Prevalence and correlates of insecticide-treated bednet use among HIV-1-infected adults in Kenya

Abstract

HIV-1-infected adults are at increased risk for malaria. Insecticide-treated bednets protect individuals from malaria. Little is known about correlates of ownership and use of bednets among HIV-1-infected individuals. We conducted a cross-sectional survey of 388 HIV-1-infected adults recruited from three sites in Kenya (Kilifi, Kisii, and Kisumu) to determine factors associated with ownership and use of optimal bednets. We defined an optimal bednet as an untorn, insecticide-treated bednet. Of 388 participants, 134(34.5%) reported owning an optimal bednet. Of those that owned optimal bednets, most (76.9%) reported using it daily. In a multivariate model, higher socioeconomic status as defined as postsecondary education [OR = 2.8 (95% CI: 1.3–6.4), p = 0.01] and living in a permanent home [OR = 1.7(1.03–2.9), p = 0.04] were significantly associated with optimal bednet ownership. Among individuals who owned bednets, employed individuals were less likely [OR = 0.2(0.04–0.8), p = 0.01] and participants from Kilifi were more likely to use bednets [OR = 2.9 (95% CI 1.04–8.1), p = 0.04] in univariate analysis. Participants from Kilifi had the least education, lowest income, and lowest rate of employment. Our findings suggest that lower socioeconomic status is a barrier to ownership of an optimal bednet. However, consistent use is high once individuals are in possession of an optimal bednet. Increasing access to optimal bednets will lead to high uptake and use.

Keywords:

• HIV-1
• malaria
• bednet
• prevention
• Kenya

Acknowledgements

We would like to thank all the study participants and those providing care for them. We would also like to thank the staff of KEMRI/University of Washington. Funding for the project was provided by the Fogarty International Center at the National Institutes of Health (Grant # 5 R24 TW007988-02, Vanderbilt U 34748).