Are slum dwellers at heightened risk of HIV infection than other urban residents? Evidence from population-based HIV prevalence surveys in Kenya
Identifieur interne : 002470 ( Pmc/Curation ); précédent : 002469; suivant : 002471Are slum dwellers at heightened risk of HIV infection than other urban residents? Evidence from population-based HIV prevalence surveys in Kenya
Auteurs : Nyovani J. Madise [Royaume-Uni] ; Abdhalah K. Ziraba [Royaume-Uni] ; Joseph Inungu [Bénin] ; Samoel A. Khamadi [Kenya] ; Alex Ezeh [Kenya] ; Eliya M. Zulu [Kenya] ; John Kebaso [États-Unis] ; Vincent Okoth [Kenya] ; Matilu Mwau [Kenya]Source :
- Health & Place [ 1353-8292 ] ; 2012.
Abstract
In 2008, the global urban population surpassed the rural population and by 2050 more than 6 billion will be living in urban centres. A growing body of research has reported on poor health outcomes among the urban poor but not much is known about HIV prevalence among this group. A survey of nearly 3000 men and women was conducted in two Nairobi slums in Kenya between 2006 and 2007, where respondents were tested for HIV status. In addition, data from the 2008/2009 Kenya Demographic and Health Survey were used to compare HIV prevalence between slum residents and those living in other urban and rural areas. The results showed strong intra-urban differences. HIV was 12% among slum residents compared with 5% and 6% among non-slum urban and rural residents, respectively. Generally, men had lower HIV prevalence than women although in the slums the gap was narrower. Among women, sexual experience before the age of 15 compared with after 19 years was associated with 62% higher odds of being HIV positive. There was ethnic variation in patterns of HIV infection although the effect depended on the current place of residence.
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DOI: 10.1016/j.healthplace.2012.04.003
PubMed: 22591621
PubMed Central: 3427858
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Madise</name><affiliation wicri:level="1"><nlm:aff id="aff1">University of Southampton, Division of Social Statistics and Centre for Global Health, Population, Poverty, and Policy, University of Southampton, Southampton SO17 1BJ, United Kingdom</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>University of Southampton, Division of Social Statistics and Centre for Global Health, Population, Poverty, and Policy, University of Southampton, Southampton SO17 1BJ</wicri:regionArea></affiliation></author><author><name sortKey="Ziraba, Abdhalah K" sort="Ziraba, Abdhalah K" uniqKey="Ziraba A" first="Abdhalah K." last="Ziraba">Abdhalah K. 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Evidence from population-based HIV prevalence surveys in Kenya</title><author><name sortKey="J Madise, Nyovani" sort="J Madise, Nyovani" uniqKey="J Madise N" first="Nyovani" last="J. Madise">Nyovani J. Madise</name><affiliation wicri:level="1"><nlm:aff id="aff1">University of Southampton, Division of Social Statistics and Centre for Global Health, Population, Poverty, and Policy, University of Southampton, Southampton SO17 1BJ, United Kingdom</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>University of Southampton, Division of Social Statistics and Centre for Global Health, Population, Poverty, and Policy, University of Southampton, Southampton SO17 1BJ</wicri:regionArea></affiliation></author><author><name sortKey="Ziraba, Abdhalah K" sort="Ziraba, Abdhalah K" uniqKey="Ziraba A" first="Abdhalah K." last="Ziraba">Abdhalah K. Ziraba</name><affiliation wicri:level="1"><nlm:aff id="aff2">Faculty of Epidemiology and Population Health, Department for Population Studies, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Faculty of Epidemiology and Population Health, Department for Population Studies, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT</wicri:regionArea></affiliation></author><author><name sortKey="Inungu, Joseph" sort="Inungu, Joseph" uniqKey="Inungu J" first="Joseph" last="Inungu">Joseph Inungu</name><affiliation wicri:level="1"><nlm:aff id="aff3">Population Services International, 08 BP 0876 Tri Postal, Cotonou, Benin</nlm:aff><country xml:lang="fr">Bénin</country><wicri:regionArea>Population Services International, 08 BP 0876 Tri Postal, Cotonou</wicri:regionArea></affiliation></author><author><name sortKey="Khamadi, Samoel A" sort="Khamadi, Samoel A" uniqKey="Khamadi S" first="Samoel A." last="Khamadi">Samoel A. Khamadi</name><affiliation wicri:level="1"><nlm:aff id="aff4">Kenya Medical Research Institute, P.O. Box 54840-00200, Nairobi, Kenya</nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Kenya Medical Research Institute, P.O. Box 54840-00200, Nairobi</wicri:regionArea></affiliation></author><author><name sortKey="Ezeh, Alex" sort="Ezeh, Alex" uniqKey="Ezeh A" first="Alex" last="Ezeh">Alex Ezeh</name><affiliation wicri:level="1"><nlm:aff id="aff5">African Population and Health Research Center, P.O. Box 10787, 00100 GPO, Nairobi, Kenya</nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>African Population and Health Research Center, P.O. Box 10787, 00100 GPO, Nairobi</wicri:regionArea></affiliation></author><author><name sortKey="Zulu, Eliya M" sort="Zulu, Eliya M" uniqKey="Zulu E" first="Eliya M." last="Zulu">Eliya M. Zulu</name><affiliation wicri:level="1"><nlm:aff id="aff6">African Institute for Development Policy (AFIDEP), P.O. Box 14688-00800, Nairobi, Kenya</nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>African Institute for Development Policy (AFIDEP), P.O. Box 