Adapting an evidence-based gender, livelihoods, and HIV prevention intervention with street-connected young people in Eldoret, Kenya

ABSTRACT

Despite being highly vulnerable to acquiring HIV, no effective evidence-based interventions (EBI) exist for street-connected young people (SCY) in low- and middle-income countries (LMICs). Therefore, this paper describes the research process of adapting an existing EBI in Eldoret, Kenya using a modified ADAPT-ITT model with a young key population. From May to August 2018 we adapted the combined Stepping Stones and Creating Futures interventions. We used community-based participatory methods, focus group discussions, and working groups with four Peer Facilitators and 24 SCY aged 16–24 years. At the inception of this project, a matched-savings programme was integrated into the intervention to further address structural drivers of HIV. Numerous adaptations came forth through the participatory process. Engaging SCY in the adaptation process ensured the programme was responsive to their needs, relevant to the street context, and respected their right to participate in the research process.

KEYWORDS:

• Street youth
• HIV prevention
• intervention
• adaptation
• Kenya

Acknowledgements

We would like to acknowledge the work of the Peer Facilitators Winnie ‘Eunice’ Nafula, Sharon Naliaka, Evans Odep Okal, and Duncan Ronga who were fundamental to completing this work and creating the Stepping Stones ya Mshefa & Kujijenga Kimaisha manual. We would also like to acknowledge the street community in Eldoret, Kenya, and their on-going struggle on the streets and thank them for their on-going support and participation in our research activities.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics statement

This study received ethics approval from MTRH Institutional Research Ethics Committee and University of Toronto Research Ethics Board. We received a waiver of parental consent for minors and participants provided written consent or assent (or a fingerprint for those unable to write) for their participation in this research project with a specially trained social worker. The study received approval from the UG County Children’s Coordinator to occur. Participants did not receive compensation for their participation in the adaptation activities. Tea and chapati were provided to participants in focus group discussions and working groups.

Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. The final manual ‘Stepping Stones ya Mshefa & Kujijenga Kimaisha’ is available from the corresponding author.

ORCID

L. Embleton http://orcid.org/0000-0002-9415-8903

Additional information

Funding

This work was carried out with the aid of a grant from the International Development Research Centre, Ottawa, Canada [Award no. 108279-16]. The views expressed herein do not necessarily represent those of IDRC or its Board of Governors. This work was also made possible due to the support of the Vanier Canada Graduate Scholarships received by Lonnie Embleton, and in part thanks to a Canadian Institutes of Health Research Chair of Applied Public Health to Dr. Braitstein. This work was supported in part by Award Number R01HD060478 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health and Human Development or the National Institutes of Health.