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Citation Information

Type Report
Title Highlighting marital HIV risk and promoting premarital VCT in Nyanza Province, Kenya
Publication (Day/Month/Year) 2008
Publisher FRONTIERS Final Report USAID
City Washington
Country/State DC
URL http://www.popcouncil.org/pdfs/2008RH_KenyaMaritaHIVPremaritalVCT.pdf
Married adolescent girls form a large segment of Kenyan youth, yet they are largely overlooked by researchers and programmers, as many programs focus on the prevention of STI/HIV and unwanted pregnancies for unmarried youth. There is the widespread perception that marriage is protective against HIV, yet evidence is increasing that girls who are married are much more likely to be infected with HIV than unmarried sexually active girls. An HIV prevalence study in Kisumu, Kenya found that married girls age 15-19 had higher rates of HIV infection when compared to unmarried girls (Glynn et al, 2001). “Highlighting Marital HIV Risk and Promoting Premarital VCT in Nyanza, Kenya” is a project of the Population Council, in collaboration with PATH and Kendu Adventist Hospital. Its specific objectives are: 1) to design and implement educational strategies to raise awareness of the risks of HIV and early marriage; 2) to promote voluntary counseling and testing for couples; and 3) to support and empower newly married girls through community-based clubs. The program was implemented in Rachuonyo and Homa Bay Districts in Nyanza Province, Kenya. The strategies to address HIV risk among married adolescent girls included: an education campaign to sensitize communities, families and young people that marriage is not protective of HIV; promotion of premarital VCT services for young couples including referral and linkage with existing services and subsidies for associated costs; and support groups for married girls. The specific achievements over two years of the intervention included: Magnet Theatre: Fourteen theatre groups facilitated Magnet Theatre activities reaching over 20,500 males and 17,300 females, through 47,260 contacts. Messages conveyed during performances related to the HIV risk associated with marriage, fidelity, and the importance of premarital/couples VCT. Radio: Radio spots were aired on Radio Ramogi and Lake Victoria FM, with a combined reach of between 300,000 and 500,000 people. Seven radio spots went on the air during hours that many community members listened to the radio. Advocacy by religious leaders: Religious leaders advocated against early marriage and encouraged community members to attend VCT. They made over 1,150 referrals for VCT, and reached over 17,400 community members with messages on marital HIV risk. Mentoring: Kendu Adventist Hospital supports mentors to mobilize and support married adolescent girls. Mentors conducted meetings that discussed HIV reaching over 7,600 married girls, STIs reaching over 5,300 married girls, VCT reaching over 6,800 girls and ARV reaching over 2,500 girls. VCT: VCT services were designed to address barriers to VCT use, including the costs of travel to the VCT sites. A coupon system was used to encourage community members to visit VCT sites in order to know their HIV status. Programmatic implications: This project underscored the special circumstances of married adolescents in Nyanza, a group for which there is no specialized programming. Many young women in Homa Bay described having been victims of sexual violence, making them vulnerable to HIV infection. Mechanisms to support projects for married adolescents, including access to mentors and other types of social support, need to be established.

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