Factors associated with psychological distress among young women in Kisumu, Kenya

Figures & data

Table 1 Demographic and lifestyle characteristics of women screened for contraceptive ring study (n=461), Kisumu, Kenya, 2014

Variable	Total N (%)
Age at screening, years
18–24	218 (47.3)
25–29	168 (36.4)
30–34	75 (16.3)
Ethnic group
Luo	418 (90.9)
Non-Luo	42 (9.1)
Marital status
Single	81 (17.9)
Married/cohabiting	307 (67.9)
Other	64 (14.2)
Religion
Roman Catholic	206 (44.8)
Other Christian	172 (37.4)
Other non-Christian	82 (17.8)
Education
None	17 (3.7)
Primary (any)	296 (64.5)
Secondary (any)	126 (27.5)
Tertiary	20 (4.4)
Occupation
Employed	291 (63.4)
Unemployed	168 (36.6)
Main source of income
None	22 (4.8)
Salary-based	256 (55.7)
Not salary-based	182 (39.6)
Number of live births
0	6 (1.3)
1–2	238 (53.2)
≥3	203 (45.4)

Notes: The sum does not always add to 461 because of missing values. The percentage in each cell is computed using the total number of non-missing records as the denominator.

Table 2 Univariable analysis of psychological distress categories by select characteristics among women screened for the contraceptive ring study (N=461), Kisumu, Kenya, 2014

