1
www.lvcthealth.org
HIV Combination Prevention
What works for young women and girls?
Kiragu M; Gitau E; Kibutha A; Thiomi...
We have rebranded. We are now LVCT Health
Building Partnerships, transforming lives 3
About LVCT Health
www.lvcthealth.org
• LVCT Health (formerly known as Liverpoo...
Building Partnerships, transforming lives 4
Presentation Outline
www.lvcthealth.org
• Kenyan epidemic
• Why young women/gi...
Building Partnerships, transforming lives 5
Background
www.lvcthealth.org
 HIV prevalence in Kenya is 5.6%
 women - high...
Building Partnerships, transforming lives 6
Young women 4 times more likely to be infected
than young men
www.lvcthealth.o...
Building Partnerships, transforming lives 7
Do YW need biomedical HIV prevention interventions?
www.lvcthealth.org
Transac...
Building Partnerships, transforming lives 8
Identifying young women at risk is hard
www.lvcthealth.org
• Because they are ...
Building Partnerships, transforming lives 9
Behavioural interventions have been adapted for YW
www.lvcthealth.org
EBI Targ...
Building Partnerships, transforming lives 10
Some biomedical prevention tools are available
www.lvcthealth.org Diagram ada...
Building Partnerships, transforming lives 11
Young women need structural interventions
www.lvcthealth.org
Stories of girls...
The IMAGE Study: Testing a structural intervention to
address HIV & Gender-base violence
Key research question: Can IMAGE ...
13
Intimate partner violence
 After 2 years, risk of physical & sexual
intimate partner violence reduced by 55%
(aRR 0.45...
Building Partnerships, transforming lives 14
Recommendations
www.lvcthealth.org
• Need for more research among young women...
Building Partnerships, transforming lives 15
Thank You
CONTACT US:
mkiragu@lvcthealth.org
one2one@lvcthealth.org
www.lvcth...
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HIV Combination Prevention What works for young women and girls?

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LVCT Health (formerly known as Liverpool VCT, Care and treatment (LVCT)) is an indigenous Kenyan non-governmental and non-profit organization.
Founded in 1998 and registered in 2001
LVCT Health envisions healthy societies and uses research results, capacity improvement and policy reform action for equitable HIV, SRH services to the most vulnerable populations.
LVCT health reached 1.3m Kenyans with HTC in 2013 with 80% linkage to care, 40,000 in care, 4300 survivors of sexual violence in 124 MOH facilities and 150,000 youthful callers to one2one hotline.

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  • LVCT Health provides technical assistance to the government of Kenya, other governments in Africa, civil society organizations and private sector in strengthening responses to HIV prevention, care and treatment, sexual and reproductive health (SRH) interventions.

    LVCT Health’s core role is to inform the policy and programming within which HIV and AIDS and wider sexual reproductive health issues can be tackled.

    We conduct research into health systems and operations and advocate for effective, evidence –based government policies

    We invest in communities and health systems across Africa, train health care providers, build organizational capacities and work to secure long term resources for health.

    We work with partners, including national and county governments, community and faith-based organizations and the private sector to deliver accessible, quality HIV and reproductive, maternal and child healthcare to the target populations.

    LVCT Health focuses on those with greatest vulnerability to HIV infection and those with special needs, including survivors of sexual violence (SV), Persons with Disabilities (PWDs), Men who have Sex with Men (MSM), sex workers (SWs), youth including adolescents, young women and girls.
  • LVCT Health provides technical assistance to the government of Kenya, other governments in Africa, civil society organizations and private sector in strengthening responses to HIV prevention, care and treatment, sexual and reproductive health (SRH) interventions.

    LVCT Health’s core role is to inform the policy and programming within which HIV and AIDS and wider sexual reproductive health issues can be tackled.

    We conduct research into health systems and operations and advocate for effective, evidence –based government policies

    We invest in communities and health systems across Africa, train health care providers, build organizational capacities and work to secure long term resources for health.

    We work with partners, including national and county governments, community and faith-based organizations and the private sector to deliver accessible, quality HIV and reproductive, maternal and child healthcare to the target populations.

