Cultural and Contextual HIV Prevention Needs of Rural Kenyan Youth

Background: The majority of new HIV infections in Kenya occur among young people, especially rural youth who have less access to HIV-related services. In order to design culturally appropriate HIV prevention programs, public health professionals must understand cultural/contextual factors that impact HIV sexual risk/protection.

Methods: Nine focus groups were conducted with youth between the ages of 14-24 (N=199; 110 females, 89 males) living in rural communities in Limuru, Kenya. Youth were recruited through youth groups, and all focus groups were conducted by trained facilitators. Focus groups were recorded and transcribed. Data were thematically analyzed with a focus on: a) multi-level factors that increase rural Kenyan youth's participation in HIV sexual risk behaviors, and b) participants ideas regarding HIV prevention interventions.

Results: Individual/dyadic level factors related to youth's participation in HIV sexual risk behaviors included: inaccurate information, substance use, poor partner communication, older partners, interpersonal/dating violence, lack of parent-child HIV communication, and survival sex. Societal/cultural level factors influencing sexual risk behaviors included: gender inequality/expectations, traditional cultural beliefs/traditions, Western cultural influences, absence of role models, HIV stigma, absence of jobs, and poverty. Ideas for HIV prevention interventions included: HIV prevention workshops/media campaigns, job skills training, HIV-related stigma reduction campaigns, condom distribution, social/athletic clubs, and community-wide demonstrations.

Conclusions: HIV prevention interventions for rural Kenyan youth should go beyond basic prevention education and address risk influences at multiple levels including: individual, dyadic/familial, society, and culture. Interventions may use a range of culturally appropriate delivery modalities, and also focus on sustainable structural level change.