title: Factors associated with repeat visits among clients attending a clinic for sexually transmitted infections in Kisumu, Kenya.
abstract: To identify factors associated with repeat visits among patients attending a clinic for sexually transmitted infections (STIs) in Kisumu, Kenya, we examined records of clinic visits from March 2009 to May 2010. Multivariable logistic regression identified factors associated with repeat visits occurring >30 days after the initial visit. Among 1473 clients (1296 single-visit individuals versus 177 individuals with repeat visits), the median age was 24 years, 67% were men and 8.6% self-reported being HIV-positive. In adjusted analyses, men with repeat visits were more likely to report ≥ 2 recent sexual partners (adjusted odds ratio [aOR] = 1.60) and being HIV-positive (aOR = 2.35). They were less likely to have been referred from other health facilities (aOR = 0.14) and more likely to have urethral discharge at their initial visit (aOR = 2.46). Among women, repeat visits were associated with vaginal discharge (aOR = 2.22), but attending the clinic with a partner was protective (aOR = 0.38). The association between sexual risk, HIV positivity and repeat visits among male clients highlights the need to focus intervention efforts on this group. For women, attending with a partner may reflect a decreased risk of re-infection if both partners are treated and counselled together.
authors.affiliation: Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, IL,  USA.
authors.forename: E
authors.initials: E
authors.lastname: Pultorak
authors.forename: E
authors.initials: E
authors.lastname: Odoyo-June
authors.forename: J
authors.initials: J
authors.lastname: Hayombe
authors.forename: F
authors.initials: F
authors.lastname: Opiyo
authors.forename: W
authors.initials: W
authors.lastname: Odongo
authors.forename: J A
authors.initials: JA
authors.lastname: Ogollah
authors.forename: S
authors.initials: S
authors.lastname: Moses
authors.forename: R C
authors.initials: RC
authors.lastname: Bailey
authors.forename: S D
authors.initials: SD
authors.lastname: Mehta
mesh_terms: D000328:Adult; D017677:Age Distribution; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D012309:Risk-Taking; D017678:Sex Distribution; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*
references.citation: Sex Transm Dis. 1998 Jan;25(1):20-3
references.pmid: 9437780
references.citation: BMC Public Health. 2009 Jul 16;9:242
references.pmid: 19607669
references.citation: Lancet. 1995 Aug 26;346(8974):530-6
references.pmid: 7658778
references.citation: Sex Transm Dis. 2000 Aug;27(7):371-85
references.pmid: 10949428
references.citation: East Afr J Public Health. 2009 Dec;6(3):263-7
references.pmid: 20803916
references.citation: Bull World Health Organ. 2006 Sep;84(9):729-38
references.pmid: 17128343
references.citation: Am J Epidemiol. 2004 Jul 1;160(1):51-8
references.pmid: 15229117
references.citation: Sex Transm Dis. 2000 Jul;27(6):343-9
references.pmid: 10907910
references.citation: J Adolesc Health. 2006 Mar;38(3):213-21
references.pmid: 16488818
references.citation: Sex Transm Infect. 2004 Jun;80(3):174-82
references.pmid: 15169997
references.citation: Sex Transm Infect. 2004 Oct;80(5):333-4
references.pmid: 15459398
references.citation: Sex Transm Dis. 1995 Jul-Aug;22(4):231-5
references.pmid: 7482106
references.citation: J Clin Microbiol. 2006 Aug;44(8):2689-97
references.pmid: 16891479
references.citation: Lancet. 1999 Feb 13;353(9152):525-35
references.pmid: 10028980
references.citation: Sex Transm Infect. 2008 Dec;84(7):528-34
references.pmid: 18708485
references.citation: Bull World Health Organ. 2007 Apr;85(4):297-304
references.pmid: 17546311