Male circumcision and sexual risk behaviors may contribute to considerable ethnic disparities in HIV prevalence in Kenya: an ecological analysis

dc.contributor.authorKenyon, Chris Richarden_ZA
dc.contributor.authorVu, Lungen_ZA
dc.contributor.authorMenten, Jorisen_ZA
dc.contributor.authorMaughan-Brown, Brendanen_ZA
dc.date.accessioned2016-01-11T06:53:31Z
dc.date.available2016-01-11T06:53:31Z
dc.date.issued2014en_ZA
dc.description.abstractBACKGROUND: HIV prevalence varies between 0.8 and 20.2% in Kenya's various ethnic groups. The reasons underlying these variations have not been evaluated before. METHODS: We used data from seven national surveys spanning the period 1989 to 2008 to compare the prevalence of a range of risk factors in Kenya's ethnic groups. Spearman's and linear regression were used to assess the relationship between HIV prevalence and each variable by ethnic group. RESULTS: The ethnic groups exhibited significant differences in a number of HIV related risk factors. Although the highest HIV prevalence group (the Luo) had the highest rates of HIV testing (Men 2008 survey: 56.8%, 95% CI 51.0-62.5%) and condom usage at last sex (Men 2008∶28.6%, 95% CI 19.6-37.6%), they had the lowest prevalence of circumcision (20.9%, 95% CI 15.9-26.0) the highest prevalence of sex with a non-married, non-cohabiting partner (Men: 40.2%, 95% CI 33.2-47.1%) and pre-marital sex (Men 2008∶73.9%, 95% CI 67.5-80.3%) and the youngest mean age of debut for women (1989 Survey: 15.7 years old, 95% CI 15.2-16.2). At a provincial level there was an association between the prevalence of HIV and male concurrency (Spearman's rho = 0.79, P = 0.04). Ethnic groups with higher HIV prevalence were more likely to report condom use (Men 2008 survey: R2 = 0.62, P = 0.01) and having been for HIV testing (Men 2008 survey: R2 = 0.47, P = 0.04). CONCLUSION: In addition to differences in male circumcision prevalence, variation in sexual behavior may contribute to the large variations in HIV prevalence in Kenya's ethnic groups. To complement the prevention benefits of the medical male circumcision roll-out in several parts of Kenya, interventions to reduce risky sexual behavior should continue to be promoted.en_ZA
dc.identifier.apacitationKenyon, C. R., Vu, L., Menten, J., & Maughan-Brown, B. (2014). Male circumcision and sexual risk behaviors may contribute to considerable ethnic disparities in HIV prevalence in Kenya: an ecological analysis. <i>PLoS One</i>, http://hdl.handle.net/11427/16281en_ZA
dc.identifier.chicagocitationKenyon, Chris Richard, Lung Vu, Joris Menten, and Brendan Maughan-Brown "Male circumcision and sexual risk behaviors may contribute to considerable ethnic disparities in HIV prevalence in Kenya: an ecological analysis." <i>PLoS One</i> (2014) http://hdl.handle.net/11427/16281en_ZA
dc.identifier.citationKenyon, C. R., Vu, L., Menten, J., & Maughan-Brown, B. (2013). Male circumcision and sexual risk behaviors may contribute to considerable ethnic disparities in HIV prevalence in Kenya: an ecological analysis. PloS one, 9(8), e106230. doi:10.1371/journal.pone.0106230en_ZA
dc.identifier.ris TY - Journal Article AU - Kenyon, Chris Richard AU - Vu, Lung AU - Menten, Joris AU - Maughan-Brown, Brendan AB - BACKGROUND: HIV prevalence varies between 0.8 and 20.2% in Kenya's various ethnic groups. The reasons underlying these variations have not been evaluated before. METHODS: We used data from seven national surveys spanning the period 1989 to 2008 to compare the prevalence of a range of risk factors in Kenya's ethnic groups. Spearman's and linear regression were used to assess the relationship between HIV prevalence and each variable by ethnic group. RESULTS: The ethnic groups exhibited significant differences in a number of HIV related risk factors. Although the highest HIV prevalence group (the Luo) had the highest rates of HIV testing (Men 2008 survey: 56.8%, 95% CI 51.0-62.5%) and condom usage at last sex (Men 2008∶28.6%, 95% CI 19.6-37.6%), they had the lowest prevalence of circumcision (20.9%, 95% CI 15.9-26.0) the highest prevalence of sex with a non-married, non-cohabiting partner (Men: 40.2%, 95% CI 33.2-47.1%) and pre-marital sex (Men 2008∶73.9%, 95% CI 67.5-80.3%) and the youngest mean age of debut for women (1989 Survey: 15.7 years old, 95% CI 15.2-16.2). At a provincial level there was an association between the prevalence of HIV and male concurrency (Spearman's rho = 0.79, P = 0.04). Ethnic groups with higher HIV prevalence were more likely to report condom use (Men 2008 survey: R2 = 0.62, P = 0.01) and having been for HIV testing (Men 2008 survey: R2 = 0.47, P = 0.04). CONCLUSION: In addition to differences in male circumcision prevalence, variation in sexual behavior may contribute to the large variations in HIV prevalence in Kenya's ethnic groups. To complement the prevention benefits of the medical male circumcision roll-out in several parts of Kenya, interventions to reduce risky sexual behavior should continue to be promoted. DA - 2014 DB - OpenUCT DO - 10.1371/journal.pone.0106230 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 T1 - Male circumcision and sexual risk behaviors may contribute to considerable ethnic disparities in HIV prevalence in Kenya: an ecological analysis TI - Male circumcision and sexual risk behaviors may contribute to considerable ethnic disparities in HIV prevalence in Kenya: an ecological analysis UR - http://hdl.handle.net/11427/16281 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/16281
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0106230
dc.identifier.vancouvercitationKenyon CR, Vu L, Menten J, Maughan-Brown B. Male circumcision and sexual risk behaviors may contribute to considerable ethnic disparities in HIV prevalence in Kenya: an ecological analysis. PLoS One. 2014; http://hdl.handle.net/11427/16281.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentInstitute of Infectious Disease and Molecular Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2014 Kenyon et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherHIVen_ZA
dc.subject.otherEthnic epidemiologyen_ZA
dc.subject.otherCircumcisionen_ZA
dc.subject.otherEthnic groupsen_ZA
dc.subject.otherHIV epidemiologyen_ZA
dc.subject.otherSomalisen_ZA
dc.subject.otherSurveysen_ZA
dc.subject.otherKenyaen_ZA
dc.titleMale circumcision and sexual risk behaviors may contribute to considerable ethnic disparities in HIV prevalence in Kenya: an ecological analysisen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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