Associations between extreme weather events, resource insecurities, and HIV vulnerabilities with self-reported urinary tract infection symptoms among adolescent girls and young women in Kenya

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Introduction: Extreme weather events (EWEs) and resource insecurities are linked to genitourinary infections, yet this is understudied in adolescent girls and young women (AGYW). We examined associations between resource insecurities, EWE exposure, HIV vulnerability factors, and self-reported urinary tract infection (UTI) symptoms among AGYW in Nairobi and Kisumu, Kenya. Material and methods: We conducted cross-sectional analyses of survey data collected with a purposive sample of AGYW (16-24 years) in Nairobi (Mathare and Majengo informal settlements) and Kisumu (Ogal and Rota beaches) (October-November 2024). We conducted adjusted and unadjusted logistic regression analyses to examine associations between resource insecurities (food, water, sanitation, menstruation), EWEs, and HIV vulnerabilities (past 6-month transactional sex, past year multiple sex partners [MSP], past 6-month mobility), with self-reported UTI symptoms. Results: Among n=589 participants (mean age: 20.6 years; SD=2.6), 41.6% self-reported UTI symptoms. Regarding past 6-month EWEs, 11.5% (n=68) experienced one, 64.5% (n=380) experienced 2-4, and 24.0% (n=141) experienced ≥5. Most (81.3%, n=478) experienced multiple EWE types, with ≥1 occurring more than once. In multivariable analyses, odds of self-reporting UTI symptoms were highest among participants reporting: ≥5 (vs. 1) past-year EWE; water insecurity; food insecurity; sanitation insecurity; menstruation insecurity; and exposure to one, two, and ≥3 resource insecurities (vs. none). Transactional sex, multiple sexual partners, and mobility were also significantly associated with self-reported UTI symptoms. Conclusions: EWEs, resource insecurity, and HIV vulnerabilities were associated with UTI symptoms. Extreme weather and poverty-informed approaches are needed to reduce UTI risks and advance the sexual and reproductive health of AGYW in Kenya.

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