Sexual practices, their influencers, and utilization of HIV services among female sex workers in Mombasa County, Kenya.

Introduction: female sex workers (FSWs) are vulnerable to acquiring HIV and other sexually transmitted infections due to unprotected sex. Understanding and addressing the gaps in safer sex among FSWs can help to reduce HIV acquisition and transmission. This study described sexual practices, their correlates and use of HIV services among FSWs in Mombasa County, Kenya. Methods: participants were recruited for a baseline survey by a time-location cluster randomized design at predetermined intervals from five bars and five clubs in Mombasa County until a sample size of 160 was reached. Descriptive statistics and inferential analysis using R were conducted, and p<0.05 was regarded as statistically significant. Results: nearly all (99%) of the participants were unmarried, and 11% had tertiary education. Ninety-eight percent (98%) reported vaginal intercourse, 51% reported using alcohol/drugs before sex, and 28% practiced unprotected intercourse. About 64% had tested for HIV within three months, 14% believed that it is safe to reuse condoms, and 10% that it is safe to engage in unprotected sex. In bi-variate analysis, FSWs were more likely to engage in unprotected intercourse if they reported more frequent sex, more frequent sex with regular clients, poor HIV knowledge, alcohol/drug use, and violence. In multivariate analysis, risky sexual practices were associated with frequency of sexual intercourse, alcohol/drug use, and poor HIV knowledge. Conclusion: female sex workers engage in unprotected sex while under the influence of substances, belief in re-using condoms and have high frequency of sexual intercourse. Inadequate knowledge of HIV and substance use significantly correlated with unprotected sex. Interventions to address these modifiable factors are needed to mitigate the risk of HIV among FSWs.

Reversible effect of castration induced hypogonadism on the morphology of the left coronary arteries in adult male rabbits.

Hypogonadism is associated with an increased risk of coronary artery disease. This study sought to describe the histomorphology of the left coronary arteries of the adult male rabbit following orchiectomy and subsequent testosterone administration. We included 20 adult male rabbits, divided into a baseline group (n=2), an interventional group subjected to castration only (n=6), an intervention group subjected to castration followed by testosterone injection (n=6), and a control group (n=6). Key variables under investigation were serum testosterone levels, the intima-media thickness of coronary arteries, smooth muscle cell density, and adventitial collagen fiber density. The mean coronary arteries' intimal medial thickness was significantly higher in the castrated group than in controls (0.488 mm and 0.388 mm, respectively), while the testosterone-injected group had a mean of 0.440 mm. Mean smooth muscle cell density was significantly lower in the castrated rabbits vs. controls (26.96% and 47.80%, respectively), this observation being reversed with testosterone injection (47.53%). Mean adventitial collagen fiber density was significantly higher in the castrated group than in controls (66.6% and 36.1%, respectively), with a marginal difference after testosterone injection (65.2%). This study demonstrates that castration-induced hypogonadism causes morphological changes in the coronary arteries that are partly reversible using testosterone injections. These findings provide a morphological basis for understanding the role of testosterone in coronary arteries.

ASSOCIATION BETWEEN QUALITY OF INTRAPARTUM CARE WITH FRESH STILLBIRTH IN A LOW-INCOME URBAN SETTING.

Introduction: Africa bears the greatest burden of stillbirth and yet, there is a paucity of data from this setting. The aim of this study was to determine the association between quality of intrapartum care and fresh stillbirth in Nairobi, Kenya. Methods and materials: This was a case control study in 4 tertiary public hospitals in Nairobi county from August 2018 to April 2019. Two hundred and fourteen women with stillbirths and 428 women with livebirths between 28-42 weeks were enrolled. Fifty-five (55) of the 214 women had fresh stillbirths and were included in this analysis. Information was obtained through interviews and data abstraction from the medical records. The exposure variables were sociodemographics, refferal status, intrapartum complications, partogram use and fetal heart rate monitoring. The two-sample t-test was used to compare continuous variables and Chi-square or Fisher's exact tests for categorical variables. The association between exposure and outcome variables was done using bivariate and multivariate analysis using logistic regression. Statistical significance was defined as a two-tailed p-value ≤ 0.05. Results: Refferal (OR 3.4, 95 % CI 1.9-6.03, P=0.001); no use of a partogram (OR 4.7 95% CI 2.6-8.4, P=<0.001); no fetal heart rate monitoring per schedule (OR 2.2, 95% CI 1.1-4.7, P=0.03), caesarean (OR 1.7, 95% CI 1-3.34, P=0.05) or beech delivery (OR 18, 95% CI=3.2-103, P=0.001) were associated with fresh stillbirth. Conclusion: Improving the referral system, intrapartum care and timely caesarean delivery can reduce the risk of fresh stillbirth.