The NIH Office of AIDS Research has prioritized the development and evaluation of culturally appropriate interventions in different international settings and populations. Discovering the right prevention tools to successfully combat HIV is a global imperative with new infections outpacing treated cases by a ratio of 2:1. UNAIDS estimates that 55% of new infections occur in persons younger than 25, and has issued a global call to action for making children and adolescents central to the development and implementation of new HIV prevention efforts. This proposal meets that goal by involving adolescents and their community leaders in the adaptation of "Know Your Network" (KYN), an HIV prevention intervention that raises awareness about the role of concurrent (or overlapping) sexual partnerships in the spread of HIV. Kenya has an estimated 6.3% national HIV prevalence and significant disparities in the distribution of HIV across ethnic groups. HIV prevalence among Kenya's nine major ethnic groups ranges from less than 1% in the Somali to 20% in the Luo. The high prevalence of HIV infection in young Luos is particularly alarming: a recent study found the prevalence of HIV increased from 1.5% in females aged 13-14 to 8.6% in females aged 15-19, and to 33.7% for women aged 20-24. Prevalence across age cohorts increased in males more slowly, from <1% in males aged 13-19, to 10.4% in males aged 20-24, and 30% in males aged 25-29. These findings underscore the critical need for HIV prevention interventions for Luo adolescents that address the drivers of the HIV epidemic in their communities, one of which is concurrency. Study Purpose: to gain understanding of Luo adolescents'sexual partnership patterns and the sociocultural context in which they form to determine how "Know Your Network," a community-based intervention, might be appropriately adapted for use as a prevention tool with this adolescent population. The study aims are to: 1) Describe Luo adolescents'sexual partnership patterns and the socio-cultural context in which they form, and identify implications for adaptations to the KYN intervention, 2) Assess the feasibility and acceptability of the adapted KYN intervention for youth. Methods:
Aim 1 will be accomplished by integrating a systematic review of recent scientific literature with a secondary analysis of concurrency among Luo adolescents using existing survey data collected by Amornkul et al.
Aim 2 will be accomplished using focused group discussions conducted separately with adults and adolescents aged 13-17.
HIV/AIDS is a leading cause of illness and premature death worldwide, and has reversed gains in human development. Some populations experience a disproportionate burden of HIV infection, and it is in these populations that HIV is spreading fastest. This project involves Kenyan adolescents, their families, and community in the adaptation of a new HIV prevention intervention for use adolescents at high risk of HIV infection.
|Knopf, Amelia; Agot, Kawango; Sidle, John et al. (2014) "This is the medicine:" A Kenyan community responds to a sexual concurrency reduction intervention. Soc Sci Med 108:175-84|
|Knopf, Amelia; Morris, Martina (2012) Lack of association between concurrency and HIV infection: an artifact of study design. J Acquir Immune Defic Syndr 60:e20-1; author reply e21|