Kisumu Street Children: A Pilot Study of STIs and HIV in Social Context
Parent Project: UCSF-Gladstone Center for AIDS Research (CFAR)
There is wide agreement that street children carry a greater risk of HIV/AIDS infection than their peers, yet this sub-epidemic has been largely ignored by the HIV research community, in part due to their marginalized status. Our ability to design interventions that will improve the health of street children is compromised by the absence of answers to fundamental questions, including: What are their rates of HIV and STIs? What are the modifiable social and contextual factors that increase their risk for infection? Given their marginalized status, how can they best be reached and recruited? We propose to collect pilot data in Kisumu, Kenya to begin to answer these questions. These data will be included in a future NIH R01 resubmission. In order to inform the recruitment of children for the pilot and for the proposed NIH resubmission, we will conduct interviews with present and former street children and with providers, in particular to assess the feasibility of conducting respondent-driven sampling (RDS) with this vulnerable population of youth (Specific Aim 1). Respondent-driven sampling is a network-based recruitment method that employs Markovian modeling to make population-level estimates based a network-recruited sample. We will conduct STI and HIV testing with a sample of fifty 13-to-17 year old street children recruited using RDS techniques (Specific Aim 2). Youth being tested will complete a brief survey to collect demographic and behavioral data. Finally, we will re-interview participants two months later to demonstrate our capacity to track and locate youth (Specific Aim 3). To our knowledge, our data will provide the first published data regarding prevalence of HIV and STIs in a sample of street children in this region in Africa. Such data, along with the understanding of the social determinants of infection, are critical to designing appropriate interventions for street children.