14688-00800, Nairobi</wicri:regionArea></affiliation></author><author><name sortKey="Kebaso, John" sort="Kebaso, John" uniqKey="Kebaso J" first="John" last="Kebaso">John Kebaso</name><affiliation wicri:level="1"><nlm:aff id="aff7">Loma Linda University, School of Public Health, 24951 North Circle Drive, Nichol Hall 1410, Loma Linda, CA 92350, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Loma Linda University, School of Public Health, 24951 North Circle Drive, Nichol Hall 1410, Loma Linda, CA 92350</wicri:regionArea></affiliation></author><author><name sortKey="Okoth, Vincent" sort="Okoth, Vincent" uniqKey="Okoth V" first="Vincent" last="Okoth">Vincent Okoth</name><affiliation wicri:level="1"><nlm:aff id="aff4">Kenya Medical Research Institute, P.O. Box 54840-00200, Nairobi, Kenya</nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Kenya Medical Research Institute, P.O. Box 54840-00200, Nairobi</wicri:regionArea></affiliation></author><author><name sortKey="Mwau, Matilu" sort="Mwau, Matilu" uniqKey="Mwau M" first="Matilu" last="Mwau">Matilu Mwau</name><affiliation wicri:level="1"><nlm:aff id="aff4">Kenya Medical Research Institute, P.O. Box 54840-00200, Nairobi, Kenya</nlm:aff><country xml:lang="fr">Kenya</country><wicri:regionArea>Kenya Medical Research Institute, P.O. Box 54840-00200, Nairobi</wicri:regionArea></affiliation></author></analytic><series><title level="j">Health & Place</title><idno type="ISSN">1353-8292</idno><idno type="eISSN">1873-2054</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>In 2008, the global urban population surpassed the rural population and by 2050 more than 6 billion will be living in urban centres. A growing body of research has reported on poor health outcomes among the urban poor but not much is known about HIV prevalence among this group. A survey of nearly 3000 men and women was conducted in two Nairobi slums in Kenya between 2006 and 2007, where respondents were tested for HIV status. In addition, data from the 2008/2009 Kenya Demographic and Health Survey were used to compare HIV prevalence between slum residents and those living in other urban and rural areas. The results showed strong intra-urban differences. HIV was 12% among slum residents compared with 5% and 6% among non-slum urban and rural residents, respectively. Generally, men had lower HIV prevalence than women although in the slums the gap was narrower. Among women, sexual experience before the age of 15 compared with after 19 years was associated with 62% higher odds of being HIV positive. There was ethnic variation in patterns of HIV infection although the effect depended on the current place of residence.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Adedimeji, A A" uniqKey="Adedimeji A">A.A. Adedimeji</name></author><author><name sortKey="Omololu, F O" uniqKey="Omololu F">F.O. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Health Place</journal-id><journal-id journal-id-type="iso-abbrev">Health Place</journal-id><journal-title-group><journal-title>Health & Place</journal-title></journal-title-group><issn pub-type="ppub">1353-8292</issn><issn pub-type="epub">1873-2054</issn><publisher><publisher-name>Elsevier</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">22591621</article-id><article-id pub-id-type="pmc">3427858</article-id><article-id pub-id-type="publisher-id">S1353-8292(12)00065-2</article-id><article-id pub-id-type="doi">10.1016/j.healthplace.2012.04.003</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Are slum dwellers at heightened risk of HIV infection than other urban residents? Evidence from population-based HIV prevalence surveys in Kenya</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>J. Madise</surname><given-names>Nyovani</given-names></name><email>N.J.Madise@soton.ac.uk</email><xref rid="aff1" ref-type="aff">a</xref><xref rid="cor1" ref-type="corresp">⁎</xref></contrib><contrib contrib-type="author"><name><surname>Ziraba</surname><given-names>Abdhalah K.</given-names></name><email>abdhalah.ziraba@lshtm.ac.uk</email><xref rid="aff2" ref-type="aff">b</xref></contrib><contrib contrib-type="author"><name><surname>Inungu</surname><given-names>Joseph</given-names></name><email>jinungu@psi.org</email><xref rid="aff3" ref-type="aff">c</xref></contrib><contrib contrib-type="author"><name><surname>Khamadi</surname><given-names>Samoel A.</given-names></name><email>SKhamadi@kemri.org</email><xref rid="aff4" ref-type="aff">d</xref></contrib><contrib contrib-type="author"><name><surname>Ezeh</surname><given-names>Alex</given-names></name><email>aezeh@aphrc.org</email><xref rid="aff5" ref-type="aff">e</xref></contrib><contrib contrib-type="author"><name><surname>Zulu</surname><given-names>Eliya M.