Winston, S. E., Chirchir, A. K., Muthoni, L. N., et al. Sexually Transmitted Infections (February 2015), doi: 10.1136/sextrans- 2014-051797.
This study characterized the sexual risk behaviors of street-connected children and youth (SCCY)
(children who spend their days or nights on the streets) in Eldoret, Kenya and analyzed the gender disparities of these risks to estimate the prevalence of and factors associated with sexually transmitted infections (STIs), including HIV. The study enrolled 200 participants between the ages of 12 and 21. Participants completed structured interviews detailing their sociodemographics, street life, risk behaviors, abuse and exploitation, and access to reproductive health care. All participants self-collected vaginal and rectal swabs. Because all HIV-positive participants were female (15 percent of all participants), the authors analyzed only factors associated with HIV in females. More than a quarter of adolescents in this study had at least one STI, and young women were again disproportionately affected (35 percent with HSV-2, compared to 27.1 percent among women aged 20–24 years nationally). The authors also found that the SCCY were engaged in high-risk sexual behaviors, including early sexual debut, multiple partners, transactional sex, and inconsistent condom use. Young women were at particularly high risk, reporting significantly more forced sex, transactional sex, and prior STIs. The authors concluded that SCCY in Eldoret, females particularly, were at high risk for STIs and HIV, and called for programmers and implementers to target prevention and education programs specifically to