Mia Kibel1, Pooja Shah2, David Ayuku3, Dominic Makori2, Eunice Kamaara4, Emily Choge4, Joyce Nyairo5, Pamela Abuya5, Mary Wahome4, Juddy Wachira3, Paula Braitstein6. 1. Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. 2. Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya. 3. Department of Behavioural Sciences, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya. 4. Department of Philosophy and Religious Studies, School of Arts and Social Sciences, Moi University, Eldoret, Kenya; African Christian Initiation Program, Eldoret, Kenya. 5. African Christian Initiation Program, Eldoret, Kenya. 6. Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya; Department of Medicine, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya. Electronic address: paula.braitstein@utoronto.ca.
Abstract
PURPOSE: Street-connected youth (SCY) in Kenya and elsewhere in sub-Saharan Africa are at high risk of HIV. Voluntary Male Medical Circumcision (VMMC) reduces the risk of female-to-male HIV transmission. Circumcision is also a traditional coming-of-age process in many Kenyan ethnic groups. This paper describes the acceptability of VMMC delivered as part of a ten-day healing, educational, and 'coming-of-age' retreat implemented as a pilot with SCY. METHODS: Male SCY aged between 12 and 24 living on the street for more than 3 months were eligible to participate. The study took place over 10 days. After medical circumcision, youth participated in education modules. Data collected included qualitative semi-structured exit interviews featuring structured and open-ended questions about factors relevant to this intervention's acceptability. RESULTS: There were 116 SCY (median age 14, IQR 13-15) who participated in the study. All were circumcised successfully, with no major complications. The majority of participants (81%) agreed that the circumcision procedure was uncomplicated, and 99% agreed the education was an important part of the initiation process. Thematic analysis of interview data highlighted four factors important to the program's acceptability: providing food, shelter, security; providing a safe place to heal; including traditional elements; and being with peers. CONCLUSIONS: This novel implementation of VMMC was found to be acceptable to SCY participants and could likely be adapted and scaled for HIV prevention and education with SCY elsewhere in Kenya and sub-Saharan Africa where circumcision is part of traditional coming-of-age processes.
PURPOSE: Street-connected youth (SCY) in Kenya and elsewhere in sub-Saharan Africa are at high risk of HIV. Voluntary Male Medical Circumcision (VMMC) reduces the risk of female-to-male HIV transmission. Circumcision is also a traditional coming-of-age process in many Kenyan ethnic groups. This paper describes the acceptability of VMMC delivered as part of a ten-day healing, educational, and 'coming-of-age' retreat implemented as a pilot with SCY. METHODS: Male SCY aged between 12 and 24 living on the street for more than 3 months were eligible to participate. The study took place over 10 days. After medical circumcision, youth participated in education modules. Data collected included qualitative semi-structured exit interviews featuring structured and open-ended questions about factors relevant to this intervention's acceptability. RESULTS: There were 116 SCY (median age 14, IQR 13-15) who participated in the study. All were circumcised successfully, with no major complications. The majority of participants (81%) agreed that the circumcision procedure was uncomplicated, and 99% agreed the education was an important part of the initiation process. Thematic analysis of interview data highlighted four factors important to the program's acceptability: providing food, shelter, security; providing a safe place to heal; including traditional elements; and being with peers. CONCLUSIONS: This novel implementation of VMMC was found to be acceptable to SCY participants and could likely be adapted and scaled for HIV prevention and education with SCY elsewhere in Kenya and sub-Saharan Africa where circumcision is part of traditional coming-of-age processes.
Authors: Susan Vorkoper; Kadija M Tahlil; Nadia A Sam-Agudu; Joseph D Tucker; Alicia A Livinski; Frances Fernando; Rachel Sturke Journal: AIDS Behav Date: 2022-08-10
Authors: Sarah E Asuquo; Kadija M Tahlil; Kathryn E Muessig; Donaldson F Conserve; Mesoma A Igbokwe; Kelechi P Chima; Ezienyi C Nwanunu; Lana P Elijah; Suzanne Day; Nora E Rosenberg; Jason J Ong; Susan Nkengasong; Weiming Tang; Chisom Obiezu-Umeh; Ucheoma Nwaozuru; Yesenia Merino; Titilola Gbaja-Biamila; David Oladele; Juliet Iwelunmor; Oliver Ezechi; Joseph D Tucker Journal: J Int AIDS Soc Date: 2021-02 Impact factor: 6.707