EFFICACY OF STRATEGIES USED TO MITIGATE HIV RISKY SEXUAL BEHAVIOR AMONG STUDENTS OF INSTITUTIONS OF HIGHER LEARNING IN WESTERN KENYA

Abstract

Researchers have confirmed that the reason for the relatively high HIV incidence among people between 15-24 years globally is Risky Sexual Behavior. Researchers subsequently identified a challenge regarding effective mitigation of the behaviour world over. They further identified Institutions of Higher Learning, which host a significant proportion of youth, as fertile breeding grounds for this behaviour. This study consequently evaluated the strategies employed in the mitigation of HIV Risky Sexual Behavior among students in these institutions in Western Kenya overall, and specifically; determined the nature and extent of HIV Risky Sexual Behavior, and further more evaluated the HIV prevention behavioural, biomedical and structural strategies in place at these institutions. HIV denial theory, process evaluation theory,UNAIDS (2010) combination HIV prevention model, and the HIV Risk taking Behaviour Scale (HRBS) model guided the study. Adopted was the cross-sectional survey design for objective one and evaluation research design for objectives 2-4. The study employed qualitative and quantitative approaches to ensure triangulation and crosschecking of the research process. Employed were probability and non-probability sampling techniques generally and specifically, cluster sampling then simple random sampling. Chosen was a sample size of 399 students from a population of 13,002 students at seven institutions. Key informants were sampled purposively as follows; 5 NGO officials, 6 county government officials, 6 officials working in health care centers and 6 dean of students and 1 student counsellor.Selection of four Focus Group Discussions was purposive with each FGD having eight purposively selected student leaders from four institutions. An interview administered semi-structured questionnaire was employed to collect data from students, an FGD guide for the FGDs and Key Informant interview guides for the key informants. Descriptive statistics, an index-score, qualitative analysis and chi-square and were done for analysis. The HIV Risky Sexual Behavior index-score revealed that a majority 269 (67.4%) of the respondents are involved in HIGH HIV Risky Sexual Behaviors. From chi-square tests, regarding behavioural strategies, information provision and counselling and other forms of psycho-social support are found to be statistically significant with p-value = 0.007 and p-value = 0.080 respectively. For the biomedical strategy, provision of ARVs and promotion of Sex and Reproductive Health services were found to be the most successful both at at p-value = 0.000. Considering structural strategies, there is a big gap in providing them. They include lack of availability of structures to address gender inequalities, violation of human rights, and homophobia related discrimination. The study concludes that HIV incidence and prevalence rates in these institutions are likely to double in the near future if stakeholders continue to apply mitigation strategies in the exact manner they are currently doing. At behavioural level, the study thus recommends enhancing counselling and other forms of psychosocial support and stigma, and discrimination reduction programmes. At the biomedical level, the study recommends an enhancement of the provision of male and female condoms, HIV testing and counselling services, testing and treatment of STIs, provision of Needle and Syringe Programmes, provision of Opioid Substitution Therapy and promotion of VMMC. At the structural level, the study recommends greatly enhancing; structures to address gender inequalities among the students, structures addressing violations of the students’ human rights,andstructures addressing HIV related discrimination of the same students.