</given-names></name><email>Eliya.Zulu@afidep.org</email><xref rid="aff6" ref-type="aff">f</xref></contrib><contrib contrib-type="author"><name><surname>Kebaso</surname><given-names>John</given-names></name><email>jkebaso@gmail.com</email><xref rid="aff7" ref-type="aff">g</xref></contrib><contrib contrib-type="author"><name><surname>Okoth</surname><given-names>Vincent</given-names></name><email>VOkoth@kemri.org</email><xref rid="aff4" ref-type="aff">d</xref></contrib><contrib contrib-type="author"><name><surname>Mwau</surname><given-names>Matilu</given-names></name><email>MMWau@kemri.org</email><xref rid="aff4" ref-type="aff">d</xref></contrib></contrib-group><aff id="aff1"><label>a</label>University of Southampton, Division of Social Statistics and Centre for Global Health, Population, Poverty, and Policy, University of Southampton, Southampton SO17 1BJ, United Kingdom</aff><aff id="aff2"><label>b</label>Faculty of Epidemiology and Population Health, Department for Population Studies, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom</aff><aff id="aff3"><label>c</label>Population Services International, 08 BP 0876 Tri Postal, Cotonou, Benin</aff><aff id="aff4"><label>d</label>Kenya Medical Research Institute, P.O. Box 54840-00200, Nairobi, Kenya</aff><aff id="aff5"><label>e</label>African Population and Health Research Center, P.O. Box 10787, 00100 GPO, Nairobi, Kenya</aff><aff id="aff6"><label>f</label>African Institute for Development Policy (AFIDEP), P.O. Box 14688-00800, Nairobi, Kenya</aff><aff id="aff7"><label>g</label>Loma Linda University, School of Public Health, 24951 North Circle Drive, Nichol Hall 1410, Loma Linda, CA 92350, USA</aff><author-notes><corresp id="cor1"><label>⁎</label>Corresponding author. Tel.: +44 2380 592534. <email>N.J.Madise@soton.ac.uk</email></corresp></author-notes><pub-date pub-type="pmc-release"><day>1</day><month>9</month><year>2012</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="ppub"><month>9</month><year>2012</year></pub-date><volume>18</volume><issue>5</issue><fpage>1144</fpage><lpage>1152</lpage><history><date date-type="received"><day>10</day><month>11</month><year>2011</year></date><date date-type="rev-recd"><day>11</day><month>4</month><year>2012</year></date><date date-type="accepted"><day>11</day><month>4</month><year>2012</year></date></history><permissions><copyright-statement>© 2012 Elsevier Ltd.</copyright-statement><copyright-year>2012</copyright-year><copyright-holder>Elsevier Ltd</copyright-holder><license xlink:href="https://creativecommons.org/licenses/by/3.0/"><license-p>Open Access under <ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by/3.0/">CC BY 3.0</ext-link> license</license-p></license></permissions><abstract><p>In 2008, the global urban population surpassed the rural population and by 2050 more than 6 billion will be living in urban centres. A growing body of research has reported on poor health outcomes among the urban poor but not much is known about HIV prevalence among this group. A survey of nearly 3000 men and women was conducted in two Nairobi slums in Kenya between 2006 and 2007, where respondents were tested for HIV status. In addition, data from the 2008/2009 Kenya Demographic and Health Survey were used to compare HIV prevalence between slum residents and those living in other urban and rural areas. The results showed strong intra-urban differences. HIV was 12% among slum residents compared with 5% and 6% among non-slum urban and rural residents, respectively. Generally, men had lower HIV prevalence than women although in the slums the gap was narrower. Among women, sexual experience before the age of 15 compared with after 19 years was associated with 62% higher odds of being HIV positive. There was ethnic variation in patterns of HIV infection although the effect depended on the current place of residence.</p></abstract><abstract abstract-type="graphical"><title>Highlights</title><p>► HIV prevalence in Nairobi slums is 12%, compared with 5% among non-slum urban residents, and 6% in rural areas. ► HIV prevalence in Kenyan urban areas is principally fuelled by very high HIV infection rates in slum areas. ► Women who have first sexual intercourse at early ages are at increased risk of becoming HIV infected. ► In Kenya there are strong patterns of HIV infection by ethnicity but living in urban areas dilutes this effect.</p></abstract><kwd-group><title>Keywords</title><kwd>HIV prevalence</kwd><kwd>Intra-urban</kwd><kwd>Slums</kwd><kwd>Kenya</kwd></kwd-group></article-meta></front><floats-group><fig id="f0005"><label>Fig. 1</label><caption><p>Conceptual framework of the relationship between HIV status and slum residence.</p></caption><graphic xlink:href="gr1"></graphic></fig><fig id="f0010"><label>Fig. 2</label><caption><p>HIV prevalence among men and women by age and place: 2006/2007 Nairobi Slum HIV prevalence study and 2008/2009 Kenya DHS.</p></caption><graphic xlink:href="gr2"></graphic></fig><fig id="f0015"><label>Fig. 3</label><caption><p>Estimated probabilities of being HIV positive among women by place of residence and ethnicity: 2006/2007 Nairobi Slum HIV Prevalence Survey and 2008/2009 Kenya DHS.</p></caption><graphic xlink:href="gr3"></graphic></fig><table-wrap id="t0005" position="float"><label>Table 1</label><caption><p>Percentage distribution of respondents by selected background characteristics, 2006/2007 Nairobi Slum HIV Prevalence Survey (NSHPS) and 2008/2009 Kenya Demographic and Health Survey (KDHS).</p></caption><table frame="hsides" rules="groups"><thead><tr><th rowspan="2"></th><th colspan="2">Nairobi slums (NSHPS)<hr></hr></th><th colspan="2">Nairobi non-slum (KDHS)<hr></hr></th><th colspan="2">Other slums (KDHS)<hr></hr></th><th colspan="2">Non-slum other urban (KDHS)<hr></hr></th><th colspan="2">Rural (KDHS)<hr></hr></th></tr><tr><th>%</th><th><italic>N</italic></th><th>%</th><th><italic>N</italic></th><th>%</th><th><italic>N</italic></th><th>%</th><th><italic>N</italic></th><th>%</th><th><italic>N</italic></th></tr></thead><tbody><tr><td><bold>Total</bold></td><td align="char"><bold>29.1</bold></td><td align="char"><bold>2742</bold></td><td align="char"><bold>6.0</bold></td><td align="char"><bold>584</bold></td><td align="char"><bold>3.2</bold></td><td><bold>306</bold></td><td align="char"><bold>8.2</bold></td><td