A nested case-control study of sexual practices and risk factors for prevalent HIV-1 infection among young men in Kisumu, Kenya.

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.