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Jasna Loos , Hilde Vandenhoudt & Christiana Nöstlinger

The diversity in sexual activity and protective behaviours among HIV-positive adolescents aged 13 to 17 years in Uganda and Kenya. Jasna Loos , Hilde Vandenhoudt & Christiana Nöstlinger Eric Wobudeya, Irene Murungi , Carolyn Nakanjaka & Sabrina Bakeera-Kitaka

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Jasna Loos , Hilde Vandenhoudt & Christiana Nöstlinger

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  1. Thediversityin sexual activity and protective behavioursamongHIV-positive adolescents aged 13 to 17 yearsin Uganda and Kenya Jasna Loos, Hilde Vandenhoudt & Christiana Nöstlinger Eric Wobudeya, Irene Murungi, Carolyn Nakanjaka & Sabrina Bakeera-Kitaka Daniel Fedha, Lilian Langat & Daniel Adipo

  2. Background Growing numbers of adolescents living with HIV (ALH) • Facing specific sexual and reproductive health (SRH) challenges (Bakeera-Kitaka et al. 2007, Birungi et al. 2009) • “Positive Living for a Brighter Future” intervention Rigorous evaluation  Baseline study • Sexual and reproductive health • HIV • Quality of life

  3. Methods baseline study • Retrospective and cross-sectional study • 583 ALH aged 13-17 years • Convenience sample at paediatric HIV-care centres • Informed assent and parental consent • Standardised questionnaire • Guided by behavioural theories and based on validated questionnaires and formative research • Trained interviewers • First descriptive analysis • Stratified by country and gender • Using SPSS 19.0

  4. Participants’ characteristics • Median age: 14 years • 55% girls – 45% boys

  5. Participants’ characteristics: HIV history • Median age informed about HIV status: 11 years • 98% in care • 70% on ARVs • 53% Kenya vs. 85% Uganda • 44% in peer support • 37% Kenya vs 51% Uganda

  6. Participants’ characteristics • 23% still had both parents • 39% lost both parents, 38% lost one parent • 61% did not live with a biological parent • 88% of ALH were in school • Median age left school: 15 years • 58% couldn’t afford school fees

  7. Sexual activity 123 ALH (21%) reported ever having had sex

  8. Sexualactivityassociatedwith… (sign. p < 0,05)

  9. Sexually active ALH: Partners • 68% mentioned their sexual partners were friends • Median age:

  10. Sexually active ALH • 65% reported more than one sexual partner • Median of 2 sexual partners • 68% had their last sexual experience longer than three months ago • 17% reported first sex was forced • 14% reported last sex was forced • 2% said they were drunk at last sex

  11. Sexually active ALH: Protective behaviour • 12 girls (17%) became pregnant • 2 boys (4%) made a girl pregnant

  12. Sexually inexperienced ALH 457 (79%) ALH reported they never had sex

  13. Sexually inexperienced ALH: Reasons • 41% feared the consequences of sex • Boys feared HIV-transmission (27%) • Girls feared pregnancy (15%) • In Uganda 32% didn’t feel ready to have sex • In Kenya 26% felt they were too young to have sex

  14. Sexually inexperienced ALH: Intentions • 7% currently had a boy/girlfriend • 7% currently received gifts from someone special • 10% thought about having sex • 17% boys vs. 5% girls • 10% thought that they will have sex in the next 3 months • 13% boys vs. 8% girls

  15. Conclusion Diversityin sexual activity and protective behaviours 79% ALH sexually inexperienced • Low intention of becoming sexually active • Different motivations for abstaining 21% ALH sexually active • First sex at 13 years & more partners • 43% never used a condom & 17% girls have been pregnant

  16. Lessons for positive prevention • Take into account the diversity • Comprehensive interventions for ALH Realistic prevention messages both groups Safer sex practices Support to abstain until they are ready • Developmental approach • Rights based approach • Influence of contextual factors on sexual behaviour  Enabling environment Encouraging school attendance Supportive peer norms &

  17. Acknowlegdments • Thank you for your attention • All the adolescents for answering our questions • Local study coordinators: Carolyn, Irene, Lilian and Daniel for the logistic miracle • Data managers, Daniel and Eric for their rigor • Funding agencies the Dutch AIDS fonds and the Belgian development cooperation

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