In Kenya, there are over 1.5 million people living with HIV, and approximately 10 percent are adolescents from ages 10 to 19. Huge strides have been made in scaling up HIV services in Kenya, however, adolescents are not being served in the same way as other groups. Complex reproductive and sexual health needs of young people are often overlooked making it difficult for many HIV-positive adolescents to seek services and adhere to treatment.
To address these challenges, ICAP, with support from PEPFAR through the CDC, is partnering with Kenya’s Ministry of Health (MoH) to provide technical support to clinics in Eastern South and Nyanza regions to provide youth-friendly services for adolescents living with HIV. ICAP is working with health facilities to introduce a comprehensive package of support for adolescents which includes sexual and reproductive health, prevention messages, special health facility hours, and psychosocial support groups led by adolescent peer educators.
“Adolescents are a special group,” said Emily Kasati, a nurse at Siaya County Referral Hospital. “We use their peers to encourage them to accept their status and to take their medications regularly.”
At many clinics, young people seeking sexual and reproductive services ranging from contraceptives to HIV testing have to stand in long queues with adults, often afraid they will be seen by family and local community members. For HIV-positive adolescents, the fear of exposure and resulting stigma can make it difficult for them to adhere to treatment and many are lost to follow-up.
To encourage HIV treatment adherence among adolescents, ICAP is training HIV-positive adolescents as peer mentors who are familiar with updated treatment guidelines and are able to lead support groups.
“I have convinced many adolescents to come back to the clinic and continue taking their medication,” said an adolescent peer mentor at Siaya County Referral Hospital who was diagnosed with HIV when she was 17. “Sometimes they think because they don’t look and feel sick they can ignore the medicine, and I counsel them and make sure they see the importance of taking care of themselves.”
In addition to HIV services, adolescents receive counseling on sexuality, developmental changes, risk assessment, teenage pregnancy, and life skills. Screening and treatment of sexually transmitted infections is also offered.
“When the adolescent peer mentors speak up, girls listen,” said nurse Kasati. “Sometimes they even come forward with their own issues.”
Since July 2014, ICAP has supported the expansion of reproductive health services at 187 sites and 175 sites in Nyanza Region and Eastern South region respectively. In addition, ICAP has trained over 30 adolescents as peer mentors and provided comprehensive services to 14,100 adolescents in Eastern South and Nyanza regions.
“This is an incredibly important intervention,” said Dr. Lulu Oguda, reproductive health advisor at ICAP. “The adolescent-centered approach will allow us to improve the overall health of adolescents seeking services at ICAP-supported facilities in Kenya.”