Understanding the risk of sexual coercion and HIV/AIDS transmission among adolescent girls; Perceptions of internally displaced persons in the eldoret idp (SHOW GROUND)camp

Background:

Worldwide, 40% of new cases of HIV infection occurred among young people aged 15-24 in 2006. Sub-Saharan Africa is the worst affected, housing 2/3 of the HIV positive population. Among those infected, 59% are female. Unintended pregnancy remains a major reproductive health problem among adolescents in sub Saharan Africa. Evidence suggests that not all exposure to the risk of HIV/AIDS and unintended pregnancy is voluntary. Eldoret IDP camp was established in January 2008 following the post elections skirmishes which erupted in Kenya. It had a population of 20000 persons, 40% being adolescents.
Objectives:

To evaluate the prevalence and context of sexual coercion among adolescents in the camp.

To assess the understanding of the IDP’s on the implication of sexual coercion on the reproductive health of adolescents.
Methods: Study population: 20000; sample size 350; Sampling technique: convenience sampling, study design; descriptive cross-sectional. FGD’s with 18-24 year olds, in-depth interviews with 15-24 year olds and key adults (community and camp leaders).
Results: 15-24 yrs olds is an at "risk group" just as other related studies have revealed. Forms of sexual coercion identified and their frequencies are as follows;

 Forced sex-75%

 Pressure through money, food, clothing's, security-45%

 Pestering/threatening from other girls-20%

 Passive acceptance-9%
Perceived health risks associated with sexual coercion were:

Exposure to STI's & unintended pregnancies-100%

Abortion-78%

Morbidity and mortality-80%

Risky behaviors - multiple partners and unprotected sex-95%
Perceived psychological effects were:

 Sexual dysphoria, anxiety, substance abuse, depression and suicidal tendencies
80% of respondents linked high rate of sexual coercion to:

Overcrowding/idleness

Economic constraints/lack of food

Material gain- clothing and toiletries.
94% of respondents reported knowing someone who was sexually coerced without the use of condoms.
Conclusions: sexual coercion is a form of violence against young adolescents which if not addressed, will undermine efforts to fight the spread of HIV/AIDS.