Why youth-friendly clinics stand to lower rates of HIV

Seeking services from health facilities as a pregnant 16-year-old adolescent was hard for Paulette Akinyi because of stigma.

Akinyi, now 25, said each time she wanted to seek medication, she was met with elderly medics and could not open up, fearing she was being judged for dropping out of school.

“At that age, I had scanty information about sex education, and when you get pregnant, all elderly people seem to be looking down on you, and it gets worse when they wear uniforms,” Akinyi said.

She said her prenatal visits to clinic were hard to go for, and she fell into depression, with thoughts of committing suicide and aborting her child hunting her.

“There was a gap of having youth-friendly services at hospitals, and to curb this, I joined a support group of adolescents and young mothers, which helped us to easily get services,” Akinyi said.

Akinyi, who hails from Miniambo village in Homa Bay, is part of support group of adolescents and young women who coalesce around health facilities to help in accessing health, gender and human rights.

Among the group is 18-year-old mother Mary Akoth* (name changed) and 17-year-old mother Lyn Adero* (name changed), both of whom contracted HIV-Aids while growing up and at birth respectively.

“We often meet to tackle stigma, ensure we get health and also fight for gender and sexual rights through peer support,” Adero said.

They were speaking during a meeting between adolescents, medics and community health promoters at Miniambo Health Centre.

These groups are part of what stakeholders’ bank on to tackle ‘Triple Threat’, a term coined to try and end new HIV infections, adolescent pregnancies and sexual and gender-based violence.

On June 5, Media for Environment, Science, Health and Agriculture (Mesha), which coalesces journalists and scientists, organised an open event in Homa Bay county to highlight the importance of the subject.

“We want to curb the triple threat because adolescents are the largest section of the population in transition to adulthood,” Caroline KinotI, the public support officer at The National Syndemic Diseases Control Council (NSDCC), said.

“And here is where first sexual intercourse, the biggest cause of HIV spread, happens.”

KinotI said in some set-ups, it is becoming normal for teenagers to get pregnant. And research shows this directly translates into a disrupted education cycle, high HIV-Aids infection rates and abuse of gender and sexual rights.

“Education is a better birth control, and creation of employment to ensure they take time in the matter,” she said.

Ludfin Bunde, an official from UNAids, said new HIV-Aids infections will not end with behaviour change of safe sex, testing and medication alone.

“It needs a multi-approach on triple threat, which brings these systemic issues, so we can keep our girls in schools and make society a better place,” she said.

Homa Bay HIV coordinator Steven Obunga said the county has the highest HIV-Aids infection rates in Kenya at 15.2 per cent per 2023 estimates.

This is down from more than 23 per cent a decade ago, compared to national rates of 3.4 per cent, and still records places where even 12- and 13-year-olds get pregnant.

“We have managed to control deaths caused by HIV infection by ensuring almost all patients get medicine. We bank on triple threat action to tackle new infection from younger age,” Obunga said.

He said from January to June alone, Homa Bay has recorded 429 pregnancies of girls aged between 15 and 19 years old in Ndhiwa, Suba and Kendu Bay regions alone.

Kenya outlines its plan in 'A Commitment Plan to End the ‘Triple Threat', which is set for 2023-30.

It states that the whole country is keen to end new HIV infections, mistimed pregnancies and sexual and gender-based violence cases among adolescents and young people.

“Kenya remains steadfast in its determination to end AIDS and reduce adolescent pregnancies by 2030,” Health CS Susan Nakhumicha says in the report.

"The country has also pledged to eliminate sexual and gender-based violence by 2026."

In 2023, health facilities in Kenya attended to 254,753 pregnant girls aged 10-19.

The report says the country still grapples with the slow progress in reducing new HIV infections among adolescents and young people.

“in 2022, approximately 75 per cent of the newly reported HIV cases in the country occurred among young people below the age of 34,” it says.

The Ministry of Health in 2023 attended to 53,960 sexual and gender-based violence cases, of which 37 per cent (20,143) were against adolescents aged 10-17, and of them 3,203 are children aged 0-9.

“The health sector bears a significant burden in managing early and unprotected sexual activity among young people,” Nakhumicha said.

"Sexual and gender-based violence increases the risk of HIV and causes both physical and psychological traumas."

Adolescents in Kenya constitute 11.6 million individuals, accounting for 24.4 per cent of the total population.