title: Sexual Behavior Among Young Carers in the Context of a Kenyan Empowerment Program Combining Cash-Transfer, Psychosocial Support, and Entrepreneurship.
abstract: This study examined associations between sexual initiation, unprotected sex, and having multiple sex partners in the past year with participation in a three-year empowerment program targeting orphan and vulnerable children (OVC). The Kenya-based program combines community-conditioned cash transfer, psychosocial empowerment, health education, and microenterprise development. Program participants (n = 1,060) were interviewed in a cross-sectional design. Analyses used gender-stratified hierarchical logit models to assess program participation and other potential predictors. Significant predictors of increased female sexual activity included less program exposure, higher age, younger age at most recent parental death, fewer years of schooling, higher food consumption, higher psychological resilience, and lower general self-efficacy. Significant predictors of increased male sexual activity included more program exposure, higher age, better food consumption, not having a living father, and literacy. Findings support a nuanced view of current cash transfer programs, where female sexual activity may be reduced through improved financial status but male sexual activity may increase. Targeting of OVC sexual risk behaviors would likely benefit from being tailored according to associations found in this study. Data suggest involving fathers in sexual education, targeting women who lost a parent at a younger age, and providing social support for female OVC may decrease risk of human immunodeficiency virus (HIV) transmission.
authors.affiliation: a Sodzo International.|b Division of Management, Policy and Community Health, School of Public Health , University of Texas , Houston.|c Center for Global Health Education , University of Texas Medical Branch , Galveston.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Goodman
authors.affiliation: b Division of Management, Policy and Community Health, School of Public Health , University of Texas , Houston.
authors.forename: Beatrice J
authors.initials: BJ
authors.lastname: Selwyn
authors.affiliation: b Division of Management, Policy and Community Health, School of Public Health , University of Texas , Houston.
authors.forename: Robert O
authors.initials: RO
authors.lastname: Morgan
authors.affiliation: b Division of Management, Policy and Community Health, School of Public Health , University of Texas , Houston.
authors.forename: Linda E
authors.initials: LE
authors.lastname: Lloyd
authors.affiliation: d Community Health Department , Maua Methodist Hospital , Meru County , Kenya.
authors.forename: Moses
authors.initials: M
authors.lastname: Mwongera
authors.affiliation: d Community Health Department , Maua Methodist Hospital , Meru County , Kenya.
authors.forename: Stanley
authors.initials: S
authors.lastname: Gitari
authors.affiliation: c Center for Global Health Education , University of Texas Medical Branch , Galveston.
authors.forename: Philip H
authors.initials: PH
authors.lastname: Keiser
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D054540:Child, Orphaned / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007630:Kenya; D008297:Male; D011209:Power, Psychological; D017678:Sex Distribution; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D012944:Social Support; D012946:Social Welfare; D055815:Young Adult