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Understanding the urban-rural disparity in HIV and poverty nexus: the case of Kenya

Magadi, Monica A.


Monica A. Magadi


Background The relationship between HIV and poverty is complex and recent studies reveal an urban-rural divide that is not well understood. This paper examines the urban-rural disparity in the relationship between poverty and HIV infection in Kenya, with particular reference to possible explanations relating to social cohesion/capital and other moderating factors. Methods Multilevel logistic regression models are applied to nationally-representative samples of 13,094 men and women of reproductive age from recent Kenya Demographic and Health Surveys. Results The results confirm a disproportionate higher risk of HIV infection among the urban poor, despite a general negative association between poverty and HIV infection among rural residents. Estimates of intra-community correlations suggest lower social cohesion in urban than rural communities. This, combined with marked socio-economic inequalities in urban areas is likely to result in the urban poor being particularly vulnerable. The results further reveal interesting cultural variations and trends. In particular, recent declines in HIV prevalence among urban residents in Kenya have been predominantly confined to those of higher socio-economic status. Conclusion With current rapid urbanization patterns and increasing urban poverty, these trends have important implications for the future of the HIV epidemic in Kenya and similar settings across the sub-Saharan Africa region.


Magadi, M. A. (2017). Understanding the urban-rural disparity in HIV and poverty nexus: the case of Kenya. Journal of Public Health, 39(3), e63-e72.

Journal Article Type Article
Acceptance Date May 27, 2016
Online Publication Date Jul 13, 2016
Publication Date 2017-09
Deposit Date Jun 1, 2016
Publicly Available Date Oct 27, 2022
Journal Journal of public health
Print ISSN 1741-3842
Electronic ISSN 1741-3850
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 39
Issue 3
Pages e63-e72
Keywords Kenya, HIV-poverty nexus, Multi-level modelling, Urban-rural differences, Theory of economics of sexual behaviour, Social cohesion-HIV theory
Public URL
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Additional Information This is a pre-copyedited, author-produced PDF of an article accepted for publication in Journal of public health following peer review. The version of record Magadi, Monica A. "Monica A. Magadi; Understanding the urban–rural disparity in HIV and poverty nexus: the case of Kenya", Journal of Public Health, Volume 39, Issue 3, 1 September 2017, Pages e63–e72,


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