title: Prevalence of sexually transmitted infections including HIV in street-connected adolescents in western Kenya.
abstract: OBJECTIVE
  The objectives of this study were to characterise the sexual health of street-connected adolescents in Eldoret, Kenya, analyse gender disparity of risks, estimate the prevalence of sexually transmitted infections (STIs), and identify factors associated with STIs.
  
  
  METHODS
  A cross-sectional study of street-connected adolescents ages 12-21 years was conducted in Eldoret, Kenya. Participants were interviewed and screened for Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, herpes simplex virus-2, syphilis and HIV. Descriptive statistics and logistic regression were used to identify factors associated with having any STI.
  
  
  RESULTS
  Of the 200 participants, 81 (41%) were female. 70.4% of females and 60.5% of males reported sexual activity. Of those that participated in at least one STI test, 28% (55/194) had ≥1 positive test, including 56% of females; 14% (28/194) had >1 positive test. Twelve females and zero males (6% overall, 14.8% of females) were HIV positive. Among females, those with HIV infection more frequently reported transactional sex (66.7% vs. 26.1%, p=0.01), drug use (91.7% vs. 56.5%, p=0.02), and reported a prior STI (50.0% vs. 14.7%, p<0.01). Having an adult caregiver was less likely among those with HIV infection (33.3% vs. 71.0%, p=0.04). Transactional sex (AOR 3.02, 95% CI (1.05 to 8.73)), a previous STI (AOR 3.46 95% CI (1.05 to 11.46)) and ≥2 sexual partners (AOR 5.62 95% (1.67 to 18.87)) were associated with having any STI.
  
  
  CONCLUSIONS
  Street-connected adolescents in Eldoret, Kenya are engaged in high-risk sexual behaviours and females in particular have a substantial burden of STIs and HIV. There is a need for STI interventions targeted to street-connected youth.
authors.affiliation: Division of Pediatric Infectious Diseases, Rhode Island Hospital/Hasbro Children's Hospital, Warren Alpert Medical School at Brown University, Providence, Rhode Island, USA.
authors.forename: Susanna E
authors.initials: SE
authors.lastname: Winston
authors.affiliation: Moi Teaching and Referral Hospital, Eldoret, Kenya.
authors.forename: Amon K
authors.initials: AK
authors.lastname: Chirchir
authors.affiliation: Moi Teaching and Referral Hospital, Eldoret, Kenya Aga Khan University Hospital, Nairobi, Kenya.
authors.forename: Lauryn N
authors.initials: LN
authors.lastname: Muthoni
authors.affiliation: Department of Behavioral Sciences, Moi University, School of Medicine, College of Health Sciences, Eldoret, Kenya.
authors.forename: David
authors.initials: D
authors.lastname: Ayuku
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.
authors.forename: Julius
authors.initials: J
authors.lastname: Koech
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya Department Child Health and Pediatrics, Moi University, School of Medicine, Eldoret, Kenya.
authors.forename: Winstone
authors.initials: W
authors.lastname: Nyandiko
authors.affiliation: Department of Pulmonary and Critical Care, The Miriam Hospital, Warren Alpert Medical School at Brown University, Providence, Rhode Island, USA Department of Medicine, Moi University, School of Medicine, College of Health Sciences, Eldoret, Kenya.
authors.forename: E Jane
authors.initials: EJ
authors.lastname: Carter
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya Department of Medicine, Moi University, School of Medicine, College of Health Sciences, Eldoret, Kenya Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA Division of Epidemiology, University of Toronto, Dalla Lana School of Public Health, Toronto, Canada Regenstrief Institute, Inc., Indianapolis, Indiana, USA.
authors.forename: Paula
authors.initials: P
authors.lastname: Braitstein
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000458:organization & administration*; D017677:Age Distribution; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D018453:Homeless Youth / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D017678:Sex Distribution; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000517:prevention & control; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: ADOLESCENT; AFRICA; EPIDEMIOLOGY (GENERAL); HIV; SCREENING