align="char"><bold>1076</bold></td><td align="char"><bold>53.5</bold></td><td align="char"><bold>5048</bold></td></tr><tr><td colspan="11"><bold>Age groups</bold></td></tr><tr><td>15–19</td><td align="char">15.2</td><td align="char">413</td><td align="char">11.4</td><td align="char">66</td><td align="char">14.4</td><td align="char">44</td><td align="char">15.3</td><td align="char">165</td><td align="char">25.5</td><td align="char">1288</td></tr><tr><td>20–24</td><td align="char">23.4</td><td align="char">636</td><td align="char">24.3</td><td align="char">142</td><td align="char">21.2</td><td align="char">65</td><td align="char">20.9</td><td align="char">224</td><td align="char">18.8</td><td align="char">947</td></tr><tr><td>25–29</td><td align="char">20.7</td><td align="char">564</td><td align="char">23.9</td><td align="char">139</td><td align="char">21.9</td><td align="char">67</td><td align="char">22.0</td><td align="char">236</td><td align="char">14.2</td><td align="char">717</td></tr><tr><td>30–34</td><td align="char">15.0</td><td align="char">409</td><td align="char">15.8</td><td align="char">92</td><td align="char">15.7</td><td align="char">48</td><td align="char">15.8</td><td align="char">170</td><td align="char">13.6</td><td align="char">687</td></tr><tr><td>35–39</td><td align="char">11.5</td><td align="char">314</td><td align="char">11.1</td><td align="char">65</td><td align="char">8.2</td><td align="char">25</td><td align="char">10.1</td><td align="char">109</td><td align="char">9.4</td><td align="char">477</td></tr><tr><td>40–44</td><td align="char">7.5</td><td align="char">205</td><td align="char">8.1</td><td align="char">48</td><td align="char">13.4</td><td align="char">41</td><td align="char">10</td><td align="char">107</td><td align="char">9.5</td><td align="char">481</td></tr><tr><td>45+</td><td align="char">6.6</td><td align="char">180</td><td align="char">5.5</td><td align="char">32</td><td align="char">[5.2]</td><td align="char">16</td><td align="char">5.9</td><td align="char">63</td><td align="char">8.9</td><td align="char">450</td></tr><tr><td colspan="11"></td></tr><tr><td colspan="11"><bold>Sex</bold></td></tr><tr><td>Female</td><td align="char">63</td><td align="char">1713</td><td align="char">49</td><td align="char">287</td><td align="char">58.5</td><td align="char">179</td><td align="char">53.4</td><td align="char">575</td><td align="char">55.1</td><td align="char">2779</td></tr><tr><td>Male</td><td align="char">37</td><td align="char">1008</td><td align="char">51</td><td align="char">297</td><td align="char">41.5</td><td align="char">127</td><td align="char">46.6</td><td align="char">501</td><td align="char">44.9</td><td align="char">2268</td></tr><tr><td colspan="11"></td></tr><tr><td colspan="11"><bold>Age at first sex</bold></td></tr><tr><td><15 years</td><td align="char">14.8</td><td align="char">403</td><td align="char">8.7</td><td align="char">51</td><td align="char">13.7</td><td align="char">42</td><td align="char">10.1</td><td align="char">108</td><td align="char">17.1</td><td align="char">861</td></tr><tr><td>15–19 years</td><td align="char">53.4</td><td align="char">1452</td><td align="char">55.9</td><td align="char">327</td><td align="char">47.7</td><td align="char">146</td><td align="char">51.1</td><td align="char">549</td><td align="char">48.2</td><td align="char">2435</td></tr><tr><td>20+ years</td><td align="char">14.5</td><td align="char">394</td><td align="char">22.0</td><td align="char">129</td><td align="char">23.9</td><td align="char">73</td><td align="char">21.6</td><td align="char">232</td><td align="char">12.5</td><td align="char">633</td></tr><tr><td>Never had sex</td><td align="char">12.8</td><td align="char">348</td><td align="char">10.7</td><td align="char">63</td><td align="char">9.8</td><td align="char">30</td><td align="char">13.4</td><td align="char">144</td><td align="char">18.2</td><td align="char">918</td></tr><tr><td>Inconsistent/refused</td><td align="char">4.6</td><td align="char">124</td><td align="char">2.6</td><td align="char">15</td><td align="char">[4.9]</td><td align="char">15</td><td align="char">3.8</td><td align="char">41</td><td align="char">4.0</td><td align="char">201</td></tr><tr><td colspan="11"></td></tr><tr><td colspan="11"><bold>Current marital status</bold></td></tr><tr><td>Never married</td><td align="char">27.1</td><td align="char">737</td><td align="char">42.6</td><td align="char">249</td><td align="char">24.5</td><td align="char">75</td><td align="char">30.2</td><td align="char">324</td><td align="char">40.2</td><td align="char">2028</td></tr><tr><td>Currently in union</td><td align="char">62.4</td><td align="char">1697</td><td align="char">53.1</td><td align="char">310</td><td align="char">59.5</td><td align="char">182</td><td align="char">61.4</td><td align="char">660</td><td align="char">52.0</td><td align="char">2626</td></tr><tr><td>Formerly married</td><td align="char">10.5</td><td align="char">287</td><td align="char">4.4</td><td align="char">25</td><td align="char">16.0</td><td align="char">49</td><td align="char">8.4</td><td align="char">91</td><td align="char">7.8</td><td align="char">393</td></tr><tr><td colspan="11"></td></tr><tr><td colspan="11"><bold>Highest education</bold></td></tr><tr><td>None</td><td align="char">3.8</td><td align="char">103</td><td align="char">1.9</td><td align="char">11</td><td align="char">9.5</td><td align="char">29</td><td align="char">4.1</td><td align="char">45</td><td align="char">7.2</td><td align="char">362</td></tr><tr><td>Primary</td><td