title: Investigation of HIV Incidence Rates in a High-Risk, High-Prevalence Kenyan Population: Potential Lessons for Intervention Trials and Programmatic Strategies.
abstract: Cost-effective HIV prevention programs should target persons at high risk of HIV acquisition. We conducted an observational HIV incidence cohort study in Kisumu, Kenya, where HIV prevalence is triple that of the national rate. We used referral and venue-sampling approaches to enroll HIV-negative persons for a 12-month observational cohort, August 2010 to September 2011, collected data using computer-assisted interviews, and performed HIV testing quarterly. Among 1292 eligible persons, 648 (50%) were excluded for HIV positivity and other reasons. Of the 644 enrollees, 52% were women who were significantly older than men (P<.01). In all, 7 persons seroconverted (incidence rate [IR] per 100 person-years=1.11; 95% confidence interval [CI] 0.45-2.30), 6 were women; 5 (IR=3.14; 95% CI 1.02-7.34) of whom were ≤25 years. Most new infections occurred in young women, an observation consistent with other findings in sub-Saharan Africa that women aged ≤25 years are an important population for HIV intervention trials in Africa.
authors.affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA cax6@cdc.gov.
authors.forename: Rennatus
authors.initials: R
authors.lastname: Mdodo
authors.affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Gust
authors.affiliation: Kenya Medical Research Institute (KEMRI)/CDC Research and Public Health Collaboration, Kisumu, Kenya.
authors.forename: Fredrick O
authors.initials: FO
authors.lastname: Otieno
authors.affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA.
authors.forename: Eleanor
authors.initials: E
authors.lastname: McLellan-Lemal
authors.affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA.
authors.forename: Robert T
authors.initials: RT
authors.lastname: Chen
authors.affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: LeBaron
authors.affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA.
authors.forename: Felicia
authors.initials: F
authors.lastname: Hardnett
authors.affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA.
authors.forename: Kyle
authors.initials: K
authors.lastname: Turner
authors.affiliation: Kenya Medical Research Institute (KEMRI)/CDC Research and Public Health Collaboration, Kisumu, Kenya.
authors.forename: Richard
authors.initials: R
authors.lastname: Ndivo
authors.affiliation: Centers for Disease Control and Prevention (CDC), HIV Research Branch, Kisumu, Kenya.
authors.forename: Clement
authors.initials: C
authors.lastname: Zeh
authors.affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA.
authors.forename: Taraz
authors.initials: T
authors.lastname: Samandari
authors.affiliation: Centers for Disease Control and Prevention (CDC), HIV Research Branch, Kisumu, Kenya.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Mills
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology; D006801:Humans; D015994:Incidence; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012309:Risk-Taking; D055815:Young Adult
keywords: HIV incidence; Kenya; clinical trials; risk factors