If you build it, will they come? Kenya healthy start pediatric HIV study: A diagnostic study investigating barriers to HIV treatment and care among children

In Kenya the proportion of eligible HIV-positive children receiving ART treatment is only 11 percent. This study explored and documented possible barriers in the community to accessing pediatric HIV testing and treatment, to guide the development of new interventions to encourage uptake. The study identified barriers such as cost, use of traditional healers, low knowledge of treatment options, attitudinal barriers, stigma, unique treatment issues, and dissatisfaction with available services. Additionally, healthcare workers missed opportunities to provide services and cited numerous service-side challenges. The study recommends prioritizing community awareness, mobile clinics, strengthening capacity of healthcare workers, supporting family-based HIV testing, and strategies to reach HIV-positive adolescents and young adults

School as a workplace in Kenya: Evaluation of the Teachers Matter HIV/AIDS project

The Horizons program of the Population Council embarked on an operations research initiative in Kenya to test the feasibility of implementing a teacher-centered workplace program based in schools. The study was conducted in partnership with the Ministry of Education, the Kenya Institute of Education, the Teachers Service Commission, and UNICEF. Called Teachers Matter, the project’s main audience was primary and secondary school teachers. The purpose of the research was to assess whether such a program would improve teachers’ HIV-related knowledge, attitudes, and behaviors; increase the proportion of teachers seeking voluntary testing and counseling; and enhance their ability to cope with HIV-related issues in the workplace. The results suggest that a teacher-centered peer education program can be successful in increasing an overall level of openness and comfort surrounding HIV issues in the school setting

Is it feasible to integrate alcohol-related risk reduction counseling into VCT services? Findings from Kenya

In Kenya, an estimated 30 percent of men report to be alcohol users which may be fueling the HIV pandemic, due to its association with high-risk sexual behavior and reduced inhibitions. The Population Council’s Horizons program collaborated on a study to improve screening of clients for alcohol use, provision of feedback of screening results, and referrals to care and support during voluntary testing and counseling (VCT) for HIV. Overall, the results indicate that it is feasible to integrate alcohol risk reduction counseling into VCT, and that it is generally accepted by providers and clients alike. This study therefore supports the formal integration of alcohol risk reduction counseling into VCT services in Kenya

The Straight Talk Campaign in Uganda: Impact of mass media initiatives—Summary report

This Horizons study in Uganda found that exposure by adolescents to Straight Talk, a mass media initiative focused on adolescent sexual and reproductive health (ASRH), was associated with greater ASRH knowledge, a greater likelihood of having been tested for HIV, and more communication with parents about ASRH issues

Caring for caregivers: An HIV/AIDS workplace intervention for hospital staff in Zambia—Evaluation results

The Horizons Program collaborated on a Caring for Caregivers initiative in Zambia whose objective was to develop and test a risk-reduction workplace program for hospital staff. This was motivated by the recognition that hospital workers are often overlooked in HIV programming, and yet many are infected or affected by HIV. It was also motivated by the fact that hospital staff are heterogeneous, with both clinical and non-clinical staff having varying levels of understanding regarding HIV transmission. Caring for Caregivers was a peer education program targeted at hospital staff and implemented in two hospitals in Zambia, with a combined staff of about 1,700 employees. Although it encountered severe challenges, it was generally well-received and demonstrated some positive outcomes. HIV prevention, treatment, and care strategies should involve healthcare workers not just as a means to reach the community, but as direct and priority beneficiaries as well

ABC messages for HIV prevention in Kenya: Clarity and confusion, barriers and facilitators

The Horizons Program and FHI/IMPACT developed a collaborative research study to explore how adults and youth in Kenya define and perceive the ABC (abstinence/being faithful/consistent condom use) terms and behaviors. Additional objectives of the study were to identify attitudes and norms around the ABC behaviors that influence perceptions of them, and the role of important actors in transmitting messages about them. Findings highlight potential challenges in promoting each of the ABC behaviors, as well as some positive elements that can be built upon when developing programs. HIV prevention programs that incorporate ABC messages—both in Kenya and elsewhere—should consider a number of lessons highlighted in this study

Helping youth prevent HIV: An evaluation of the Straight Talk program in Uganda

Mass media initiatives are being implemented globally to provide information and foster HIV preventive behavior, however there has been limited evaluation of these efforts in sub-Saharan Africa. The Straight Talk (ST) program in Uganda has targeted youth with HIV and reproductive health (RH) information for over a decade. Evaluation results show positive associations between exposure to ST media and a number of key outcomes among youth, including sexual behavior, knowledge, and attitudes. In 2005–06, the Horizons Program conducted the first impact evaluation of the ST program in Uganda to document its effects on young people. This brief focuses on the findings of the adolescent survey. Overall, the study indicates that many Ugandan adolescents have benefited from ST products, and that greater exposure was associated with greater benefits. This includes less sexual activity among exposed males, and higher levels of HIV testing and RH knowledge among exposed youth. The ST program is using the results of the Horizons’ evaluation to strengthen the successful elements of its activities and address gaps

ABCs for HIV prevention in Kenya: Messages, beliefs, and barriers

A great deal of attention has been focused recently on promoting the “ABCs” of HIV prevention— abstinence or delaying sex, being faithful to one sexual partner or reducing the number of sexual partners, and consistently using condoms during sex. Yet even as programs that focus on the ABCs to prevent sexual HIV transmission are rolled out, questions remain about how well different groups in varied cultural contexts understand the terms, as well as how best to address challenges to adopting the ABC behaviors. The Horizons Program and FHI/IMPACT developed a collaborative research study in 2004 to explore how adults and youth in Kenya define and perceive the ABC terms and behaviors. Additional study objectives, noted in this research summary, were to identify attitudes and norms around the ABC behaviors that influence perceptions of them, and the role of important actors in transmitting messages about them. Findings highlight potential challenges in promoting each of the ABC behaviors, as well as some positive elements that can be built upon when developing programs

Beacon of hope: Evaluation of the Kenya Girl Guides Association HIV/AIDS program for school children

This Horizons report presents findings from an evaluation of the Kenya Girl Guides Participatory Peer Education Program for HIV and AIDS Prevention. The objective of the program was to train Girl Guide patrol leaders as peer educators, who in turn would communicate key information and concepts about such topics as HIV prevention, relationships, and self-esteem to other Girl Guides, and ultimately to their school peers. The results demonstrate that peer education conducted by Girl Guides is a feasible strategy for imparting HIV and AIDS education to school-going youth; however, such a program would need to be branded, strengthened, and appropriately resourced to attain positive results that extend beyond the Girl Guides to include their peers. The results also demonstrate that school girls in this study are operating in an environment where their male counterparts are more than seven times as likely to be sexually experienced, and may be exerting considerable pressure to have sex even on the strongest of girls. HIV risk-reduction programs directed at school girls may be more successful if they also address the risk behavior of school boys