Sexual Behavior Is More Risky in Rural Than in Urban Areas Among Young Women in Nyanza Province, Kenya

Abstract

HIV/sexually transmitted disease interventions in sub-Saharan Africa have largely been focused on urban areas, where sexual behavior is supposed to be more risky than in rural areas. The goal of this study was to measure sexual risk behavior among young adults in Nyanza province in Kenya and to compare rural and urban areas. In a cross-sectional study, 584 household members aged 15 to 29 years in Kisumu town and the rural districts Siaya and Bondo were selected by multistage random sampling and were administered a face-to-face questionnaire. For women, sexual behavior was more risky in rural than in urban areas, also after adjusting for sociodemographic differences. Rural women reported less frequently being a virgin at marriage, a higher number of lifetime partners, and less consistent condom use with nonspousal partners. For men, sexual risk behavior was equally high in urban and rural areas. The potential for further HIV spread in rural Nyanza is large. HIV/sexually transmitted disease interventions should be expanded from urban to rural areas in Nyanza.