Kenyan Women Bearing the Cost of Climate Change

Climate change-induced crises can aggravate intimate partner violence (IPV); the loss of income when weather affects the agricultural industry can exacerbate violence at home. In Kenya, climate change has increased precipitation during the rainy season and raised temperatures during the dry season, resulting in floods and droughts. For 75% of Kenyans, agricultural activities are their primary source of income. This research aims to assess patterns in IPV and severe weather events (SWE). We examined Integrated Public Use Microdata Series-Demographic Health Survey (IPUMS-DHS) data from 2008 and 2014 for IPV severity and frequency. We used Emergency Events Database (EM-DAT) data along with GPS coordinates to identify SWEs (defined as any flood >10 days) by county in Kenya. Overall, women were more likely to experience IPV if their spouse worked in agriculture (Odds Ratio (OR) = 1.22, 95% Confidence Interval (CI): 1.10–1.36). There was a 60% increase in the odds of reporting IPV in counties that experienced an SWE as compared to counties that did not experience an SWE (OR = 1.60, 95% CI: 1.35–1.89). This analysis further supports the growing body of research that suggests a relationship between climate change-related weather events and violence against women.

Perinatal Depression and Its Impact on Infant Outcomes and Maternal-Nurse SMS Communication in a Cohort of Kenyan Women

Background Perinatal depression is broadly defined as depressive symptoms during pregnancy or within the 12 months following delivery, affecting approximately 20-25% of pregnant and postpartum women in low- and middle-income countries. The wide accessibility of mobile phones allows mobile health (mHealth) interventions to be considered a solution to identify perinatal depression and provide appropriate referrals for treatment. This study, nested in a larger SMS communication project, examined the prevalence and correlates of perinatal depression, determined the association between antenatal depression and infant morbidity/mortality, and compared SMS communication patterns between women with and without perinatal depression. Methods This was a prospective longitudinal cohort of pregnant women seeking antenatal services at two public sector health clinics in Kenya. SMS messages were sent to participants with educational content related to their pregnancy and infant health and two-way SMS communication occurred with a nurse. Sociodemographic and obstetric characteristics, SMS messaging behaviors, infant health status, and depressive symptoms were assessed by a standardized questionnaire administered at enrollment (30-36 weeks gestation) and follow-up (14 weeks postpartum). Generalized estimating equation (GEE) with Poisson link was used to evaluate correlates of perinatal depressive symptoms, infant outcomes, and frequency of SMS messaging. Results Of the 572 women with complete follow-up information, 188 (32.9%) screened positive for elevated depressive symptoms (≥10 by EPDS scale) at some time point during pregnancy or postpartum. The strongest predictors of depressive symptoms included abuse during pregnancy, fewer years of schooling, and maternal unemployment. Antenatal depressive symptoms were associated with an increased risk of infant illness or hospitalization (RR = 1.12, 95% CI: 1.11, 1.13). Women with antenatal or persistent perinatal depressive symptoms sent fewer SMS messages during the study period than their counterparts without depression. Conclusions Prevalence of elevated perinatal depressive symptoms was high in this cohort of Kenyan women. Our findings highlight the importance of screening perinatal women for experiences of abuse and symptoms of depression. Differences in messaging frequency between women with vs. without depressive symptoms presents a potential opportunity to provide more support for those perinatal depression.

Public Debates on Women's Issues in Postcolonial Kenya: Selections From Viva

Vol 3. No. 1 (2022) With contributions by Emma Rose Ryan and Ainhoa Leoz Asiáin. This issue of SourceLab introduces readers to the history of Viva: The Magazine For Kenyan Women, a Postcolonial Kenyan publication that discusses women's rights and issues. This publication is part of the digital documentary edition series SourceLab, based at the University of Illinois at Urbana-Champaign. Our Editorial Board conducts rigorous peer-review of every edition.

Late antiretroviral refills and condomless sex in a cohort of HIV-seropositive pregnant and postpartum Kenyan women

Introduction The postpartum period can be challenging for women living with HIV. Understanding how the postpartum period impacts ART adherence and condomless sex could inform the development of comprehensive sexual and reproductive health and HIV services tailored to the needs of women living with HIV during this critical interval. Methods In a longitudinal cohort study of HIV-seropositive Kenyan women, late ART refills and self-reported condomless sex were compared between the woman’s pregnancy and the postpartum period. Analyses were conducted using generalized estimating equations and adjusted for alcohol use, depressive symptoms, intimate partner violence (IPV), and having a recent regular partner. Effect modification was explored for selected variables. Results and discussion 151 women contributed visits. Late ART refills occurred at 7% (32/439) of pregnancy visits compared to 18% (178/1016) during the postpartum period (adjusted relative risk [aRR] 2.44, 95% confidence interval [CI] 1.62–3.67). This association differed by women’s education level. Women with ≥8 years of education had late ART refills more during the postpartum period than pregnancy (aRR 3.00, 95%CI 1.95–4.62). In contrast, in women with <8 years of education, late ART refills occurred similarly during pregnancy and the postpartum period (aRR 0.88, 95%CI 0.18–4.35). Women reported condomless sex at 10% (60/600) of pregnancy visits compared to 7% (72/1081) of postpartum visits (aRR 0.76, 95%CI 0.45–1.27). This association differed by whether women had experienced recent IPV. Women without recent IPV had a significant decline in condomless sex from pregnancy to postpartum (aRR 0.53, 95%CI 0.30–0.95) while women with recent IPV had no significant change in condomless sex from pregnancy to postpartum (aRR 1.76, 95%CI 0.87–3.55). Conclusion Improved support for ART adherence during the postpartum period and addressing IPV to limit condomless sex could improve HIV treatment and prevention outcomes for HIV-seropositive women as well as their infants and sexual partners.

Longer duration of anti-retroviral therapy is associated with decreased risk of human papillomaviruses detection in Kenyan women living with HIV

Objective: A longitudinal study was conducted among women living with HIV in Kenya to determine if duration of anti-retroviral (ART) usage altered detection and persistence of oncogenic (high-risk) human papillomaviruses (HR-HPV). Methods: Women living with HIV without cervical dysplasia were enrolled at a cervical cancer screening clinic. Three cervical swabs, HIV viral loads, and CD4 cell counts were obtained at enrollment and at two annual visits. HPV genotyping was performed on swabs (Roche Linear Array). Linear regression models assessed effects of ART duration on HR-HPV detection and persistence. Results: Seventy-seven women, median age 38 years, completed three study visits and were included in the analysis. The mean time from HIV diagnosis to enrollment was 9.6 years (SD 3.9 years). The mean ART duration was 6.2 years (SD 3.1 years). Most women had undetectable HIV viral loads and CD4 cell counts above 500 cells/L. Each additional year of ART use reduced the likelihood of detection of HR-HPV by 10–15% and persistent detection of A9 HR-HPV by 20%. Conclusion: Among Kenyan women living with HIV, longer duration of ART use was associated with significantly reduced risk of all detection and persistent detection of HR-HPV.