AEGiS-14IAC: HIV infection among agricultural employees in Rift Valley Province, Kenya: prevalence, risk factors, and suitability for vaccine efficacy trials.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

HIV infection among agricultural employees in Rift Valley Province, Kenya: prevalence, risk factors, and suitability for vaccine efficacy trials.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. WePeC6185)

Sateren WB, Renzullo PO, Mason C, Wasunna M, Robb M, Langat L, Elson L
Walter Reed Army Institute of Research, Rockville, MD, United States

BACKGROUND: The HIV pandemic in Africa requires a range of interventions. One such intervention is a preventive vaccine. In order to test these in phase III trials, the epidemiology of the epidemic must be established in potential trial sites. A pilot cross-sectional seroprevalence survey was conducted in an agricultural company situated near a major national highway in the Rift Valley Province of Kenya. The company supports a population of 70,000 employees and dependents belonging to four major tribes.

METHODS: After providing informed consent, volunteers completed a risk behavior questionnaire and provided a blood sample. Blood samples were tested with two rapid tests. Positive and discrepant samples were confirmed by ELISA. Results were confidential and not disclosed to the employer.

RESULTS: A total of 845 individuals volunteered. HIV status was determined for 821. Of these, 81 (9.9%) were positive. HIV prevalence varied by: gender (females 17.4%, males 8.0%); age (17-19 year olds 3.5% increasing with age and highest among 40 to 44 year olds, 16.7%); marital status (single 5.0%, married 11.8%, widowed 40%); and education (none 25.0%, primary 10.5%, secondary 8.5%, post-secondary 2.9%). Luo tribe members were found to have a significantly higher HIV prevalence (24.8%) than Kalenjin tribe members (4.5%) (OR = 7.04, 95% CI 3.62 - 13.7). These tribes reported different rates of male circumcision (Luo 18.6%, Kalenjin 99%). Overall, circumcised men were significantly less likely to be HIV+ (OR = 0.15, 95% CI 0.08 - 0.28). Adjusting the tribal OR for circumcision rates significantly reduced the differences between the tribes, OR = 2.90, 95% CI 0.81 - 10.4. Over 97% of cohort members expressed a willingness to participate in a future HIV vaccine trial.

CONCLUSIONS: This study provides valuable information for the characterization of the HIV epidemic in a population which may be suitable for phase III vaccine efficacy trials in Africa.

Keywords: AEGIS, Prevalence, Risk Factors, HIV Infections, AIDS Vaccines, HIV, Cross-Sectional Studies, Circumcision, HIV Seroprevalence, Risk-Taking, Clinical Trials, HIV Seropositivity, HIV Antibodies, Kenya, HIV Seronegativity, Seroepidemiologic Studies, Africa, Human, Male, Female, Epidemiology, surgery, immunology

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