Since the vast majority of HIV prevention campaigns are not tailored specifically towards young people and are developed without their input, adolescents may fail to identify with the content and approach of the messages. Future initiatives to provide HIV pre-exposure prophylaxis (PrEP) to adolescent girls must bridge this gap to be successful. Narratives collected in this study will improve our ability to use the power of adolescents' stories to improve engagement with prevention messages by their peers, which can enhance the uptake of future combination bio-behavioral interventions.
Adolescents are at particularly high risk for HIV infection worldwide. In Kenya, there were an estimated 18,000 new infections among adolescents aged 15-19 years in 2015. The 2014 Kenya Demographic Health Survey revealed low levels of HIV knowledge and high levels of risk behavior among adolescent girls aged 15-19 years. These recent data highlight the importance of developing interventions that resonate with adolescents in order to reduce the number of new HIV infections in this priority population. When adolescents are given agency to create a narrative that reflects what is salient to them, the creative process may increase their knowledge and the resulting prevention messages are more likely to resonate with their peers. The proposed study will leverage the cultural importance of role play and live theater in Kenya to inform the development of public service announcement (PSA) creation workshops for adolescent girls in Kisumu County to increase HIV knowledge and decrease risk behaviors among their peers. The specific aims are: 1) elicit adolescents' narratives regarding sexual health and HIV prevention, as voiced to peers; 2) characterize determinants shaping adolescents' mental and behavioral HIV prevention models; and 3) assess the feasibility and acceptability of HIV prevention PSA creation workshops. Our mixed-methods study integrates well with existing HIV prevention programs in Kenya and will synergize with the planned roll-out of PrEP in this region.