Analysis of prevalence and hiv risk factors among Adolescents and young people in Kisumu and Homa bay Counties, Kenya

Abstract

This study explored the extent to which adolescents and young people aged 15-24 have been affected by the HIV epidemic in Homa Bay and Kisumu counties, Kenya. Both Homa Bay and Kisumu are among the top five counties with the highest HIV prevalence in Kenya, together with Siaya, Migori, and Busia. In 2018, HIV prevalence was 20.7% in Homa Bay and 16.3% in Kisumu. Young people, especially adolescent girls and young women, remain highly vulnerable due to various intersecting social, economic, cultural and behavioural influences. The study aimed to establish the HIV prevalence among this age group, identify the major risk factors driving infection between both genders, and assess how effective the current existing HIV prevention programs are, to guide more focused and sustainable interventions in the two regions. A total of 118 participants were selected for this study based on Cochrane’s formula, using Kenya’s HIV prevalence rate of 4%. A mixed-methods approach, combining both quantitative data from county health records and a structured survey involving 118 respondents (64 AGYW and 54 ABYM) was used. The qualitative bits were also obtained from four focus group discussions held and three key informant interviews. The results from the questionnaires were entered into data analysis software and were processed to produce table frequencies and percentages, whereas the verbal responses were transcribed, coded and analysed thematically to highlight behavioural and structural factors shaping risk patterns. The findings of the study indicated a gender imbalance in HIV burden, with AGYW, particularly those aged 20-24, recording higher infection rates than the boys. From this study, the identified risk factors for AGYW included economic hardship, limited access to higher education, intergenerational and transactional relationships, gender- based violence, and reduced power in sexual negotiation. For ABYM, the most outstanding risk factors were the social pressures tied to masculinity, substance use, and their poor health- seeking behaviour. The results also proved that HIV among adolescents in the two counties remains exceedingly high and different between the two genders despite the interventions put in place. To solve this, the HIV response requires integrated approaches that use both biomedical interventions with economic empowerment, gender violence response, youth- friendly services and active community participation. Sustainable solutions should aim to reduce economic vulnerability, empower young women, involve young men and enhance accessibility and cultural suitability of prevention services to curb new infections in HIV endemic areas.