HIV Knowledge, Information Sources, and Perceived Risk among Reproductive-Aged Individuals in Kisumu, Kenya: A Latent Profile Analysis.

Abstract

Information, education, and communication programs to improve HIV knowledge and communication skills are critical to HIV responses. It is unclear if improved HIV knowledge translates to decreased HIV acquisition risks. We identified typologies of HIV knowledge to assess the relationship with HIV risk perceptions and prevention behaviors using data from reproductive-aged adults without previously diagnosed HIV at screening for entry into the RV393 HIV incidence cohort in Kisumu County, Kenya. Staff-administered questionnaires on sociodemographic characteristics, HIV knowledge, information sources (e.g., radio, television, community, school, etc.), and prevention/risk behaviors. HIV knowledge and information source typologies were identified using latent profile analysis (LPA). Mixture modeling was used to assess the relationship between typologies and perceived risk. Prevention/risk behaviors were compared and stratified by typology and risk perception (high or low/no risk). Of 926 participants in the analyses, 46.8% were female and 58.1% had at least a secondary education. LPA fit statistics suggested a three-class model (BIC = 7738; entropy = 0.793). Differences in latent profiles were characterized by engagement in community-sourced information. Across all classes, participants with high risk perception reported significantly greater numbers of sex partners and were more likely to exchange sex compared to those reporting low/no risk. HIV testing practices and consistent condom use were similar irrespective of typology. There was alignment between risk perception and risk/prevention behaviors, but knowledge and information typologies were not significantly associated with risk perception. Building knowledge alone may not be sufficient to improve outcomes, thus necessitating structural interventions that facilitate enabling environments for prevention services.