Project 450928

THE ISSUE: Global regions most impacted by HIV are also greatly affected by climate change and extreme weather events (EWE), such as droughts and floods. Yet the pathways linking climate change and EWE with HIV prevention outcomes are understudied. This is particularly true among adolescents and youth. In Sub-Saharan Africa, adolescent girls aged 15-19 account for more than 80% of new adolescent HIV infections, and young women aged 15-24 have HIV infection rates two-fold higher than their young men counterparts. OUR IDEA: This innovative study will identify pathways from structural drivers of climate-related factors and poverty to HIV prevention outcomes via resource scarcity (water, food and sanitation insecurity). We focus on 2 Kenyan locations (1: urban slums in Nairobi [Kibera, Mukuru, Mathare], 2: rural and peri-urban Kisumu, on Lake Victoria) greatly impacted by climate change. OUR APPROACH: Our 4 year mixed-methods study will examine the intersection of structural factors (ecological [extreme weather, climate change, seasonality], socioeconomic [poverty, education]), resource scarcity (food, water and sanitation insecurity), and HIV prevention cascade outcomes (demand [e.g. HIV knowledge], supply [e.g. condom access], adherence [e.g. safer sex efficacy], prevention practices [e.g. condom use]) among youth aged 15-24 in Kenya. Phase 1: Qualitative research to develop interview guides and pilot data collection tools. Phase 2: Longitudinal survey with youth (n=500, 250 per location) in Kisumu and Nairobi at 4 time-points over 2 years corresponding with rainy and dry seasons. Longitudinal interviews at 2 time-points with 40 participants (20 per location) corresponding with a rainy and a dry season. Phase 3: Mixed-methods integration and participatory knowledge mobilization, including community dialogue and think tanks. IMPACT: Knowledge of structural drivers of HIV prevention among youth to identify target mechanisms to inform future HIV prevention interventions.