Piloting an evidence-based intervention for HIV prevention among street youth in Eldoret, Kenya

L. Embleton,C. H. Logie,P. Braitstein,E. Di Ruggiero,D. Ayuku

doi:10.1007/s00038-020-01349-8

L. Embleton, C. H. Logie + Show 3 more

Open Access

https://doi.org/10.1007/s00038-020-01349-8

Copy DOI

Abstract

ObjectivesThis study presents findings from piloting an adapted evidence-based intervention, Stepping Stones and Creating Futures, to change street-connected young people’s HIV knowledge, condom-use self-efficacy, and sexual practices.MethodsEighty street-connected young people participated in a pre- and post-test mixed methods design in Eldoret, Kenya. The primary outcome of interest was HIV knowledge. Secondary outcomes included condom-use self-efficacy and sexual practices. Multiple linear regression models for change scores with adjustment for socio-demographic variables were fitted. Qualitative and quantitative findings are presented together, where integration confirms, expands on, or uncovers discordant findings.ResultsParticipants had a significant increase in HIV knowledge from pre- to post-intervention. The median HIV knowledge score pre-intervention was 11 (IQR 8–13) and post-intervention 14 (IQR 12–16). Attendance was significantly associated with HIV knowledge change scores. Qualitatively participants reported increased HIV and condom-use knowledge and improved condom-use self-efficacy and health-seeking practices.ConclusionsOur findings support the potential for further testing with a rigorous study design to investigate how best to tailor the intervention, particularly by gender, and increase the overall effectiveness of the program.

Highlights

In Kenya, street-connected young people (SCY), for whom the streets play a central role in their everyday lives and social identities (Office of the United Nations High Commissioner for Human Rights 2017), engage in sexual practices that increase their exposure to HIV (Kaime-Atterhog et al 2007; Embleton et al 2015, 2016; Wachira et al 2015, 2016)
Objectives This study presents findings from piloting an adapted evidence-based intervention, Stepping Stones and Creating Futures, to change street-connected young people’s HIV knowledge, condom-use self-efficacy, and sexual practices
Eighty street-connected young people participated in a pre- and post-test mixed methods design in Eldoret, Kenya

Summary

Introduction

In Kenya, street-connected young people (SCY), for whom the streets play a central role in their everyday lives and social identities (Office of the United Nations High Commissioner for Human Rights 2017), engage in sexual practices that increase their exposure to HIV (Kaime-Atterhog et al 2007; Embleton et al 2015, 2016; Wachira et al 2015, 2016). Street-connected young women experience sexual and gender-based violence and are highly reliant on young men for security, economic, and material provisioning, and they are often perceived as ‘unable to work’ and/or rely on survival sex (Sorber et al 2014; Embleton et al 2015, 2016; Wachira et al 2015; Winston et al 2015). Knowledge of HIV is critical in recognizing ones’ vulnerability to acquiring HIV and can increase the likelihood of engaging in preventive practices

Objectives

Methods

Results

Discussion

Conclusion