Early sex work initiation and condom use among alcohol-using female sex workers in Mombasa, Kenya: a cross-sectional analysis

Early initiation of sex work is prevalent among female sex workers (FSWs) worldwide. The objectives of this study were to investigate if early initiation of sex work was associated with: (1) consistent condom use, (2) condom negotiation self-efficacy or (3) condom use norms among alcohol-using FSWs in Mombasa, Kenya

Mobile Phone Interventions for Adolescent Sexual and Reproductive Health: A Systematic Review

CONTEXT: Interventions for adolescent sexual and reproductive health (ASRH) are increasingly using mobile phones but may not effectively report evidence. OBJECTIVE: To assess strategies, findings, and quality of evidence on using mobile phones to improve ASRH by using the mHealth Evidence Reporting and Assessment (mERA) checklist recently published by the World Health Organization mHealth Technical Evidence Review Group. DATA SOURCES: Systematic searches of 8 databases for peer-reviewed studies published January 2000 through August 2014. STUDY SELECTION: Eligible studies targeted adolescents ages 10 to 24 and provided results from mobile phone interventions designed to improve ASRH. DATA EXTRACTION: Studies were evaluated according to the mERA checklist, covering essential mHealth criteria and methodological reporting criteria. RESULTS: Thirty-five articles met inclusion criteria. Studies reported on 28 programs operating at multiple levels of the health care system in 7 countries. Most programs (82%) used text messages. An average of 41% of essential mHealth criteria were met (range 14%-79%). An average of 82% of methodological reporting criteria were met (range 52%-100%). Evidence suggests that inclusion of text messaging in health promotion campaigns, sexually transmitted infection screening and follow-up, and medication adherence may lead to improved ASRH. LIMITATIONS: Only 3 articles reported evidence from lower- or middle-income countries, so it is difficult to draw conclusions for these settings. CONCLUSIONS: Evidence on mobile phone interventions for ASRH published in peer-reviewed journals reflects a high degree of quality in methods and reporting. In contrast, current reporting on essential mHealth criteria is insufficient for understanding, replicating, and scaling up mHealth interventions

The impact of an alcohol harm reduction intervention on interpersonal violence and engagement in sex work among female sex workers in Mombasa, Kenya: Results from a randomized controlled trial

To evaluate whether an alcohol harm reduction intervention was associated with reduced interpersonal violence or engagement in sex work among female sex workers (FSWs) in Mombasa, Kenya

Adolescent/Youth Reproductive Mobile Access and Delivery Initiative for Love and Life Outcomes (ARMADILLO) Study: formative protocol for mHealth platform development and piloting

BackgroundThere is a high unmet need for sexual and reproductive health (SRH) information and services among youth (ages 15-24) worldwide (MacQuarrie KLD. Unmet Need for Family Planning among Young Women: Levels and Trends 2014). With the proliferation of mobile technology, and its popularity with this age group, mobile phones offer a novel and accessible platform for a discreet, on-demand service providing SRH information. The Adolescent/Youth Reproductive Mobile Access and Delivery Initiative for Love and Life Outcomes (ARMADILLO) formative study will inform the development of an intervention, which will use the popular channel of SMS (text messages) to deliver SRH information on-demand to youth.Methods/DesignFollowing the development of potential SMS message content in partnership with SRH technical experts and youth, formative research activities will take place over two phases. Phase 1 will use focus group discussions (FGDs) with youth and parents/caregivers to develop and test the appropriateness and acceptability of the SMS messages. Phase 2 will consist of ‘peer piloting’, where youth participants will complete an SRH outcome-focused pretest, be introduced to the system and then have three weeks to interact with the system and share it with friends. Participants will then return to complete the SRH post-test and participate in an in-depth interview about their own and their peers’ opinions and experiences using ARMADILLO.DiscussionThe ARMADILLO formative stage will culminate in the finalization of country-specific ARMADILLO messaging. Reach and impact of ARMADILLO will be measured at later stages. We anticipate that the complete ARMADILLO platform will be scalable, with the potential for national-level adoption

Women's roles in voluntary medical male circumcision in Nyanza Province, Kenya.

Women are an important audience for voluntary medical male circumcision (VMMC) communication messages so that they know that VMMC provides only partial protection against HIV. They may also be able to influence their male partners to get circumcised and practice other HIV protective measures after VMMC. This study was conducted in two phases of qualitative data collection. Phase 1 used in-depth interviews to explore women's understanding of partial protection and their role in VMMC. Phase 2 built on the findings from the Phase 1, using focus groups to test VMMC communication messages currently used in Nyanza Province and to further explore women's roles in VMMC. Sixty-four sexually active women between the ages of 18 and 35 participated. In Phase 1, all women said they had heard of partial protection, though some were not able to elaborate on what the concept means. When women in Phase 2 were exposed to messages about partial protection, however, participants understood the messages well and were able to identify the main points. In Phases 1 and 2, many participants said that they had discussed VMMC with their partner, and for several, it was a joint decision for the man to go for VMMC. These findings suggest that current VMMC messaging is reaching women, though communications could more effectively target women to increase their ability to communicate about partial HIV protection from VMMC. Also, women seem to be playing an important role in encouraging men to get circumcised, so reaching out to women could be a valuable intervention strategy for increasing VMMC uptake and promoting use of other HIV protective measures after VMMC