Predictors of Factors Sustaining HIV/STI Protective Behaviours among Adolescent Girls and Young Women in Mukuru Slums, Nairobi: A Retrospective Cohort Study

Abstract

Aims: To identify factors which contribute to sustained human immunodeficiency virus protective behaviours for out-of-school slum-dwelling young women aged 15-24 years by assessing consistent condom use and having one sexual partner of a group of young women who previously benefited from three different Behaviour Change Communication program models at least one year before. Study Design: The design for this study is retrospective cohort. Place and Duration of the Study: Mukuru Slums in Nairobi, Kenya between November 2015 and April 2017. Methodology: Using probability proportionate to size sampling, 446 adolescent girls and young women (227 previously exposed, 219 unexposed to three different programs) were identified from four villages in the Mukuru Slums and enrolled in the study. Odds ratios with p-values and Pearson’s correlation coefficients were used to determine relationships of select independent variables and dependent variables. One-way ANOVA test was performed to show the differences in the impact of the different programmes. Results: Bivariate and multivariate analyses; and one-way ANOVA test showed statistically significant (P<.05) differences between program models in sustaining protective behaviours. Other predictors of sustained consistent condom use were: a minimum of secondary school level of education (P=.0004) and an income of at least KES 1,000 per month (P=.002); and for one sexual partner: a minimum of secondary school level education (P=.0003) and living with parents (P=.019). Conclusion: The findings show that a Behaviour Change Communication program model integrating Evidence-based Behavioural Interventions, gender and economic empowerment was more efficacious for sustaining protective behaviours than program models that do not.  Developers of programmes for slum-dwelling adolescent girls and young women should consider employing strategies to encourage adolescent girls to live with their parents; married women with more than one sexual partners to use condoms during sex; opportunities availed for those eligible and willing to return to school.