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Update for my situation - I disabled the surround sound component of my audio (Razer Synapse) and I have sound in game. If I re-enable Synapse, I lose Rimworld sound again.

So that seems to be the root of the problem for me, at least.

I am having this same issue. Sound was fine with a15, but after the update yesterday, nothing.

I have also tried restarting, starting a new game, uninstalling/reinstalling with no luck. Have also updated audio and video drivers.
OS is Win10. My sound settings in game are not zero (I tried putting them down to zero and back up, to see what would happen - answer is nothing ).

Otherwise sound on the computer (and in other Steam games) is working fine.