This paper presents the results of an implementation research of a pilot intervention, mainstreaming meaningful youth participation in a health care management system in Western Kenya with the aim to address adolescent sexual and reproductive health and rights (SRHR). This qualitative case study included 29 key informant interviews and 13 focus group discussions conducted in five community health units across four counties. The results demonstrate positive attitudes towards the principle of youth participation, yet, also a mismatch between the aspirations of young people to be active decision-making agents and the actual roles and responsibilities assigned to them. This paper further identifies factors that inhibit and enable effective youth participation at multiple levels; individual (such as education, discipline, migration, gender); organisational (such as guidelines and structures, financial support, and political interference) and societal (norms seeing SRHR as taboo and young people as unequal to adults), and formulates recommendations to address these.

The purpose of the study was to assess the relationship between sexual practices and HIV seropositive status disclosure to sexual partners by People Living with Human Immune-Deficiency Virus (PLWHIV) in Nairobi, Kenya. A survey was conducted among 232 PLWHIV who were registered members of HIV support groups in an informal settlement. Results showed that half (50.5%) of the respondents had disclosed their HIV seropositive status to their sexual partners. Chi-square results revealed statistically significant relationships between HIV seropositive disclosure and the following sexual behaviours: condom use in the last sexual encounter (χ2 = 12.144; df = 1; p = 0.001); regular sexual partner (χ2 = 5.124; df = 1; p = 0.024); agreement on HIV testing with sexual partner (χ2 = 3.873; df = 1; p = 0.039) and knowledge of sexual partners’ HIV serostatus (χ2 = 6.536; df = 1; p = 0.011). The binary logistic regression results established four positive predictors of self-disclosure to sexual partners as regular sexual partner (AOR = 2.506; p = 0.012), knowledge of sexual partners’ HIV serostatus (AOR = 3.949; p = 0.015), condom use during the last sexual encounter (AOR = 3.507; p = 0.035) and agreement on HIV testing with sexual partner (AOR = 2.560; p = 0.020).  However, the desire to conceive (AOR = 3.050; p = 0.094) and the method of testing HIV serostatus (AOR = 0.853; p = 0.530) were not significant predictors of HIV seropositivity disclosure. It was concluded that respondents who knew their partners HIV serostatus and also used a condom during their last sexual encounter were four times more likely to disclose than those who were not aware of partners’ serostatus or those who did not use a condom in their last sexual encounter. Furthermore, those who were in regular sexual relationships and also agreed on HIV testing with sexual partners were twice more likely to disclose than those in casual sexual relationships. An analysis of sexual practices of PLWHIV can therefore enhance the formulation of targeted strategies aimed at enhancing HIV prevention and reduction of risky sexual behaviour among PLWHIV.

The purpose of the study was to assess whether sociocultural factors have an influence on the self-disclosure of HIV serostatus to intimate partners among People Living with HIV and AIDS (PLWHA). A survey was conducted among 232 randomly selected respondents who were HIV seropositive and were members of a registered community-based support group for PLWHA in Nairobi, Kenya. Data was gathered by means of semi-structured interviews and focus group discussions. Results revealed that the marital status of the respondents varied from never married (13.4%), married (27.6%), separated (26.3%), divorced (4.3%) and widowed (28.4%). Approximately half of the respondents (50.4%) had disclosed their HIV serostatus to their intimate partners while 49.6% had not. The binary logistic regression results established that some socio-cultural factors fostered HIV seropositivity disclosure while others did not. The positive predictors of HIV serostatus disclosure were gender inequalities in the sexual relationship (AOR=4.129; p=0.011), the role of females as dependent housewives (AOR=1.322; P=0.004), anticipated divorce following HIV disclosure (AOR=2.578; p=0.014) and the cultural belief that HIV was a curse (AOR=2.444; p=0.005). However, sexual behaviour such as homosexuality, rape, incest, sex with minors and extramarital sex (AOR=0.225; p=0.001), intimate partner violence (AOR=0.220; p=0.001), the subordination of females by their male partners (AOR=0.351; p=0.002) and the fear of exclusion from the cultural rite of wife inheritance during widowhood (AOR=0.410; p=0.002) were negative predictors of disclosure of HIV serostatus. This implies that there was no likelihood of HIV disclosure, thereby putting intimate partners at risk of HIV infection. It was recommended that there was the need to promote community discourse on HIV and AIDS in order to reduce the socio-cultural barriers to self-disclosure of HIV seropositive status and to increase the community acceptance of people living with HIV and AIDS.

The purpose of the study was to establish whether anticipated stigma and discrimination from intimate partners and social support networks such as family, friends, neighbours, community, religious affiliates and workmates predicted the likelihood of self-disclosure of HIV seropositive status by People Living with HIV and AIDS (PLWHA) in Kenya. A survey was conducted among a random sample of 232 adult Persons Living with HIV and AIDS in Nairobi, Kenya. Data was collected using interviews and focus group discussions. The results revealed that 50.5% had disclosed their HIV seropositive status, while 49.5% had not. The results of regression analysis revealed that anticipated stigma and discrimination by intimate partners and social support networks were statistically significant negative predictors of self-disclosure of HIV seropositive status among PLWHA as evidenced by the Adjusted Odds Ratio (AOR < 1.000). The negative predictors included anticipated intimate partner violence (AOR= 0.635; p = 0.016), abandonment by the family (AOR= 0.410; p = 0.002), isolation by friends (AOR=0.136; p=0.001), exclusion from social functions (AOR= 0.365; p = 0.002), exclusion from access to community amenities (AOR= 0.416; p = 0.032), exclusion by the religious group (AOR= 0.446; p = 0.032), and dismissal from the workplace (AOR= 0.266; p = 0.002). However, the anticipated desertion by intimate partners (AOR= 0.539; p = 0.086) and the anticipated segregation by the community (AOR= 0.0.538; p = 0.076) were not statistically significant predictors. These findings established that the study participants who anticipated negative consequences from their intimate partners and social support networks were not likely to disclose their HIV seropositive status. These findings further established that there was an inverse relationship between anticipated stigma and discrimination and self-disclosure of HIV seropositive status among PLWHA. This implies that anticipated stigma and discrimination promoted the non-disclosure of HIV seropositive status instead of fostering disclosure. The study concluded that anticipated stigma and discrimination against PLWHA act as risk factors for non-disclosure of HIV seropositive status thereby putting intimate partners and significant others at risk of HIV infection.

The purpose of the study was to determine whether socio-demographic characteristics of People Living with HIV and AIDS (PLWHA) predicted self-disclosure of HIV seropositivity status in Kenya. A survey was conducted among a random sample of 232 respondents in Nairobi County. Data was gathered through interviews and focus group discussions. The findings indicated that 28.0% of the respondents were male and 72.0% were female. The respondents were aware of their HIV seropositive status for at least one year prior to the study. About half of the respondents (50.9%) had disclosed their HIV seropositive status, while 49.1% had not disclosed. The binary logistic regression established that the socio-demographic predictors of HIV seropositive status disclosure were educational attainment (AOR =1.266; p = 0.001), regular employment status (AOR = 1.691; p = 0.001) perceptions of financial security (AOR = 2.440; p = 0.020) and knowledge of management of HIV (AOR = 3.505; p = 0.001). However, respondents’ sex (p = 0.162), age (p = 0.921) and marital status p = 0.621) were not statistically significant predictors of HIV seropositivity disclosure to sexual partners. This implies that public health programmes should focus on educational interventions, financial security, and training on the management protocols for People Living with HIV and AIDS in order to promote HIV seropositivity status disclosure to sexual partners.