1. Track name: Track 1: Prevention of New HIV Infections
Category name: Adolescents and youth
Title of abstract: Utilizing HIV combination prevention interventions in reaching sexually
exploited children in slums in Kenya.
Authors: H.Karoki1
, J.Thiomi1
, P.Jeckonia1
.
Affiliations: 1
LVCT Health
Corresponding author and contact: hkaroki@lvcthealth.org
Background
Kenya’s HIV prevalence has reduced from 7.2 % to 5.6% in the last 4 years. Despite reduced
prevalence, girls and women continue to be disproportionately affected by the epidemic. The
2014 Kenya HIV estimate showed that women contributed to 49% of new HIV infections, with
those aged 15 to 24 contributing upto 21%. Nearly 14% of women reported sexual debut before
15 years (KMOT 2009). Findings from a qualitative cross sectional study showed increased
sexual exploitation, vulnerability to HIV infection and negative Sexual Reproductive Health
(SRH) outcomes among girls and young women aged 10 to 24 years in Korogocho slums,
Kenya. In 2013 LVCT Health established a program known as One Child at a Time (OCaT) to
respond to the HIV risk and the negative SRH outcomes among children aged 10 to 17.
Objective(s)
The purpose of OCaT program is to provide combination prevention interventions aimed at
reducing vulnerability to HIV infection, sexual exploitation and negative SRH outcomes.
Methodology
Korogocho, Kibera and Kibagare slums in Nairobi were purposively selected. Community
Health Workers (CHWs) and HIV testing and counselling service providers were identified and
sensitized on program objectives and criteria for selecting participants. A risk screening tool was
developed and is applied to recruit participants who report sexual exploitation. Consent is
obtained from participants, their parents or guardians. Combination prevention interventions that
include quarterly HIV testing and counselling, condoms, SRH information and services, family
planning and cervical cancer screening are offered. Participants are then enrolled in OCAT
groups where they receive evidence based interventions (Sister to Sister, Respect-K and Healthy
Choices II) and health education. A sub population is selected and trained on delivering
knowledge and skills to their peers for program continuity. Financial and material support for
those out of school and need reintegration is provided.
Results
From February 2014 to January 2015, 201 boys and 920 girls have been enrolled in OCaT. All
children have been tested for HIV, with 98% (1099) receiving quarterly HIV testing and
counselling. Twenty two children (2%) tested positive for HIV and were successfully enrolled to
care and treatment. Eighty percent (896) children have been trained on Healthy Choices II, 38%
(348) girls have undergone Sister to Sister, and 70% (786) Respect-K. Thirteen peer educators
were trained to facilitate five OCaT clubs consisting of 30 members each. Nineteen boys and 82
girls have been re - integrated into school (61 primary, 27 secondary and 13 tertiary). In
collaboration with the children’s offices at sub county level, 20 orphaned children experiencing
sexual violence have been supported with legal aid and 6 of those rescued and placed in
shelters/orphanages.

2. Conclusion and recommendations
OCaT program demonstrates positive effects of an adolescent tailored HIV combination
prevention approach in resource-limited settings. There is need to invest and scale up targeted
interventions that respond to HIV prevention and SRH needs of adolescents in order to reduce
new HIV infections. Community inclusivity is key for success in programming and continuity of
HIV community focused interventions.