A Nested Case–Control Study of Sexual Practices and Risk Factors for Prevalent HIV-1 Infection Among Young Men in Kisumu, Kenya

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Abstract
Objectives: To investigate sexual practices and risk factors for prevalent HIV infection among young men in Kisumu, Kenya. Goal: The goal of this study was to identify behaviors associated with HIV in Kisumu to maximize the effectiveness of future prevention programs. Study Design: Lifetime sexual histories were collected from a nested sample of 1337 uncircumcised participants within the context of a randomized controlled trial of male circumcision to reduce HIV incidence. Results: Sixty-five men (5%) tested positive for HIV. Multiple logistic regression revealed the following independent predictors of HIV: older age, less education, being married, being Catholic, >4 lifetime sex partners, prior treatment for an STI, sex during partner's menstruation, ever practicing bloodletting, and receipt of a medical injection in the last 6 months. Prior HIV testing and postcoital cleansing were protective. Conclusions: This analysis confirms the importance of established risk factors for HIV and identifies practices that warrant further investigation.