A novel critical consciousness-based HIV prevention intervention for male youth in Kenya

Background: Cultural, social, and gender norms play a role in fueling the international HIV pandemic among youth. HIV prevention interventions that successfully challenge these norms are urgently needed. This study assessed the feasibility, acceptability, and initial outcomes of a critical consciousness-based HIV prevention intervention challenging social and gender norms that promote HIV-related risk behaviors among male Kenyan youth.

Methods: A critical consciousness-based HIV prevention intervention was delivered to two groups of 37 male Kenyan youth (ages 16-24) and focused on challenging social and gender norms related to multiple sexual partners, early sexual debut, gender-based violence, and substance use. Various stimuli (e.g. media images, music videos, audio scripts, and role plays) were presented to participants who critically analyzed societal messages related to HIV risk behaviors present in those stimuli through a critical consciousness coaching technique. Data were collected immediately post-intervention, and 3-months and 9-months post intervention.

Results: Qualitative and quantitative data revealed high degrees of feasibility and acceptability, and demonstrated that: a) stimuli made the critical analysis of social messages accessible, b) session material was enjoyable and applicable to their lives; c) youth developed a critical analysis of social messages beyond the initial intervention; d) youth changed their HIV-related risk-behaviors; and e) youth encouraged their peers to challenge social norms and/or change their HIV-related risk behaviors.

Conclusions: This study demonstrates promise for incorporating critical consciousness into HIV prevention interventions both internationally and domestically. Such strategies will likely have transferability across multiple populations with social and gender norms promoting HIV-related risk behavior.