align="char">64.7</td><td align="char">1761</td><td align="char">25.0</td><td align="char">146</td><td align="char">54.9</td><td align="char">168</td><td align="char">38.9</td><td align="char">418</td><td align="char">62.6</td><td align="char">3111</td></tr><tr><td>Secondray or higher</td><td align="char">31.5</td><td align="char">857</td><td align="char">73.1</td><td align="char">427</td><td align="char">35.6</td><td align="char">109</td><td align="char">57</td><td align="char">612</td><td align="char">31.2</td><td align="char">1575</td></tr><tr><td colspan="11"></td></tr><tr><td colspan="11"><bold>Ethnicity</bold></td></tr><tr><td>Kikuyu</td><td align="char">30.4</td><td align="char">827</td><td align="char">33.3</td><td align="char">194</td><td align="char">11.8</td><td align="char">36</td><td align="char">24.3</td><td align="char">262</td><td align="char">15.7</td><td align="char">790</td></tr><tr><td>Kamba</td><td align="char">19.0</td><td align="char">517</td><td align="char">14.1</td><td align="char">82</td><td align="char">[3.9]</td><td align="char">12</td><td align="char">7.5</td><td align="char">81</td><td align="char">11.6</td><td align="char">587</td></tr><tr><td>Luhya</td><td align="char">16.5</td><td align="char">449</td><td align="char">17.5</td><td align="char">102</td><td align="char">24.6</td><td align="char">75</td><td align="char">17.8</td><td align="char">192</td><td align="char">15.9</td><td align="char">802</td></tr><tr><td>Luo</td><td align="char">19.1</td><td align="char">521</td><td align="char">15.3</td><td align="char">90</td><td align="char">13.4</td><td align="char">41</td><td align="char">10.7</td><td align="char">115</td><td align="char">13.1</td><td align="char">663</td></tr><tr><td>Others</td><td align="char">15.0</td><td align="char">407</td><td align="char">19.9</td><td align="char">116</td><td align="char">46.2</td><td align="char">141</td><td align="char">39.6</td><td align="char">426</td><td align="char">43.7</td><td align="char">2204</td></tr></tbody></table><table-wrap-foot><fn><p>[ ] Based on fewer than 25 cases.</p></fn></table-wrap-foot></table-wrap><table-wrap id="t0010" position="float"><label>Table 2</label><caption><p>Percentage respondents HIV positive by selected characteristics and place of residence. Nairobi Slum HIV Prevalence Survey (NSHPS), 2006/2007, Kenya Demographic and Health Survey (KDHS), 2008/2009.</p></caption><table frame="hsides" rules="groups"><thead><tr><th></th><th colspan="4"><bold>Slum areas (NSHPS)</bold><hr></hr></th><th colspan="4"><bold>Non-slum urban (KDHS)</bold><hr></hr></th><th colspan="4"><bold>Rural (KDHS)</bold><hr></hr></th></tr><tr><th><bold>Characteristic</bold></th><th><bold>Men</bold></th><th><bold>Women</bold></th><th><bold>All</bold></th><th><italic><bold>n</bold></italic></th><th><bold>Men</bold></th><th><bold>Women</bold></th><th><bold>All</bold></th><th><italic><bold>n</bold></italic></th><th><bold>Men</bold></th><th><bold>Women</bold></th><th><bold>All</bold></th><th><italic><bold>n</bold></italic></th></tr></thead><tbody><tr><td><bold>Total</bold></td><td align="char">9.5</td><td align="char">13.2</td><td align="char">11.8</td><td align="char">3048</td><td align="char">2.9</td><td align="char">7.7</td><td align="char">5.3</td><td align="char">1332</td><td align="char">4.5</td><td align="char">7.2</td><td align="char">6</td><td align="char">5048</td></tr><tr><td colspan="13"><bold>Age group</bold></td></tr><tr><td>15–19</td><td align="char">2.7</td><td align="char">6.0</td><td align="char">5.0</td><td align="char">463</td><td align="char">1.0</td><td align="char">0.0</td><td align="char">0.6</td><td align="char">66</td><td align="char">0.6</td><td align="char">3.0</td><td align="char">1.8</td><td align="char">1288</td></tr><tr><td>20–24</td><td align="char">2.9</td><td align="char">8.4</td><td align="char">7.2</td><td align="char">705</td><td align="char">0.8</td><td align="char">6.0</td><td align="char">3.4</td><td align="char">142</td><td align="char">1.8</td><td align="char">6.5</td><td align="char">4.3</td><td align="char">948</td></tr><tr><td>25–29</td><td align="char">6.5</td><td align="char">15.1</td><td align="char">12</td><td align="char">635</td><td align="char">4.3</td><td align="char">5.4</td><td align="char">4.9</td><td align="char">139</td><td align="char">8.3</td><td align="char">11.4</td><td align="char">10.2</td><td align="char">717</td></tr><tr><td>30–34</td><td align="char">10.5</td><td align="char">17.2</td><td align="char">14.2</td><td align="char">459</td><td align="char">4.5</td><td align="char">18.6</td><td align="char">11.3</td><td align="char">92</td><td align="char">6.8</td><td align="char">8.4</td><td align="char">7.7</td><td align="char">687</td></tr><tr><td>35–39</td><td align="char">17.1</td><td align="char">18.5</td><td align="char">17.8</td><td align="char">342</td><td align="char">5.3</td><td align="char">5.6</td><td align="char">4.8</td><td align="char">65</td><td align="char">11.7</td><td align="char">8.9</td><td align="char">10.1</td><td align="char">477</td></tr><tr><td>40–44</td><td align="char">10.6</td><td align="char">23.6</td><td align="char">18.1</td><td align="char">248</td><td align="char">1.7</td><td align="char">14.8</td><td align="char">8.8</td><td align="char">48</td><td align="char">6.0</td><td align="char">9.8</td><td align="char">8.1</td><td align="char">481</td></tr><tr><td>45+</td><td align="char">20.0</td><td align="char">20.5</td><td align="char">20.2</td><td align="char">198</td><td