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

IF 3.6

The journal of climate change and health Pub Date : 2026-03-01 Epub Date: 2026-04-04 DOI:10.1016/j.joclim.2026.100654

Carmen H. Logie , Zerihun Admassu , Andie MacNeil , Aryssa Hasham , Lawrence Mbuagbaw , Humphres Evelia , Julia Kagunda , Beldine Omondi , Clara Gachoki , Mercy Chege , Mumbi Mwangi , Lesley Gittings , Caetano Dorea , Perry Hystad , Janet M. Turan , Manjulaa Narasimhan

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Abstract

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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肯尼亚少女和年轻妇女中极端天气事件、资源不安全和艾滋病毒脆弱性与自我报告的尿路感染症状之间的关系

极端天气事件（ewe）和资源不安全与泌尿生殖系统感染有关，但这在少女和年轻女性（AGYW）中的研究不足。我们研究了内罗毕和肯尼亚基苏木的AGYW中资源不安全感、EWE暴露、HIV易感因素和自我报告的尿路感染（UTI）症状之间的关系。材料和方法我们对内罗毕（Mathare和Majengo非正式定居点）和基苏木（Ogal和Rota海滩）的AGYW（16-24岁）有目的样本收集的调查数据进行了横断面分析（2024年10月至11月）。我们进行了调整和未调整的逻辑回归分析，以检验资源不安全感（食物、水、卫生设施、月经）、ewe和艾滋病毒脆弱性（过去6个月的交易性行为、过去一年的多个性伴侣[MSP]、过去6个月的流动性）与自我报告的尿路感染症状之间的关系。结果在589名参与者（平均年龄：20.6岁；SD=2.6）中，41.6%的人自我报告尿路感染症状。在过去6个月的ewe中，11.5% （n=68）经历了一次，64.5% （n=380）经历了2-4次，24.0% （n=141）经历了≥5次。大多数（81.3%,n=478）患者有多种EWE类型，且≥1型不止发生一次。在多变量分析中，自我报告尿路感染症状的几率在报告的参与者中最高：过去一年EWE≥5 (vs. 1)；水不安全;食品不安全;卫生安全;月经不安全感;暴露于1、2和≥3种资源不安全感（vs.无）。交易性行为、多个性伴侣和流动性也与自我报告的尿路感染症状显著相关。结论尿路感染、资源不安全、HIV易感性与尿路感染症状相关。在肯尼亚，需要采取极端天气和了解贫困情况的办法来减少尿路感染风险，并促进老年妇女的性健康和生殖健康。

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