africa

Price, Matthew A.; Rida, Wasima; Mwangome, Mary; Mutua, Gaudensia; Middelkoop, Keren; Roux, Surita; Okuku, Haile Selassie; Bekker, Linda‐Gail; Anzala, Omu; Ngugi, Elizabeth; Stevens, Gwynneth; Chetty, Paramesh; Amornkul, Pauli N.; Sanders, Eduard J.

doi:10.1097/qai.0b013e31823d8693

Cited by 108 publications

(59 citation statements)

References 36 publications

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“…Demographic factors suggest that social vulnerability, including low education, poor housing and no regular income, are risk factors for HIV infection in this population (5, 9–11), as it has been found in the South African population in general (49). Most behavioral variables are bivariately associated with HIV infection in the expected direction.…”

Section: Discussionmentioning

confidence: 70%

“…Studies have shown that older MSM are more likely to be infected than younger MSM (8, 10, 11, 15, 17, 18, 21, 22), although incidence seems higher among younger MSM (7). HIV infection also seems to be associated with indicators of social vulnerability, including lower levels of education (9, 10), being unemployed (5), and low income (11). Behavioral risk factors for HIV infection in sub-Saharan MSM include having engaged in receptive anal intercourse (6, 8, 9, 11), number of sexual partners (15, 16), having been paid for sex (12, 16, 18, 21) (while having paid for sex seems to be a protective factor (9)), and having experienced violence (5, 17, 22).…”

Section: Introductionmentioning

confidence: 99%

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Gender Expression and Risk of HIV Infection Among Black South African Men Who Have Sex with Men

et al. 2015

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To explore demographic, behavioral and psychosocial risk factors for HIV infection in South African MSM we recruited 480 MSM (aged 18 and 44 years) using respondent-driven sampling. Data were collected through individual computer-assisted face-to-face interviews. Participants were tested for HIV. RDS-adjusted HIV prevalence is 30.1% (unadjusted 35.6%). Few participants had ever engaged in both receptive and insertive anal sex; sex with women was frequently reported. Independent demographic and behavioral correlates of HIV infection include age, education, number of male sexual partners, ever having been forced to have sex, and ever having engaged in transactional sex; engagement in sex with women was a protective factor. Psychosocial risk factors independently associated with HIV infection were feminine identification, internalized homophobia, and hazardous drinking. Our findings confirm what has been found in other studies, but also suggest that the dynamics and context of sexual transmission among MSM in South Africa differ from those among MSM in Western countries.

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Section: Discussionmentioning

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Gender Expression and Risk of HIV Infection Among Black South African Men Who Have Sex with Men

et al. 2015

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“…In Kenya, incidence of HIV was of 6/100 PY in Kilifi and 10/100 PY in Nairobi. 22 Another study conducted in coastal Kenya found an HIV-1 incidence of 6/100 PY among men who have sex with men and women and 35/100 PY among men who have sex with men exclusively. 23 …”

Section: Men Who Have Sex With Men (Msm)mentioning

confidence: 99%

“… * An additional study 22 was not included due to the small numbers of sex workers included for HIV incidence measurement …”

Section: Tablementioning

confidence: 99%

Concentrated HIV subepidemics in generalized epidemic settings

Tanser

Oliveira

Maheu‐Giroux

et al. 2014

Current Opinion in HIV and AIDS

118

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Purpose of review A relatively neglected topic to date has been the occurrence of concentrated epidemics within generalized epidemic settings and the potential role of targeted interventions in such settings. We review recent studies in high-risk groups as well as findings relating to geographical heterogeneity and the potential for targeting ‘high-transmission zones’ in the ten highest HIV prevalence countries in sub-Saharan Africa and the world. Recent findings Recent studies have confirmed earlier findings that, even in the context of generalized epidemics, men who have sex with men (MSM) have a substantially higher prevalence than the general population. Estimates of prevalence of HIV among people who inject drugs (PWID) in sub-Saharan countries are rarely available and, when they are, often outdated. We identified recent studies of sex workers (SW) in Kenya and Uganda. In all three cases – MSM, PWID and SW – HIV prevalence estimates are mostly based on convenience. Moreover, good estimates of the total size of these populations are not available. Our review of recent studies of high-risk populations defined on the basis of geography showed very high levels of both new and existing infections in Kenya (slums), South Africa (peri-urban communities) and Uganda (fishing villages). Summary Recent empirical findings combined with evidence from phylogenetic studies and supported by mathematical models provide a clear rationale for testing the feasibility, acceptability, and effectiveness of targeted HIV prevention approaches in hyper-endemic populations to supplement measures aimed at the general population.

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“…New HIV infection rate of 3.9 per 100 person-years was observed among men reporting high-risk sexual behavior [26] and 5.8 per 100 person-years among bisexual MSM [27] in Costal Kenya. Similarly, HIV incidence of 6.1 per 100 person-years was found among exclusive MSM in Mombasa, Kenya [28], while 3.4 per 100 person-years [29] and 5.4 per 100 person-years [30] observed among MSM in China. Moreover, HIV acquisition rate of 5.8 per 100 person-years was shown among patients and commercial sex workers attending STI clinics in Pune, India [31] and 3.66 per 100 person-years observed among female sex workers in Kampala, Uganda [32].…”

Section: Hiv Incidence Ratementioning

confidence: 99%

Prevalence and Incidence of HIV Infection among Fishermen along Lake Victoria Beaches in Kisumu County, Kenya

Ondondo¹,

Ng’ang’a²,

Mpoke³

et al. 2014

WJA

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Background: Herpes simplex virus type-2 (HSV-2) and human papillomavirus (HPV) are common sexually transmitted infections (STIs) among fishing communities and are associated with high HIV prevalence in this underserved population. However, there is limited knowledge on HIV incidence among fishermen. This study aimed at determining prevalence, incidence and risk factors associated with HIV infection among fishermen in Kisumu Kenya. Methods: Three hundred fishermen were evaluated for baseline HIV, HSV-2, HPV infection and a structured questionnaire administered. HIV incidence was assessed after 12 months among those initially HIV negative. HIV incidence rate in person-years and prevalence were estimated.

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Identifying At-Risk Populations in Kenya and South Africa

Cited by 108 publications

References 36 publications

Gender Expression and Risk of HIV Infection Among Black South African Men Who Have Sex with Men

Gender Expression and Risk of HIV Infection Among Black South African Men Who Have Sex with Men

Concentrated HIV subepidemics in generalized epidemic settings

Prevalence and Incidence of HIV Infection among Fishermen along Lake Victoria Beaches in Kisumu County, Kenya

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