align="char">2.1</td><td align="char">6.9</td><td align="char">3.9</td><td align="char">32</td><td align="char">4.9</td><td align="char">6.0</td><td align="char">5.6</td><td align="char">450</td></tr><tr><td colspan="13"><bold>Ethnicity</bold></td></tr><tr><td>Kikuyu</td><td align="char">4.7</td><td align="char">10.2</td><td align="char">8.3</td><td align="char">875</td><td align="char">0.6</td><td align="char">4.9</td><td align="char">2.9</td><td align="char">407</td><td align="char">2.4</td><td align="char">5.5</td><td align="char">4.2</td><td align="char">790</td></tr><tr><td>Kamba</td><td align="char">6.8</td><td align="char">10.5</td><td align="char">8.8</td><td align="char">533</td><td align="char">3.8</td><td align="char">8.6</td><td align="char">6.1</td><td align="char">148</td><td align="char">1.9</td><td align="char">4.3</td><td align="char">3.2</td><td align="char">588</td></tr><tr><td>Luhya</td><td align="char">10.3</td><td align="char">15.8</td><td align="char">13.7</td><td align="char">524</td><td align="char">0.0</td><td align="char">8.5</td><td align="char">3.7</td><td align="char">218</td><td align="char">2.1</td><td align="char">9.7</td><td align="char">6.1</td><td align="char">802</td></tr><tr><td>Luo</td><td align="char">23.6</td><td align="char">21.8</td><td align="char">22.4</td><td align="char">566</td><td align="char">9.2</td><td align="char">20.5</td><td align="char">15.1</td><td align="char">159</td><td align="char">19</td><td align="char">23.5</td><td align="char">21.4</td><td align="char">664</td></tr><tr><td>Others</td><td align="char">5.4</td><td align="char">8.7</td><td align="char">7.5</td><td align="char">549</td><td align="char">4.0</td><td align="char">5.0</td><td align="char">4.5</td><td align="char">400</td><td align="char">2.2</td><td align="char">3.0</td><td align="char">2.7</td><td align="char">2204</td></tr><tr><td colspan="13"><bold>Current marital status</bold></td></tr><tr><td>Never married/in union</td><td align="char">3.0</td><td align="char">6.4</td><td align="char">5.0</td><td align="char">819</td><td align="char">1.1</td><td align="char">3.9</td><td align="char">2.4</td><td align="char">490</td><td align="char">1.5</td><td align="char">3.7</td><td align="char">2.5</td><td align="char">2028</td></tr><tr><td>Currently in union</td><td align="char">11.3</td><td align="char">11.7</td><td align="char">11.5</td><td align="char">1889</td><td align="char">4.2</td><td align="char">7.4</td><td align="char">5.8</td><td align="char">778</td><td align="char">6.6</td><td align="char">6.0</td><td align="char">6.2</td><td align="char">2627</td></tr><tr><td>Formerly in union</td><td align="char">19.0</td><td align="char">33.1</td><td align="char">29.8</td><td align="char">339</td><td align="char">[0.0]</td><td align="char">27.1</td><td align="char">21.9</td><td align="char">64</td><td align="char">16.4</td><td align="char">24.7</td><td align="char">22.4</td><td align="char">393</td></tr><tr><td><bold>Age at first sex</bold></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td><15 years</td><td align="char">7.2</td><td align="char">24.2</td><td align="char">15.4</td><td align="char">449</td><td align="char">2.3</td><td align="char">25</td><td align="char">7.9</td><td align="char">114</td><td align="char">2.8</td><td align="char">14.4</td><td align="char">7.8</td><td align="char">861</td></tr><tr><td>15–19 years</td><td align="char">11.1</td><td align="char">14.1</td><td align="char">13.0</td><td align="char">1611</td><td align="char">3.4</td><td align="char">8.1</td><td align="char">5.6</td><td align="char">718</td><td align="char">5.2</td><td align="char">8.0</td><td align="char">6.8</td><td align="char">2435</td></tr><tr><td>20+ years</td><td align="char">9.8</td><td align="char">12.8</td><td align="char">11.5</td><td align="char">468</td><td align="char">4.5</td><td align="char">5.1</td><td align="char">4.9</td><td align="char">287</td><td align="char">10.1</td><td align="char">3.6</td><td align="char">6.8</td><td align="char">633</td></tr><tr><td>Never had sex</td><td align="char">3.3</td><td align="char">4.1</td><td align="char">3.9</td><td align="char">381</td><td align="char">0.0</td><td align="char">1.1</td><td align="char">0.6</td><td align="char">174</td><td align="char">0.5</td><td align="char">1.2</td><td align="char">1</td><td align="char">918</td></tr><tr><td>Inconsistent/refused</td><td align="char">13.3</td><td align="char">7.4</td><td align="char">9.4</td><td align="char">139</td><td align="char">[0.0]</td><td align="char">18.4</td><td align="char">17.1</td><td align="char">41</td><td align="char">[0.0]</td><td align="char">9.1</td><td align="char">9.0</td><td align="char">201</td></tr><tr><td colspan="13"><bold>Education</bold></td></tr><tr><td>None</td><td align="char">[20.8]</td><td align="char">20.4</td><td align="char">20.5</td><td align="char">132</td><td align="char">[0.0]</td><td align="char">[5.3]</td><td align="char">3.8</td><td align="char">26.0</td><td align="char">5.7</td><td align="char">5.1</td><td align="char">5.5</td><td align="char">362</td></tr><tr><td>Primary</td><td align="char">9.8</td><td align="char">14.1</td><td align="char">12.7</td><td align="char">1942</td><td align="char">3.9</td><td align="char">8.6</td><td align="char">6.8</td><td align="char">384</td><td align="char">4.8</td><td align="char">8.0</td><td align="char">6.6</td><td align="char">3110</td></tr><tr><td>Secondary+</td><td align="char">8.6</td><td align="char">9.3</td><td align="char">8.9</td><td