Urbanization, Poverty and Culture in the Spatial Patterns of the HIV/AIDS Epidemic in Kenya

Abstract

With 1.3 million people infected and 150,000 deaths in 2003, the HIV/AIDS epidemic con- tinues to greatly impact on the Kenyan society. Sentinel surveillance data since 1990 display a regionally-varying epidemic which suggests disparity in the transmission of HIV/AIDS and in the factors influencing its spatial diffusion and intensity across the country. At the national level, the epidemic has been higher among the urban residents. However, provincially disag- gregated prevalence does not show correlation with the percentage population that is urban. In spite of this, circular migration as migrants maintain link with their rural homes could be influencing constant diffusion between the rural and urban areas. High prevalence levels in Nyanza province, which has high poverty incidence, suggest the role of poverty in the spread of the epidemic. However, low prevalence in North Eastern province, which has equally-high poverty incidence, indicates that there is more than poverty in the spatial diffusion dynamics of the epidemic. Positively-strong correlation with the Nilotic ethnic group and negative corre- lation with the Central Bantu, the Western Hamitic, and the Eastern Hamitic suggest the in- fluence of cultural practices in the spatial patterns of the HIV/AIDS epidemic. An expansive surveillance system at lower administrative level would provide more information to explore further the factors influencing the spatial patterns for better mitigation intervention of the epidemic in Kenya.