Abstract
Adolescents and youth living with HIV (AYLHIV) are a uniquely vulnerable population facing challenges around adherence, disclosure of HIV status and stigma. Providing school-based support for AYLHIV offers an opportunity to optimize their health and wellbeing. The purpose of this study was to evaluate the feasibility of school-based supportive interventions for AYLHIV in Kenya. From 2016-2019, with funding from ViiV Healthcare, the Elizabeth Glaser Pediatric AIDS Foundation implemented the innovative Red Carpet Program (RCP) for AYLHIV in participating public healthcare facilities and boarding schools in Homa Bay and Turkana Counties in Kenya. In this analysis, we report the implementation of the school-based interventions for AYLHIV in schools, which included: a) capacity building for overall in-school HIV, stigma and sexual and reproductive health education; b) HIV care and treatment support; c) bi-directional linkages with healthcare facilities; and d) psychosocial support (PSS). Overall, 561 school staff and 476 school adolescent health advocates received training to facilitate supportive environments for AYLHIV and school-wide education on HIV, stigma, and sexual and reproductive health. All 87 boarding schools inter-linked to 66 regional healthcare facilities to support care and treatment of AYLHIV. Across all RCP schools, 546 AYLHIV had their HIV status disclosed to school staff and received supportive care within schools, including treatment literacy and adherence counselling, confidential storage and access to HIV medications. School-based interventions to optimize care and treatment support for AYLHIV are feasible and contribute to advancing sexual and reproductive health within schools.
Highlights
School attendance is a critical component in the lives and development of adolescents and youth, including those living with HIV [1,2,3]
Routine programmatic Red Carpet program (RCP) data collected included: number of schools in the project; number of RCP healthcare facilities (HCFs) linked to schools; number of school staff, adolescent health advocates (AHA), and SHC staff trained; number of AYLHIV who had their HIV status disclosed at school; number of AYLHIV who accessed antiretroviral treatment (ART) support and Psychosocial support services (PSS) at school; and estimated number of adolescents and youth in schools reached with HIV, SRH and stigma educational activities
Across the 87 schools, 546 AYLHIV (~ 6 AYLHIV per RCP school) had their HIV status disclosed at school and received care and treatment and PSS within schools; 536 AYLHIV received bi-directional coordination of their care with interlinked HCFs (10 AYLHIV had their care at non-RCP HCFs and received school-based support only)
Summary
School attendance is a critical component in the lives and development of adolescents and youth, including those living with HIV [1,2,3]. School experience contributes to the emotional, social, cognitive, and behavioral development of children and adolescents [1], and provides a unique opportunity to reach adolescents and youth living with HIV (AYLHIV) beyond their homes to support their health, treatment, self-management and wellbeing [4, 5]. Public day and boarding schools are two of the most common forms of academic settings for children and youth in many countries, including Kenya [6]. In Kenya, adolescents and youth spend 8–10 hours per week in a day school and 9 months of their daily lives in a boarding school during the school year, where they reside away from their homes [8]. For youth at boarding schools, their teachers, school staff, and peers become their main community and source of support as daily contact with families and caregivers is limited [9]
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