Phiri Nomsa, Mambo Susan, Otieno Odawa Careena
Department of Environmental Health and Disease Control, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Nairobi County, Kenya.
Department of Community Health, Great Lakes University of Kisumu, Kisumu, Kisumu County, Kenya.
Open Res Eur. 2025 Jul 25;4:134. doi: 10.12688/openreseurope.17611.2. eCollection 2024.
Young people living with HIV in Sub-Saharan Africa account for the largest proportion of the vulnerable population in the world. Kenya has little evidence to showcase the utilization of sexual and reproductive health services among young people living with HIV. Nairobi County has one of the highest HIV burdens among adolescents and youth in the country. Consequently, this study aimed to assess factors associated with the utilization of sexual and reproductive health services among young people aged 15-24 years living with HIV.
A health facility-based cross-sectional study design with convergent parallel mixed methods technique was used. Purposive sampling with predetermined criteria was used to select six high-volume public health facilities in six high-burden sub-counties of Nairobi. A total of 253 participants completed the semi-structured questionnaires on utilization and associated factors.12 healthcare workers were purposively selected as key informant sessions in individual key informant sessions on their perception of young people's utilization.
4Stepwise multivariable binary logistic regression was used to analyse the quantitative data using Stata version 14. NVivo software was used to code and thematically analyse the data. Results 47 % of the participants had utilized the services. Collection of condoms (45.7%) was the most utilized while treatment of sexually transmitted infections (8.2%) was the least utilized services. Female sex (AOR--adjusted odds ratio : 3.60 95%, Cl: 1.67-6.40), increase in age (AOR: 2.27 95%, Cl: 1.1C-4.65), HIV status disclosure to a sexual partner (AOR: 2.00 95%, Cl: 1.11-3.80) and privacy for sexual and reproductive health services at a health facility (AOR: 3.27 95%Cl: 1.42-7.60) were factors significantly associated with utilization.
Given higher utilization rates of sexual reproductive services were demonstrated among females and those who disclosed their HIV status to sexual partner , strengthening behavioral interventions to engage young men and disclosure support strategies can address the existing disparities.
撒哈拉以南非洲地区的艾滋病毒感染者中，年轻人占全球弱势群体的最大比例。肯尼亚几乎没有证据表明艾滋病毒感染者中的年轻人对性健康和生殖健康服务的利用情况。内罗毕县在该国青少年和青年中艾滋病毒负担最高。因此，本研究旨在评估15至24岁艾滋病毒感染者中与性健康和生殖健康服务利用相关的因素。
采用基于卫生设施的横断面研究设计，并运用收敛平行混合方法技术。采用具有预定标准的目的抽样法，在内罗毕六个高负担次县中选择六个高流量的公共卫生设施。共有253名参与者完成了关于利用情况及相关因素的半结构化问卷。有目的地选择了12名医护人员，就他们对年轻人利用情况的看法进行个别关键信息访谈。
采用逐步多变量二元逻辑回归，使用Stata 14版本分析定量数据。使用NVivo软件对数据进行编码和主题分析。结果显示，47%的参与者使用了这些服务。避孕套的领取（45.7%）是使用最多的服务，而性传播感染的治疗（8.2%）是使用最少的服务。女性（调整后的优势比[AOR]：3.60，95%置信区间[CI]：1.67 - 6.40）、年龄增长（AOR：2.27，95%CI：1.10 - 4.65）、向性伴侣披露艾滋病毒感染状况（AOR：2.00，95%CI：1.11 - 3.80）以及在卫生设施获得性健康和生殖健康服务的隐私（AOR：3.27，95%CI：1.42 - 7.60）是与利用情况显著相关的因素。
鉴于女性以及向性伴侣披露艾滋病毒感染状况的人对性生殖服务的利用率较高，加强针对年轻男性的行为干预措施和披露支持策略可以解决现有的差距。
