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 - 18/01/26

Doi : 10.1016/j.joclim.2026.100654

Carmen H. Logie ^1,^2,^3,^4,^⁎ , Zerihun Admassu ¹ , Andie MacNeil ¹ , Aryssa Hasham ¹ , Lawrence Mbuagbaw ^5,^6,^7,^8,^9,¹⁰ , Humphres Evelia ¹¹ , Julia Kagunda ¹² , Beldine Omondi ¹¹ , Clara Gachoki ¹² , Mercy Chege ¹² , Mumbi Mwangi ¹² , Lesley Gittings ^13,¹⁴ , Caetano Dorea ¹⁵ , Perry Hystad ¹⁶ , Janet M. Turan ¹⁷ , Manjulaa Narasimhan ^18,¹⁹

¹ Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St W, Toronto, ON, M5S 1V4, Canada

² United Nations University Institute for Water, Environment, and Health, 225 East Beaver Creek Road, Richmond Hill, ON, L4B 3P4, Canada

³ Centre for Gender & Sexual Health Equity, Faculty of Medicine, University of British Columbia, 1190 Hornby St. (11th floor), Vancouver, BC, V6Z 2K5, Canada

⁴ Women’s College Research Institute, Women’s College Hospital, 76 Grenville St, Toronto, ON, M5S 1B2, Canada

⁵ Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada

⁶ Department of Anesthesia, McMaster University, Hamilton, ON, Canada

⁷ Department of Pediatrics, McMaster University, Hamilton, ON, Canada

⁸ Biostatistics Unit, Father Sean O’Sullivan Research Centre, St Joseph’s Healthcare, Hamilton, ON, Canada

⁹ Centre for Development of Best Practices in Health (CDBPH), Yaoundé Central Hospital, Yaoundé, Cameroon

¹⁰ Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa

¹¹ Centre for the Study of Adolescence, Mbaazi Avenue off Kingara Road, Nairobi, Kenya

¹² Elim Trust, Jacaranda Drive 71 Mushroom Gardens, Kiambu, Kenya

¹³ School of Health Studies, Faculty of Health Sciences, Western University, 151 Richmond St, London, ON, N6A 5B9, Canada

¹⁴ Centre for Social Science Research, University of Cape Town, Cape Town, South Africa

¹⁵ Department of Civil Engineering, University of Victoria, Victoria, BC, Canada

¹⁶ College of Health, Oregon State University, Corvallis, Oregon, USA

¹⁷ Department of Health Policy and Organization, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL, 35294, USA

¹⁸ Department of Sexual and Reproductive Health and Research, WHO, 1211, Geneva, Switzerland

¹⁹ UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Avenue Appia 20, 1211, Geneva, Switzerland

^⁎ Corresponding author: Carmen H. Logie, Factor-Inwentash Faculty of Social Work, 246 Bloor Street W, Ontario, M5S 1V4, University of Toronto, Toronto, Canada Factor-Inwentash Faculty of Social Work University of Toronto 246 Bloor Street W Toronto Ontario M5S 1V4 Canada

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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, MSP, 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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Keywords : urinary tract infection, young women, Kenya, resource insecurity, extreme weather events