Tackling the Triple Threat in Kenya: Factors Associated with Protection against HIV Risk, Gender-Based Violence, and Pregnancy among Adolescent Girls and Young Women

Maughan-Brown B, Banougnin BH, Little MT, Hertzog L, Matsha-Carpentier N, Mugambi C, Gichane H, Cluver L, Toska E

The government of Kenya’s Triple Threat strategy recognises the need for urgent intervention to address the high incidence of HIV, gender-based violence (GBV) and pregnancy among adolescent girls and young women (AGYW). We used nationally representative data among AGYW aged 13–24 (n = 1344) from the 2018-19 Kenya Violence Against Children & Youth Survey (VACS) in multivariable logistic regression analyses to examine associations between three potential protective factors – gender-equitable attitudes, food security and parental monitoring – and outcomes related to the triple threat: Intimate partner violence (IPV); sexual violence; high HIV exposure risk; adolescent pregnancy; child marriage; and not being in school or paid work. Results showed that AGYW with gender-equitable attitudes were less likely to report IPV (adjusted odds-ratio (aOR):0.47, p < 0.01) and adolescent pregnancy (aOR:0.58, p < 0.05). AGYW who were food secure were less likely to report adolescent pregnancy (aOR:0.57, p < 0.05) and child marriage (aOR:0.51, p < 0.05). Those with high parental monitoring were less likely to report IPV (aOR:0.44, p < 0.01), sexual violence (aOR:0.49, p < 0.05), adolescent pregnancy (aOR:0.61, p < 0.05), and child marriage (aOR:0.41, p < 0.01). AGYW who had gender-equitable attitudes, food security and high parental monitoring (i.e., all three factors compared to none) had lower predicted probabilities of reporting IPV (22.3% vs. 5.0%), sexual violence (20.4% vs. 6.0%), adolescent pregnancy (23.7% vs. 7.7%), and child marriage (10.0% vs. 1.6%). The findings indicate that improving gender-equitable attitudes, food security and parental monitoring may positively impact multiple outcomes related to the triple threat; and that addressing all three may have the greatest impact.

Keywords:

HIV

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Food security

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AGYW

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Kenya

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Motherhood

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Gender norms

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Parenting practices