Young people have some of the highest new HIV infection rates in Kenya, but the situation is worse if they live on the streets.
Researchers from Moi University and its partners say girls living on the streets of Eldoret could be dying from Aids in high numbers without having been diagnosed.
One former street-connected young woman said, “The girls are many but most of them have died due to HIV. Many of the girls I started with [on the street] are dead.”
The young women described their inability to negotiate condom use with young men under the influence of alcohol and other substances. They also explained how substance use leaves them vulnerable to sexual and gender-based violence.
“The small girls sniff glue and it becomes too much for them, then the boys come to them and force themselves on them,” one girl said.
The girls and young men were interviewed to identify the barriers they face in accessing HIV prevention and care.
The researchers said street-connected youths face heightened vulnerability to HIV due to circumstances such as living in unsafe housing, substance use and gender violence.
“Even if I seduce those girls, I don’t have money or a house, I sleep outside. So, I will just buy her cheap alcohol and then take her to Mangula [barracks location] because there I won’t have to pay for anything,” one young man in Eldoret said.
“Then, when they [other street boys] see I have taken her to the forest they will follow me, and around 30–40 will also have sex with her. So, if she is sick, we will all be infected.”
The qualitative study was conducted in Uasin Gishu, Trans Nzoia, Bungoma, Nakuru and Kitale counties between May 2017 and September 2018.
The researchers conducted 41 in-depth interviews and seven focus group discussions with 100 participants aged 15 to 24, of which 43 were street-connected.
The researchers – who published their work last year in the Journal of International Aids Society – said despite multiple limitations, their study has important insights.
“We suggest there is a need to prioritise sexual and gender-based violence prevention and structural interventions, such as cash transfers, safe and secure housing, and food provision for street-connected youths to reduce their risk of acquiring HIV and improve care and treatment outcomes,” they said.
Their study was titled: “If they had a place to live, they would be taking medication: a qualitative study identifying strategies for engaging street-connected young people in the HIV prevention-care continuum in Kenya”.
Other researchers are from Ampath-Eldoret, University of Toronto, Moi Teaching and Referral Hospital, and the London School of Hygiene & Tropical Medicine.
The 2018 National HIV prevalence among males and females aged 15-24 years was estimated at 1.34 per cent and 2.61 per cent in 2017 respectively. The overall HIV prevalence was 1.98 per cent, which means 184,718 young adults were living with HIV in 2017.
The risk of HIV among those on the streets is considered higher, but there are no statistics on prevalence among them.
Overall, the rate of new HIV infections in the general populations have reduced.
In December, the National Syndemic Diseases Control Council said 13 counties have cut new HIV infections by nearly half in one year, helped by a mix of interventions that included viral suppression in the HIV-positive people taking ARVs.
Data from the council showed Mombasa, which reduced new infections by 52 per cent between 2021 and 2022, leads the pack.
“Counties of Mombasa, Taita Taveta, Lamu and Kilifi recorded a decline of more than 50 per cent in new HIV infections between 2021 and 2022,” NSDCC county support division programme officer Douglas Bosire told journalists in Machakos.
Nine other counties-Tana River, Kwale, Nairobi, Homa Bay, Migori, Siaya, Kisumu, Kisii and Nyamira-cut new infections by between 49 per cent and 44 per cent, the 2023 status report presented by Bosire shows.