Variable level	Total (N=461), n (%)a	High (score: 13–24; N=96), n (%)a	Moderate (score: 5–12; N=269), n (%)a	Low/no (score: 0–4; N=96), n (%)a	High vs low/no; odds ratio (95% CI)	High vs low/no; P-value	Moderate vs low/no; odds ratio (95% CI)	Moderate vs low/no; P-value	Overall P-valuea
Age at screening, years									0.276
18–24	218 (47.3)	45 (46.9)	118 (43.9)	55 (57.3)	0.71 (0.30, 1.65)	0.424	0.59 (0.30, 1.19)	0.141
25–29	168 (36.4)	36 (37.5)	104 (38.7)	28 (29.2)	1.11 (0.46, 2.73)	0.812	1.03 (0.49, 2.16)	0.943
30–34	75 (16.3)	15 (15.6)	47 (17.5)	13 (13.5)	Ref		Ref
Ethnic group									0.137
Luo	418 (90.9)	91 (94.8)	245 (91.1)	82 (86.3)	2.89 (0.98, 8.48)	0.054	1.62 (0.79, 3.33)	0.191
Non-Luo	42 (9.1)	5 (5.2)	24 (8.9)	13 (13.7)	Ref		Ref
Marital status									0.075
Single	81 (17.9)	16 (16.8)	43 (16.3)	22 (23.7)	0.20 (0.06, 0.66)	0.008	0.24 (0.08, 0.69)	0.008
Married/cohabiting	307 (67.9)	61 (64.2)	180 (68.2)	66 (71.0)	0.26 (0.09, 0.74)	0.012	0.33 (0.13, 0.88)	0.027
Separated/divorced/widowed	64 (14.2)	18 (18.9)	41 (15.5)	5 (5.4)	Ref		Ref
Religion									0.884
Roman Catholic	206 (44.8)	47 (49.0)	119 (44.2)	40 (42.1)	1.33 (0.59, 3.01)	0.490	1.01 (0.52, 1.96)	0.973
Other Christian	172 (37.4)	34 (35.4)	100 (37.2)	38 (40.0)	1.01 (0.44, 2.34)	0.974	0.89 (0.46, 1.74)	0.743
Other non-Christian	82 (17.8)	15 (15.6)	50 (18.6)	17 (17.9)	Ref		Ref
Education									0.007
Primary or less	313 (68.2)	78 (81.3)	177 (66.0)	58 (61.1)	2.76 (1.43, 5.35)	0.003	1.24 (0.76, 2.02)	0.383
Secondary or more	146 (31.8)	18 (18.8)	91 (34.0)	37 (38.9)	Ref		Ref
Occupation									0.910
Employed	291 (63.4)	60 (62.5)	169 (63.1)	62 (65.3)	0.89 (0.49, 1.61)	0.692	0.91 (0.56, 1.49)	0.702
Unemployed	168 (36.6)	36 (37.5)	99 (36.9)	33 (34.7)	Ref		Ref
Main source of incomec									0.576
Salary-based	256 (58.4)	52 (59.8)	147 (56.5)	57 (62.6)	0.89 (0.48, 1.62)	0.695	0.78 (0.47, 1.27)	0.312
Not salary-based	182 (41.6)	35 (40.2)	113 (43.5)	34 (37.4)	Ref		Ref
Concerned about food insecurity									<0.001
Yes	393 (85.2)	89 (92.7)	235 (87.4)	69 (71.9)	4.98 (2.04, 12.1)	<0.001	2.70 (1.52, 4.80)	<0.001
No	68 (14.8)	7 (7.3)	34 (12.6)	27 (28.1)	Ref		Ref
Inherited or notd									0.821
Yes	115 (30.8)	25 (31.3)	70 (31.7)	20 (27.8)	1.18 (0.59, 2.39)	0.640	1.21 (0.67, 2.18)	0.535
No	258 (69.2)	55 (68.8)	151 (68.3)	52 (72.2)	Ref		Ref
Perceived overall health status									<0.001
Poor	62 (13.7)	30 (31.6)	26 (9.8)	6 (6.4)	7.50 (2.53, 22.2)	<0.001	1.86 (0.68, 5.11)	0.230
Good	296 (65.2)	49 (51.6)	183 (69.1)	64 (68.1)	1.15 (0.55, 2.40)	0.712	1.23 (0.70, 2.14)	0.475
Excellent	96 (21.1)	16 (16.8)	56 (21.1)	24 (25.5)	Ref		Ref
Age at first sex, years									0.171
≤15	154 (41.5)	36 (49.3)	91 (41.6)	27 (34.2)	1.87 (0.97, 3.61)	0.060	1.37 (0.80, 2.35)	0.253
>15	217 (58.5)	37 (50.7)	128 (58.4)	52 (65.8)	Ref		Ref
Unprotected vaginal or anal sex in the past 3 months									0.314
Yes	305 (91.9)	60 (93.8)	182 (92.9)	63 (87.5)	2.14 (0.62, 7.36)	0.226	1.86 (0.76, 4.51)	0.172
No	27 (8.1)	4 (6.3)	14 (7.1)	9 (12.5)	Ref		Ref
Transactional sex history									0.288
Yes	368 (95.3)	72 (93.5)	214 (94.7)	82 (98.8)	0.18 (0.02, 1.55)	0.117	0.22 (0.03, 1.71)	0.147
No	18 (4.7)	5 (6.5)	12 (5.3)	1 (1.2)	Ref		Ref
Transactional sex in the past 3 months									0.122
Yes	48 (14.0)	7 (10.4)	35 (17.2)	6 (8.3)	1.28 (0.41, 4.05)	0.670	2.29 (0.92, 5.72)	0.076
No	294 (86.0)	60 (89.6)	168 (82.8)	66 (91.7)	Ref		Ref
HIV(+) partners in the past 3 months									<0.001
Yes	83 (27.7)	29 (49.2)	50 (28.9)	4 (5.9)	15.5 (4.97, 48.2)	<0.001	6.50 (2.24, 18.9)	<0.001
No	217 (72.3)	30 (50.8)	123 (71.1)	64 (94.1)	Ref		Ref
Ever experienced forced sex									<0.001
Yes	121 (34.6)	33 (47.8)	79 (38.2)	9 (12.2)	6.62 (2.84, 15.4)	<0.001	4.46 (2.10, 9.48)	<0.001
No	229 (65.4)	36 (52.2)	128 (61.8)	65 (87.8)	Ref		Ref
Ever physically hurt or threatened to hurt by sex partner									0.001
Yes	95 (24.5)	30 (39.0)	54 (23.8)	11 (13.3)	4.18 (1.90, 9.16)	<0.001	2.04 (1.01, 4.14)	0.048
No	292 (75.5)	47 (61.0)	173 (76.2)	72 (86.7)	Ref		Ref
Got into trouble because of drinkinge									0.259
Yes	37 (8.1)	10 (10.5)	23 (8.7)	4 (4.2)	2.71 (0.81, 8.99)	0.104	2.19 (0.73, 6.52)	0.160
No	419 (91.9)	85 (89.5)	242 (91.3)	92 (95.8)	Ref		Ref
Ever used drugsf									0.324
Yes	27 (5.9)	8 (8.4)	16 (6.0)	3 (3.2)	2.82 (0.72, 11.0)	0.136	1.95 (0.55, 6.90)	0.297
No	430 (94.1)	87 (91.6)	251 (94.0)	92 (96.8)	Ref		Ref
Drug use in the past 30 daysb									0.322
Yes	8 (25.8)	4 (44.4)	3 (16.7)	1 (25.0)	2.40 (0.17, 33.2)	0.513	0.60 (0.05, 8.00)	0.699
No	23 (74.2)	5 (55.6)	15 (83.3)	3 (75.0)	Ref		Ref
Person making decision on when to stop bearing children									0.002
The man	55 (12.1)	22 (23.2)	27 (10.2)	6 (6.3)	5.11 (1.94, 13.5)	0.001	1.82 (0.72, 4.59)	0.205
The woman	74 (16.2)	17 (17.9)	46 (17.3)	11 (11.6)	2.15 (0.93, 4.96)	0.072	1.69 (0.83, 3.44)	0.148
Both the man and the woman	327 (71.7)	56 (58.9)	193 (72.6)	78 (82.1)	Ref		Ref
Person making decision on avoiding childbearing									0.532
The man	47 (10.4)	13 (14.0)	26 (9.8)	8 (8.6)	1.93 (0.74, 5.01)	0.178	1.18 (0.51, 2.75)	0.698
The woman	109 (24.2)	26 (28.0)	62 (23.5)	21 (22.6)	1.47 (0.74, 2.90)	0.270	1.07 (0.60, 1.91)	0.808
Both the man and the woman	294 (65.3)	54 (58.1)	176 (66.7)	64 (68.8)	Ref		Ref
Self-reported STI in the past 3 months									<0.001
Yes	109 (29.1)	34 (46.6)	62 (27.9)	13 (16.5)	4.43 (2.08, 9.41)	<0.001	1.97 (1.01, 3.83)	0.046
No	265 (70.9)	39 (53.4)	160 (72.1)	66 (83.5)	Ref		Ref
HIV test result (lab-confirmed)									0.008
Positive	66 (14.4)	23 (24.0)	35 (13.1)	8 (8.4)	3.43 (1.44, 8.14)	0.005	1.63 (0.73, 3.67)	0.234
Negative	393 (85.6)	73 (76.0)	233 (86.9)	87 (91.6)	Ref		Ref