    LVCT Health focuses on those with greatest vulnerability to HIV infection and those with special needs, including survivors of sexual violence (SV), Persons with Disabilities (PWDs), Men who have Sex with Men (MSM), sex workers (SWs), youth including adolescents, young women and girls.
  • LVCT Health provides technical assistance to the government of Kenya, other governments in Africa, civil society organizations and private sector in strengthening responses to HIV prevention, care and treatment, sexual and reproductive health (SRH) interventions.

    LVCT Health’s core role is to inform the policy and programming within which HIV and AIDS and wider sexual reproductive health issues can be tackled.

    We conduct research into health systems and operations and advocate for effective, evidence –based government policies

    We invest in communities and health systems across Africa, train health care providers, build organizational capacities and work to secure long term resources for health.

    We work with partners, including national and county governments, community and faith-based organizations and the private sector to deliver accessible, quality HIV and reproductive, maternal and child healthcare to the target populations.

    LVCT Health focuses on those with greatest vulnerability to HIV infection and those with special needs, including survivors of sexual violence (SV), Persons with Disabilities (PWDs), Men who have Sex with Men (MSM), sex workers (SWs), youth including adolescents, young women and girls.
  • LVCT Health provides technical assistance to the government of Kenya, other governments in Africa, civil society organizations and private sector in strengthening responses to HIV prevention, care and treatment, sexual and reproductive health (SRH) interventions.

    LVCT Health’s core role is to inform the policy and programming within which HIV and AIDS and wider sexual reproductive health issues can be tackled.

    We conduct research into health systems and operations and advocate for effective, evidence –based government policies

    We invest in communities and health systems across Africa, train health care providers, build organizational capacities and work to secure long term resources for health.

    We work with partners, including national and county governments, community and faith-based organizations and the private sector to deliver accessible, quality HIV and reproductive, maternal and child healthcare to the target populations.

    LVCT Health focuses on those with greatest vulnerability to HIV infection and those with special needs, including survivors of sexual violence (SV), Persons with Disabilities (PWDs), Men who have Sex with Men (MSM), sex workers (SWs), youth including adolescents, young women and girls.
  • LVCT Health provides technical assistance to the government of Kenya, other governments in Africa, civil society organizations and private sector in strengthening responses to HIV prevention, care and treatment, sexual and reproductive health (SRH) interventions.

    LVCT Health’s core role is to inform the policy and programming within which HIV and AIDS and wider sexual reproductive health issues can be tackled.

    We conduct research into health systems and operations and advocate for effective, evidence –based government policies

    We invest in communities and health systems across Africa, train health care providers, build organizational capacities and work to secure long term resources for health.

    We work with partners, including national and county governments, community and faith-based organizations and the private sector to deliver accessible, quality HIV and reproductive, maternal and child healthcare to the target populations.

    LVCT Health focuses on those with greatest vulnerability to HIV infection and those with special needs, including survivors of sexual violence (SV), Persons with Disabilities (PWDs), Men who have Sex with Men (MSM), sex workers (SWs), youth including adolescents, young women and girls.
  • LVCT Health provides technical assistance to the government of Kenya, other governments in Africa, civil society organizations and private sector in strengthening responses to HIV prevention, care and treatment, sexual and reproductive health (SRH) interventions.

    LVCT Health’s core role is to inform the policy and programming within which HIV and AIDS and wider sexual reproductive health issues can be tackled.

    We conduct research into health systems and operations and advocate for effective, evidence –based government policies

    We invest in communities and health systems across Africa, train health care providers, build organizational capacities and work to secure long term resources for health.

    We work with partners, including national and county governments, community and faith-based organizations and the private sector to deliver accessible, quality HIV and reproductive, maternal and child healthcare to the target populations.

    LVCT Health focuses on those with greatest vulnerability to HIV infection and those with special needs, including survivors of sexual violence (SV), Persons with Disabilities (PWDs), Men who have Sex with Men (MSM), sex workers (SWs), youth including adolescents, young women and girls.
  • LVCT Health provides technical assistance to the government of Kenya, other governments in Africa, civil society organizations and private sector in strengthening responses to HIV prevention, care and treatment, sexual and reproductive health (SRH) interventions.