align="char">974</td><td align="char">2.8</td><td align="char">7.1</td><td align="char">4.8</td><td align="char">923</td><td align="char">3.6</td><td align="char">6.3</td><td align="char">4.9</td><td align="char">1575</td></tr><tr><td colspan="13"><bold>Wealth quintiles</bold></td></tr><tr><td>Poorest</td><td align="char">9.4</td><td align="char">14.5</td><td align="char">12.2</td><td align="char">565</td><td align="char">1.8</td><td align="char">5.0</td><td align="char">3.1</td><td align="char">96</td><td align="char">1.8</td><td align="char">5.7</td><td align="char">4.3</td><td align="char">728</td></tr><tr><td>Second</td><td align="char">9.3</td><td align="char">19.5</td><td align="char">15.0</td><td align="char">659</td><td align="char">7.5</td><td align="char">9.9</td><td align="char">8.7</td><td align="char">161</td><td align="char">3.6</td><td align="char">7.2</td><td align="char">5.7</td><td align="char">1033</td></tr><tr><td>Middle</td><td align="char">7.8</td><td align="char">13.3</td><td align="char">11.2</td><td align="char">596</td><td align="char">3.7</td><td align="char">7.7</td><td align="char">5.7</td><td align="char">368</td><td align="char">5.4</td><td align="char">9.2</td><td align="char">7.4</td><td align="char">1047</td></tr><tr><td>Fourth</td><td align="char">11.7</td><td align="char">11.1</td><td align="char">11.3</td><td align="char">594</td><td align="char">1.0</td><td align="char">6.3</td><td align="char">3.7</td><td align="char">403</td><td align="char">4.2</td><td align="char">3.8</td><td align="char">4</td><td align="char">1080</td></tr><tr><td>Least poor</td><td align="char">9.9</td><td align="char">8.8</td><td align="char">9.2</td><td align="char">633</td><td align="char">2.1</td><td align="char">8.6</td><td align="char">5.6</td><td align="char">304</td><td align="char">6.0</td><td align="char">9.7</td><td align="char">7.9</td><td align="char">1159</td></tr><tr><td colspan="13"><bold>Circumcised men</bold></td></tr><tr><td>No/Don't know</td><td align="char">20.8</td><td></td><td></td><td align="char">216</td><td align="char">3.3</td><td></td><td></td><td align="char">60</td><td align="char">14.0</td><td></td><td></td><td align="char">365</td></tr><tr><td>Yes</td><td align="char">6.9</td><td></td><td></td><td align="char">929</td><td align="char">2.8</td><td></td><td></td><td align="char">601</td><td align="char">2.6</td><td></td><td></td><td align="char">1903</td></tr></tbody></table><table-wrap-foot><fn><p>[ ] based on fewer than 25 cases.</p></fn></table-wrap-foot></table-wrap><table-wrap id="t0015" position="float"><label>Table 3</label><caption><p>Odds ratios of being HIV positive by place of residence and other background characteristics, 2006/2007 Nairobi Slum HIV Prevalence Survey and 2008/2009 Kenya Demographic and Health Survey.</p></caption><table frame="hsides" rules="groups"><thead><tr><th rowspan="2"><bold>Place of residence</bold></th><th colspan="3"><bold>Men</bold><hr></hr></th><th colspan="3"><bold>Women</bold><hr></hr></th></tr><tr><th><bold>Unadjusted odds ratios</bold></th><th><bold>95% CI</bold></th><th><italic><bold>n</bold></italic></th><th><bold>Unadjusted odds ratios</bold></th><th><bold>95% CI</bold></th><th><italic><bold>n</bold></italic></th></tr></thead><tbody><tr><td>All slums</td><td>1.0</td><td></td><td align="char">1185</td><td align="char">1.0</td><td></td><td align="char">1986</td></tr><tr><td>Other urban</td><td>0.39</td><td align="char">(0.26, 0.59)</td><td align="char">712</td><td align="char">0.61</td><td align="char">(0.46, 0.80)</td><td align="char">820</td></tr><tr><td>Rural</td><td>0.44</td><td align="char">(0.33, 0.58)</td><td align="char">2018</td><td align="char">0.52</td><td align="char">(0.43, 0.64)</td><td align="char">2718</td></tr><tr><td colspan="7">
</td></tr><tr><td></td><td><bold>Adjusted odds ratios</bold></td><td><bold>95% CI</bold></td><td><italic><bold>n</bold></italic></td><td><bold>Adjusted odds ratios</bold></td><td><bold>95% CI</bold></td><td><italic><bold>n</bold></italic></td></tr><tr><td colspan="7"><bold>Place of residence</bold></td></tr><tr><td>All slums</td><td>1.0</td><td></td><td align="char">1185</td><td align="char">1.0</td><td></td><td align="char">1986</td></tr><tr><td>Other urban</td><td>0.51</td><td align="char">(0.32, 0.81)</td><td align="char">712</td><td align="char">0.63</td><td align="char">(0.33, 1.24)</td><td align="char">820</td></tr><tr><td>Rural</td><td>0.61</td><td align="char">(0.44, 0.84)</td><td align="char">2018</td><td align="char">0.51</td><td align="char">(0.30, 0.86)</td><td align="char">2718</td></tr><tr><td colspan="7"><bold>Age group</bold></td></tr><tr><td>15–19</td><td>1.0</td><td></td><td align="char">832</td><td align="char">1.0</td><td></td><td align="char">1083</td></tr><tr><td>20–24</td><td>1.39</td><td align="char">(0.59, 3.25)</td><td align="char">699</td><td align="char">1.25</td><td align="char">(0.82, 1.89)</td><td align="char">1292</td></tr><tr><td>25–29</td><td>3.11</td><td align="char">(1.34, 7.18)</td><td align="char">628</td><td align="char">2.48</td><td align="char">(1.62,3.80)</td><td align="char">996</td></tr><tr><td>30–34</td><td>4.60</td><td align="char">(1.94, 10.89)</td><td align="char">612</td><td align="char">2.7</td><td align="char">(1.72, 4.24)</td><td align="char">741</td></tr><tr><td>35–39</td><td>7.54</td><td align="char">(3.14, 18.13)</td><td align="char">456</td><td align="char">2.34</td><td align="char">(1.47, 3.74)</td><td align="char">584</td></tr><tr><td>40–44</td><td>4.66</td><td align="char">(1.84, 