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Open Access Research article

Understanding orphan and non-orphan adolescents’ sexual risks in the context of poverty: a qualitative study in Nyanza Province, Kenya

Milka Juma1*, Jane Alaii2, L Kay Bartholomew3, Ian Askew4 and Bart Van den Born1

Author affiliations

1 Department of Health Promotion, Maastricht University, Maastricht, The Netherlands

2 Context Factor Solutions, P.O. Box 27598, Nairobi, Kenya

3 University of Texas School of Public Health Houston, Houston, Texas, USA

4 Population Council, P.O Box 17643, 00500 Nairobi, Kenya

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Citation and License

BMC International Health and Human Rights 2013, 13:32  doi:10.1186/1472-698X-13-32

Published: 25 July 2013

Abstract

Background

Some studies show orphanhood to be associated with increased sexual risk-taking while others have not established this relationship, but have found factors other than orphanhood as predictors of sexual risk behaviours and outcomes among adolescents. This study examines community members’ perceptions of how poverty influences adolescent sexual behaviour and outcomes in four districts of Nyanza Province, Kenya.

Methods

Eight study sites within the four districts were randomly selected. Focus group discussions were conducted with a purposive sample of adolescents, parents and caregivers. Key informant interviews were undertaken with a purposive sample of community leaders, child welfare and healthcare workers, and adolescents. The two methods elicited information on factors perceived to predispose adolescent orphans and non-orphans to sexual risks. Data were analysed through line-by-line coding, grouped into families and retrieved as themes and sub-themes.

Results

Participants included 147 adolescents and parents/caregivers in 14 focus groups and 13 key informants. Poverty emerged as a key predisposing factor to sexual risk behaviour among orphans and non-orphans. Poverty was associated with lack of food, poor housing, school dropout, and engaging in income generating activities, all of which increase their vulnerability to transactional sex, early marriage, sexual experimentation, and the eventual consequences of increased risk of unintended pregnancies and STI/HIV.

Conclusion

Poverty was perceived to contribute to increasing sexual risks among orphan and non-orphan adolescents through survival strategies adopted to be able to meet their basic needs. Policies for prevention and intervention that target adolescents in a generalized poverty and HIV epidemic should integrate economic empowerment for caregivers and life skills for adolescents to reduce vulnerabilities of orphan and non-orphan adolescents to sexual risk behaviour.

Keywords:
Poverty; Orphan; Non-orphan; Adolescents; Sexual risk behaviour