    LVCT Health’s core role is to inform the policy and programming within which HIV and AIDS and wider sexual reproductive health issues can be tackled.

    We conduct research into health systems and operations and advocate for effective, evidence –based government policies

    We invest in communities and health systems across Africa, train health care providers, build organizational capacities and work to secure long term resources for health.

    We work with partners, including national and county governments, community and faith-based organizations and the private sector to deliver accessible, quality HIV and reproductive, maternal and child healthcare to the target populations.

    LVCT Health focuses on those with greatest vulnerability to HIV infection and those with special needs, including survivors of sexual violence (SV), Persons with Disabilities (PWDs), Men who have Sex with Men (MSM), sex workers (SWs), youth including adolescents, young women and girls.
  • LVCT Health provides technical assistance to the government of Kenya, other governments in Africa, civil society organizations and private sector in strengthening responses to HIV prevention, care and treatment, sexual and reproductive health (SRH) interventions.

    LVCT Health’s core role is to inform the policy and programming within which HIV and AIDS and wider sexual reproductive health issues can be tackled.

    We conduct research into health systems and operations and advocate for effective, evidence –based government policies

    We invest in communities and health systems across Africa, train health care providers, build organizational capacities and work to secure long term resources for health.

    We work with partners, including national and county governments, community and faith-based organizations and the private sector to deliver accessible, quality HIV and reproductive, maternal and child healthcare to the target populations.

    LVCT Health focuses on those with greatest vulnerability to HIV infection and those with special needs, including survivors of sexual violence (SV), Persons with Disabilities (PWDs), Men who have Sex with Men (MSM), sex workers (SWs), youth including adolescents, young women and girls.
  • LVCT Health provides technical assistance to the government of Kenya, other governments in Africa, civil society organizations and private sector in strengthening responses to HIV prevention, care and treatment, sexual and reproductive health (SRH) interventions.

    LVCT Health’s core role is to inform the policy and programming within which HIV and AIDS and wider sexual reproductive health issues can be tackled.

    We conduct research into health systems and operations and advocate for effective, evidence –based government policies

    We invest in communities and health systems across Africa, train health care providers, build organizational capacities and work to secure long term resources for health.

    We work with partners, including national and county governments, community and faith-based organizations and the private sector to deliver accessible, quality HIV and reproductive, maternal and child healthcare to the target populations.

    LVCT Health focuses on those with greatest vulnerability to HIV infection and those with special needs, including survivors of sexual violence (SV), Persons with Disabilities (PWDs), Men who have Sex with Men (MSM), sex workers (SWs), youth including adolescents, young women and girls.
  • 12
  • LVCT Health provides technical assistance to the government of Kenya, other governments in Africa, civil society organizations and private sector in strengthening responses to HIV prevention, care and treatment, sexual and reproductive health (SRH) interventions.

    LVCT Health’s core role is to inform the policy and programming within which HIV and AIDS and wider sexual reproductive health issues can be tackled.

    We conduct research into health systems and operations and advocate for effective, evidence –based government policies

    We invest in communities and health systems across Africa, train health care providers, build organizational capacities and work to secure long term resources for health.

    We work with partners, including national and county governments, community and faith-based organizations and the private sector to deliver accessible, quality HIV and reproductive, maternal and child healthcare to the target populations.

    LVCT Health focuses on those with greatest vulnerability to HIV infection and those with special needs, including survivors of sexual violence (SV), Persons with Disabilities (PWDs), Men who have Sex with Men (MSM), sex workers (SWs), youth including adolescents, young women and girls.
  • HIV Combination Prevention What works for young women and girls?