Notes: The percentage in each cell is computed using the total number of non-missing records as the denominator. In some cases, the respondents had missing data for either the covariates or outcome or both.

a Test of overall significance of each predictor effect in the model.

b Only persons who did not respond “no” to the question “Ever used drugs” were asked to answer the question “Drug use in the past 30 days”.

c Reports that income was derived from being an employee (salary-based) or that it was derived from personal entrepreneurial activities or via financial support from others (non-salary-based).

d Refers to the Luo cultural practice in which a widow is required to marry a male relative of her late husband (often his brother) or in more recent times a professional inheritor receives money or types of payment for inheriting a widow.²²

e Got into trouble with family or friends, missed school, or got into fights, as a result of drinking alcohol.

f Drugs used to relax, increase energy, or to have a good time (eg, mandrax, bhang, miraa, heroin, cocaine, valium, glue, and kuber). Excludes drugs used to treat an illness or disease.

Abbreviations: CI, confidence interval; HIV, human immunodeficiency virus; Ref, reference; STI, sexually transmitted infections.

Table 3 Final multivariable model for psychological distress among women screened for the contraceptive ring study (N=342), Kisumu, Kenya, 2014

Variable level	Total (N=342), n (%)	High (score: 13–24) (N=68), n (%)	Moderate (score: 5–12) (N=201), n (%)	Low/no (score: 0–4) (N=73), n (%)	High vs low/no; adj odds ratio (95% CI)	High vs low/no; adj P-value	Moderate vs low/no; adj odds ratio (95% CI)	Moderate vs low/no; adj P-value	Overall, adj P-valuea
Education									0.150
Primary or less	219 (64.0)	52 (76.5)	127 (63.2)	40 (54.8)	2.17 (0.99, 4.77)	0.053	1.33 (0.74, 2.39)	0.334
Secondary or more	123 (36.0) 16 (23.5)		74 (36.8)	33 (45.2)	Ref		Ref
Concerned about food insecurity									0.014
Yes	286 (83.6)	63 (92.6)	174 (86.6)	49 (67.1)	3.65 (1.23, 10.9)	0.020	2.39 (1.22, 4.67)	0.011
No	56 (16.4)	5 (7.4)	27 (13.4)	24 (32.9)	Ref		Ref
Ever experienced forced sex									<0.001
Yes	113 (33.0)	32 (47.1)	73 (36.3)	8 (11.0)	6.06 (2.43, 15.1)	<0.001	4.27 (1.91, 9.53)	<0.001
No	229 (67.0)	36 (52.9)	128 (63.7)	65 (89.0)	Ref		Ref
Self-reported STI in past 3 months									0.002
Yes	82 (24.0)	29 (42.6)	44 (21.9)	9 (12.3)	4.02 (1.65, 9.83)	0.002	1.62 (0.72, 3.62)	0.240
No	260 (76.0)	39 (57.4)	157 (78.1)	64 (87.7)	Ref		Ref

Notes: The percentage in each cell is computed using the total number of non-missing records as the denominator. In some cases, the respondents had missing data for either the covariates or outcome or both.

a Test of overall significance of each predictor effect in the model accounting for the effect of other predictors in the model.

Abbreviations: CI, confidence interval; Ref, reference; adj, adjusted; STI, sexually transmitted infections.

AgotKHIV/AIDS interventions and the politics of the African woman’s bodyNelsonLSeagerJA Companion to Feminist GeographyMalden, MABlackwell Publishing2005

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