Factors associated with age of first sex among women screened for an observational contraceptive vaginal ring study in Kisumu, Kenya, 2014

Sex at an early age can have later life negative health outcomes. Insights on early sexual activity may help in the development of future health-promotion products and interventions related to pregnancy and sexually transmitted infections (STIs) prevention. Among Kenyan women participating in a contraceptive vaginal ring study, we determined: (1) the proportion with first sex at ≤15 years (early sex) and (2) factors associated with early sex. Baseline data collection and testing for pregnancy, STIs, and HIV were undertaken. A log-binomial or a modified Poisson regression was used to estimate univariable prevalence ratios and multivariable adjusted prevalence ratios (aPRs). Among 332 women aged 18-34 years, the median age of first sex was 16 years, with 40.1% experiencing early sex. Overall, 29.8% reported an older first sex partner (≥5 years); 83.9% indicated lack of readiness or intentions at first sex; and 56.2% received money, gifts, or favors as part of first sex. Early sex was more prevalent among inherited widows (a Luo cultural practice, aPR 1.49), gift recipients (aPR 1.38), women with a forced/unwanted sex history (aPR 1.42), or those with a partner of unknown or positive HIV status in the past 3 months (aPR 1.45). Sex before or at the age 15 may be associated with higher sexual risk behaviors. Complex power and gender relations may additionally influence exposure to sexual risk in our research setting. Les rapports sexuels à un âge précoce peuvent avoir des conséquences négatives sur la santé plus tard dans la vie. Des informations sur l'activité sexuelle précoce peuvent aider au développement de futurs produits et interventions de promotion de la santé liés à la prévention de la grossesse et des infections sexuellement transmissibles (IST). Parmi les femmes kényanes participant à une étude sur l'anneau vaginal contraceptif, nous avons déterminé: (1) la proportion de femmes ayant eu un premier rapport sexuel à ≤15 ans (rapports sexuels précoces) et (2) les facteurs associés aux rapports sexuels précoces. La collecte de données de base et le dépistage de la grossesse, des IST et du VIH ont été entrepris. Une régression log binomiale ou une régression de Poisson modifiée a été utilisée pour estimer les ratios de prévalence univariés et les ratios de prévalence ajustés multivariables (aPR). Chez 332 femmes âgées de 18 à 34 ans, l'âge médian du premier rapport sexuel était de 16 ans, 40,1% ayant eu des rapports sexuels précoces. Dans l'ensemble, 29,8% ont déclaré un premier partenaire sexuel plus âgé (≥ 5 ans); 83,9% ont indiqué un manque de préparation ou d'intentions lors du premier rapport sexuel; et 56,2% ont reçu de l'argent, des cadeaux ou des faveurs dans le cadre de leur premier rapport sexuel. Les rapports sexuels précoces étaient plus fréquents chez les veuves héritées (une pratique culturelle Luo, aPR 1,49), les bénéficiaires de cadeaux (aPR 1,38), les femmes ayant des antécédents sexuels forcés / non désirés (aPR 1,42) ou celles dont le partenaire était séropositif ou inconnu en les 3 derniers mois (aPR 1,45). Les rapports sexuels avant ou à 15 ans peuvent être associés à des comportements sexuels à risque plus élevé. Le pouvoir complexe et les relations de genre peuvent également influencer l'exposition aux risques sexuels dans notre contexte de recherche

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 ¼ 1.11; 95% confidence interval [CI] 0.45-2.30), 6 were women; 5 (IR ¼ 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

Evaluation of online videos to engage viewers and support decision-making for COVID-19 vaccination: how narratives and race/ethnicity enhance viewer experiences

BackgroundVaccine hesitancy has hampered the control of COVID-19 and other vaccine-preventable diseases.MethodsWe conducted a national internet-based, quasi-experimental study to evaluate COVID-19 vaccine informational videos. Participants received an informational animated video paired with the randomized assignment of (1) a credible source (differing race/ethnicity) and (2) sequencing of a personal narrative before or after the video addressing their primary vaccine concern. We examined viewing time and asked video evaluation questions to those who viewed the full video.ResultsAmong 14,235 participants, 2,422 (17.0%) viewed the full video. Those who viewed a personal story first (concern video second) were 10 times more likely to view the full video (p < 0.01). Respondent–provider race/ethnicity congruence was associated with increased odds of viewing the full video (aOR: 1.89, p < 0.01). Most viewers rated the informational video(s) to be helpful, easy to understand, trustworthy, and likely to impact others' vaccine decisions, with differences by demographics and also vaccine intentions and concerns.ConclusionUsing peer-delivered, personal narrative, and/or racially congruent credible sources to introduce and deliver vaccine safety information may improve the openness of vaccine message recipients to messages and engagement

An investigation of the role of uncertainty in the choice component of foraging in a captive group of chimpanzees (Pan troglodytes)

Ph.D.Terry L. Mapl

Small mammal populations on reclaimed strip-mined areas in Freestone County, Texas

Due to the character of the original source materials and the nature of batch digitization, quality control issues may be present in this document. Please report any quality issues you encounter to [email protected], referencing the URI of the item.Bibliography: leaves 38-40.Not availabl

Factors associated with physical violence by a sexual partner among girls and women in rural Kenya

Intimate partner physical violence increases women's risk for negative health outcomes and is an important public health concern. The purpose of the present study was to determine 1) the proportion of girls (≤18 years) and women (>18 years) who experienced physical violence by a sexual partner, and 2) factors (including self-reported HIV infection) associated with girls and women who experienced physical violence by a sexual partner. Cross-sectional surveys conducted in the Gem Health and Demographic Surveillance System (HDSS) area in Siaya County, western Kenya in 2011-2012 (Round 1) and 2013-2014 (Round 2). Among 8003 unique participants (582 girls and 7421 women), 11.6% reported physical violence by a sexual partner in the last 12 months (girls: 8.4%, women: 11.8%). Three factors were associated with physical violence by a sexual partner among girls: being married or cohabiting (nearly 5-fold higher risk), low education, and reporting forced sex in the last 12 months (both with an approximate 2-fold higher risk). Predictive factors were similar for women, with the addition of partner alcohol/drug use and deliberately terminating a pregnancy. Self-reported HIV status was not associated with recent physical violence by a sexual partner among girls or women. Gender-based physical violence is prevalent in this rural setting and has a strong relationship with marital status, low education level, and forced sex among girls and women. Concerted efforts to prevent child marriage and retain girls in school as well as implementation of school and community-based anti-violence programs may help mitigate this risk

Teen pregnancy in rural western Kenya: a public health issue

Rates of teenage pregnancy remain high in sub-Saharan Africa. The KEMRI Health and Demographic Surveillance System provided the sampling frame for a survey. Analysis focused on 1,952 girls aged 13–19 years. Over a third (37.2%; n = 727) were sexually active and 23.3% (n = 454) had ever been pregnant. Adjusted odds of reporting a history of pregnancy were greater for older compared to younger teens, teens who were ever married or cohabiting compared to those who were single, teens with a primary education or less compared to those with a higher level of education, and teens who experienced partner violence in the last 12 months. Three-quarters of teens pregnant in the last 12 months did not want to get pregnant (n = 190); only 64.2% (n = 122) answered yes to using any family planning method. Teen pregnancy and its consequences are serious public health issues. Higher education levels are a crucial component to address the problem