    1. 1. 1 www.lvcthealth.org HIV Combination Prevention What works for young women and girls? Kiragu M; Gitau E; Kibutha A; Thiomi J; Otiso L 6th International Conference on Peer Education, Sexuality, HIV & AIDS 2014 Dates: 16- 18 June 2014
    2. 2. We have rebranded. We are now LVCT Health
    3. 3. Building Partnerships, transforming lives 3 About LVCT Health www.lvcthealth.org • LVCT Health (formerly known as Liverpool VCT, Care and treatment (LVCT)) is an indigenous Kenyan non-governmental and non-profit organization. • Founded in 1998 and registered in 2001 • LVCT Health envisions healthy societies and uses research results, capacity improvement and policy reform action for equitable HIV, SRH services to the most vulnerable populations. • LVCT health reached 1.3m Kenyans with HTC in 2013 with 80% linkage to care, 40,000 in care, 4300 survivors of sexual violence in 124 MOH facilities and 150,000 youthful callers to one2one hotline.
    4. 4. Building Partnerships, transforming lives 4 Presentation Outline www.lvcthealth.org • Kenyan epidemic • Why young women/girls? • What interventions work for young women? • Recommendations
    5. 5. Building Partnerships, transforming lives 5 Background www.lvcthealth.org  HIV prevalence in Kenya is 5.6%  women - higher prevalence than men (6.9% v. 4.4%)  100,000 new infections (65% young women)
    6. 6. Building Partnerships, transforming lives 6 Young women 4 times more likely to be infected than young men www.lvcthealth.org 0 5 10 15 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 HIVprevalence(%) Men Women NB: KAIS 2007 data
    7. 7. Building Partnerships, transforming lives 7 Do YW need biomedical HIV prevention interventions? www.lvcthealth.org Transactional sex Biologic factors Coerced sex Cultural norms that define masculinity and femininity Economic factors Lack of access to HIV/ SRH services Lack of access to information
    8. 8. Building Partnerships, transforming lives 8 Identifying young women at risk is hard www.lvcthealth.org • Because they are in the general population • Because they are usually well with rare visits to health facility • Our health services are not tailored for them • Because they lack information • Identification of risk among them is not defined
    9. 9. Building Partnerships, transforming lives 9 Behavioural interventions have been adapted for YW www.lvcthealth.org EBI Target population Key characteristics of the intervention HC I and II  Sexually active youth  Non-sexually active youth • Group intervention • targets children aged 10-13 years old for HC I and 14-17 year old for HC II • 8 sessions Sister to Sister Young women • Targets women aged 18 -45 years in groups of 3 to 5 • Aims at reducing risk behaviours and preventing HIV and STI infections Shuga Youth out of school • Multi-media behaviour intervention • Group intervention • 10 session • Targets youth between 15-24 years with the following key themes RESPECT Individuals at highest risk • Individual intervention • delivered by trained HTC provider • 2 sessions with a focus on reduction of risk behaviour
    10. 10. Building Partnerships, transforming lives 10 Some biomedical prevention tools are available www.lvcthealth.org Diagram adapted from Omu Anzala • We don’t know which tools should be combined for effective prevention among young women
    11. 11. Building Partnerships, transforming lives 11 Young women need structural interventions www.lvcthealth.org Stories of girls below 18 years written up and compiled into a booklet ‘Lost Innocence: Stories of children exploited through sex work in Korogocho, Nairobi’. Available at www.lvct.org
    12. 12. The IMAGE Study: Testing a structural intervention to address HIV & Gender-base violence Key research question: Can IMAGE empower women and reduce intimate partner violence? Gender violence HIV infection Poverty & economic inequalities Mobility and migration Gender Inequalities Microfinance Gender training IMAGE
    13. 13. 13 Intimate partner violence  After 2 years, risk of physical & sexual intimate partner violence reduced by 55% (aRR 0.45 95% CI 0.23-0.91) HIV Risk Among young IMAGE participants (age<35): - Increased communication about HIV - Increased VCT - Reduced unprotected sex (Pronyk et al. AIDS 22, 2008) Result of IMAGE Study
    14. 14. Building Partnerships, transforming lives 14 Recommendations www.lvcthealth.org • Need for more research among young women: – Incidence – Prevalence – Vulnerability factors affecting sexual risk • Develop tools to identifying ‘high risk’ young women (who are not sex workers) • Develop mechanisms and avenues of engagement outside of the health sector • Advocacy for prioritization of young women
    15. 15. Building Partnerships, transforming lives 15 Thank You CONTACT US: mkiragu@lvcthealth.org one2one@lvcthealth.org www.lvcthealth.org

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