Underestimating HIV acquisition perceived risk in Kenya: Sexual-risk taking in urban and rural areas

Background: This study measures the association between sexual risk-taking and HIV acquisition perceived risk. Methods: Retrospective cross-sectional data, Kenya Demographic and Health Survey-2003 was used. Data were weighted for stratum and primary sampling units attaining linearized standard errors. A sample of 6,190 was retained in the design based analysis. The main outcome variable was sexual risk-taking, a dichotomous variable, while the main independent variable-HIV acquisition perceived risk-was a categorical variable. Parametric testing using Univariate and Multivariate logistic regression was performed. Stata version 10.1 was used for all analyses, p<0.05. Results: 33% and 25% of the respondents had sexual risk-taking behaviors-urban and rural areas respectively. 53% of those who perceived themselves to have small-risk of acquiring HIV had high sexual-risk taking in urban areas compared to 50% in rural areas, p<0.001. In the adjusted results, those who perceived themselves to have small risks of acquiring HIV were 1.99 times more likely to have sexual-risk taking behaviors (95% CI 1.33-2.97, p<0.001) compared to those who perceived themselves to have no-risk of acquiring HIV in urban areas. Those in rural areas were 1.47 times more likely to have sexual risk-taking behaviors (95% CI 1.11-1.94, p<0.01) compared to those who perceived themselves to have no-risk. Conclusion: Kenya's HIV/AIDS is not improving parallel to current HIV/AIDS programs and policies. On average, majority of Kenyans have almost two folds of underestimating their perceived risk of acquiring HIV in urban and rural regions. There is a need for better measurements to evaluate HIV acquisition risk among Kenyans.