11.77)</td><td align="char">349</td><td align="char">2.26</td><td align="char">(1.38, 3.72)</td><td align="char">444</td></tr><tr><td>45+</td><td>6.03</td><td align="char">(2.42,15.00)</td><td align="char">339</td><td align="char">1.49</td><td align="char">(0.86, 2.55)</td><td align="char">384</td></tr><tr><td colspan="7"><bold>Ethnicity</bold></td></tr><tr><td>Kikuyu</td><td align="char">1.0</td><td></td><td align="char">744</td><td align="char">1</td><td></td><td align="char">1222</td></tr><tr><td>Kamba</td><td align="char">1.3</td><td>(0.71, 2.27)</td><td align="char">482</td><td align="char">1.22</td><td>(0.75, 1.97)</td><td align="char">571</td></tr><tr><td>Luhya</td><td align="char">1.43</td><td>(0.83, 2.46)</td><td align="char">659</td><td align="char">1.38</td><td align="char">(0.89, 2.14)</td><td align="char">872</td></tr><tr><td>Luo</td><td align="char">7.88</td><td>(4.97, 12.51)</td><td align="char">592</td><td align="char">3.05</td><td align="char">(2.07, 4.49)</td><td align="char">865</td></tr><tr><td>Others</td><td align="char">1.18</td><td>(0.70, 1.97)</td><td align="char">1438</td><td align="char">1.08</td><td align="char">(0.68, 1.73)</td><td align="char">1994</td></tr><tr><td colspan="7"><bold>Current marital status</bold></td></tr><tr><td>Never married/in union</td><td align="char">1.0</td><td></td><td align="char">1641</td><td align="char">1.0</td><td></td><td align="char">1587</td></tr><tr><td>Currently in union</td><td align="char">1.36</td><td>(0.79, 2.34)</td><td align="char">2096</td><td align="char">0.88</td><td align="char">(0.64, 1.21)</td><td align="char">3336</td></tr><tr><td>Formerly in union</td><td align="char">3.56</td><td>(1.81, 6.96)</td><td align="char">178</td><td align="char">3.78</td><td align="char">(2.62, 5.43)</td><td align="char">602</td></tr><tr><td><15 years</td><td align="char">1.0</td><td></td><td align="char">801</td><td align="char">1.0</td><td></td><td align="char">676</td></tr><tr><td>15–19 years</td><td align="char">1.34</td><td>(0.91, 1.96)</td><td align="char">1881</td><td align="char">0.56</td><td align="char">(0.43,0.72)</td><td align="char">2811</td></tr><tr><td>20+ years</td><td align="char">1.36</td><td>(0.85, 2.18)</td><td align="char">620</td><td align="char">0.38</td><td align="char">(0.26, 0.56)</td><td align="char">804</td></tr><tr><td>Never had sex</td><td align="char">0.58</td><td>(0.29, 2.00)</td><td align="char">558</td><td align="char">0.18</td><td align="char">(0.10, 0.32)</td><td align="char">899</td></tr><tr><td>Inconsistent/refused</td><td align="char">0.03</td><td>(1.09, 7.23)</td><td align="char">55</td><td align="char">0.43</td><td align="char">(0.27, 0.68)</td><td align="char">334</td></tr><tr><td colspan="7"><bold>Education</bold></td></tr><tr><td>None</td><td align="char">1.0</td><td></td><td align="char">164</td><td align="char">1.0</td><td></td><td align="char">601</td></tr><tr><td>Primary or lower</td><td align="char">1.3</td><td>(0.62, 2.89)</td><td align="char">2103</td><td align="char">0.90</td><td align="char">(0.61, 1.33)</td><td align="char">3207</td></tr><tr><td>Secondary</td><td align="char">0.89</td><td>(0.40, 1.95)</td><td align="char">1648</td><td align="char">0.83</td><td align="char">(0.54, 1.27)</td><td align="char">1716</td></tr><tr><td colspan="7"><bold>Wealth quintiles</bold></td></tr><tr><td>Poorest</td><td align="char">1.0</td><td></td><td align="char">712</td><td align="char">1.0</td><td></td><td align="char">1022</td></tr><tr><td>Second</td><td align="char">1.02</td><td>(0.64, 1.61)</td><td align="char">819</td><td align="char">1.13</td><td align="char">(0.83, 1.55)</td><td align="char">1042</td></tr><tr><td>Middle</td><td align="char">1.32</td><td>(0.83, 2.09)</td><td align="char">820</td><td align="char">1.12</td><td align="char">(0.82, 1.55)</td><td align="char">1110</td></tr><tr><td>Fourth</td><td align="char">0.89</td><td>(0.54, 1.48)</td><td align="char">765</td><td align="char">0.84</td><td align="char">(0.60, 1.17)</td><td align="char">1172</td></tr><tr><td>Least poor</td><td align="char">1.26</td><td>(0.78,2.04)</td><td align="char">799</td><td align="char">0.95</td><td align="char">(0.67, 1.33)</td><td align="char">1178</td></tr><tr><td colspan="7"><bold>Interactions</bold></td></tr><tr><td>Ethnicity by place</td><td>Not significant</td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>Kamba, other urban</td><td></td><td></td><td></td><td align="char">1.44</td><td align="char">(0.50, 4.16)</td><td></td></tr><tr><td>Kamba, rural</td><td></td><td></td><td></td><td align="char">0.90</td><td align="char">(0.36, 2.27)</td><td></td></tr><tr><td>Luhya, other urban</td><td></td><td></td><td></td><td align="char">1.49</td><td align="char">(0.56, 3.94)</td><td></td></tr><tr><td>Luhya, rural</td><td></td><td></td><td></td><td align="char">1.26</td><td align="char">(0.61, 2.60)</td><td></td></tr><tr><td>Luo, other urban</td><td></td><td></td><td></td><td align="char">1.61</td><td align="char">(0.68, 3.81)</td><td></td></tr><tr><td>Luo, rural</td><td></td><td></td><td></td><td align="char">1.96</td><td align="char">(1.03, 3.74)</td><td></td></tr><tr><td>Others, other urban</td><td></td><td></td><td></td><td align="char">0.72</td><td align="char">(0.28, 1.86)</td><td></td></tr><tr><td>Others, rural</td><td></td><td></td><td></td><td align="char">0.55</td><td align="char">(0.27, 0.12)</td><td></td></tr></tbody></table></table-wrap></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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