EFFECTIVENESS OF HIV/AIDS PREVENTION...
Transcript of EFFECTIVENESS OF HIV/AIDS PREVENTION...
EFFECTIVENESS OF HIV/AIDS PREVENTIONMEASURES TARGETING STREET YOUTH INNAIKUHl, KENYA
A RESEARCH PROPOSAL SUBMITTED IN PARTFULFILLMENT OF THE REQUIREMENTS FORTHE AWARD OF THE DEGREE OF BACHELOR OFSCIENCE IN NURSING, OF THE UNIVERSITY OFNAIROBI
BY
NANCY NYAMBURA KAGWANJAH32/7586/04
JULY 2008
Declaration
I, Nancy Nyambura Kagwanja declare that this is my own original work and further, that
it has not been presented for the award of degree or diploma in any other university
Signed ~-----
Date 9. \.1 O'llo~
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Certificate of approval
This research proposal has been submitted for examination for the degree of Bachelor of
Science in nursing with my approval as university supervisor.
Date
Dr. James Mwaura, BSc, MSc, PhD
Lecturer and Clinical Psychologist
College of Health Sciences
University of Nairobi
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Dedication
This research proposal is dedicated to my parents who have been very supportive and
provided the necessary resources for my education.
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Acknowledgement
My gratitude and deep appreciation is to all the people who in various ways have assisted
me in accomplishment of this work. In particular, I would like to thank the following
1. Dr. James Mwaura who helped in clarification of issues and painstakingly read all
the drafts of this research proposal.
2. Fellow classmates for their encouragement, support and criticism during the writing
process.
3. Beverly Mademba for her critique of the initial draft.
4. Tarns, Mukami and my parents for their support and encouragement.
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Table of contents
Declaration ii
Certificate of approval iii
Dedication .iv
Acknowledgement v
List offigures x
List of tables x
Acronyms and Abbreviations xi
EXECUTIVE SUMMARY xii
CHAPTER ONE 1
1.1 Introduction 1
1.2 Background 2
1.3 Problem Statement 3
1.4 Study Justification 3
1.5 Hypotheses 4
1.6 Objectives 4
1.6.1 Broad Objective 4
1.6.2 Specific objectives 5
1.7 Research Questions 5
1.8 Expected benefits of the study 5
CHAPTER 2: LITERATURE REVIEW 7
2.1 Introduction 7
2.2 Global HIV Situation 9
2.3 Kenyan HIV situation 10
2.4 Behavioral intervention ModeL 10
2.5 Programs targeting Street youth 12
CHAPTER 3: MATERlALS AND METHODS 18
3.1 Study Design 18
3.2 Study Area 18
3.3 Study Variables 18
3.4 Conceptual model 19
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3.5 Sampling method 19
3.6 Study Tools 20
1.7 Data Collection 21
3.8 Data Processing 21
3.9 Presentation of results 22
3.10 Control of biases and errors 22
3.11 Ethical considerations 22
3.12 Study limitations 22
Proposed budget 24
Schedule of Activities .............................•..........•••..•.....................•...••. 25
References 26
Appendices 29
Appendix 1: Questionnaire 29
Appendix 2: Infomed Consent Form 32
Appendix 3: Interview Consent Form .33
Appendix 4: Letter Requestin Authorization for Research 34
Appendix 5: Maps showing study area 35
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Definition of terms
Street youth- Young people livingon the street aged between 10-24 years. For the
purpose of this study it will include even those who have undergone
rehabilitation programs and are either back on the street or out of the
street
Vulnerability- refers to risk of infection with HIV
Risky behavior- Acts/ practices that increase the likelihood of an individual getting
infected. In the context of HIV, these include multiple sexual partners,
unprotected sex, violent sex and sex WIder the influence of drugs and/or
alcohol as well as injecting drug use
BIV prevention
measures- Interventions designed to lower the possibility of infection
with HIV. The ones considered in this study include increasing
awareness through Information, Education and
Communication, IEC, being faithful to one partner, voluntary
counseling and testing, reduction of risk behaviour such as
needle sharing, delivery of newborns in hospital.
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List of figures
Figure 1: Map of Kenya showing location of Nairobi 36Figure 2: Map of Nairobi Province 35Figure 3: Map of Nairobi Central Business District 36
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List of tablesTable 1: HIV prevalence by province 10
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Acronyms and AbbreviationsAIDS- Acquired Immune Deficiency Syndrome
CRTU- Contraceptive and Reproductive Health Technology Research and Utilization
DOW-USA- Doctors of the World, United States of America
FHI- Family Health International
mv-Human Immunodeficiency Virus
IEC- Information, Education and Communication
KEMRI - Kenya Medical Research Institute
KSHS- Kenya Shillings
MOH- Ministry of Health
NACC-National AIDS Control Council
NARC- National Alliance and Rainbow Coalition
NASCOP- National Aids and STD Control Program
NYS- National Youth Service
RH- Reproductive Health
SFRF- Street Families Rehabilitation Fund
SKI- Street Kids International
SPSS- Statistical Package for Social Sciences
STD- Sexually Transmitted Disease
STI- Sexually Transmitted Infection
UNAIDS- United Nations
UNICEF-United Nations Child Emergency Fund
USAID- United States Agency for International Development
VCT-Voluntary Counseling and Testing
. WHO- World Health Organization
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EXECUTIVE SUMMARY
This is a cross-sectional descriptive study that aims at establishing whether Human-
Immunodeficiency Virus (HIV) prevention measures directed at street youth have been
effective in achieving behavior change among the youth living on the streets. There are
many programs that have attempted to rehabilitate street youth and in the course of the
rehabilitation process many have included Information Education and Communication
(IEC) on HIV /AIDS. The information on whether there has been behavior change as a
result of these efforts is not readily available. This could be due to few studies being done
in the area.
Street youth are among the vulnerable groups at risk of HIV infection due to poor
socioeconomic status, violence and a higher predisposition than the general youth to
exploitation. Vulnerable and marginalized communities and groups are often pushed
aside by governments and health services, yet reaching and involving them is the key to a
successful HIV response. The problem of neglect has been very prominent among street
youth with few programs being directed at them, and the few that work with them often
using approaches that may not reach them adequately. The efforts at rehabilitation of
street youth as well as the successes and/or failures more so in relation to HIV /AIDS
have not been documented much. The aim of this study is to fill that gap.
The study area will be Nairobi city, one of the largest urban centers in East Africa chosen
because of its cosmopolitan characteristics which means that the study fmdings can be
generalized to other urban centers. The study will use available published information
and questionnaires to get information from the street youth who have been through some
form of rehabilitation program to fmd out their current perception of individual risk of
.contracting HIV as well as their knowledge, attitudes and practices in relation to HIV
prevention measures. Five BscN students will be used as research assistants to administer
the questionnaires. The study will also use the services of a certified Voluntary
Counseling and Testing (VCT) counselor to test and counsel the participants.
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A study sample of 385 study subjects will be used. The study subjects will be obtained
using snowballing sampling technique. The study tool will be pretested on 20 street
youths randomly selected in Nakuru town. Necessary revision of the study tool will then
be effected to ensure validity and reliability of the tool. The main themes in the tool are
perception of individual risk of HIV infection, HIVIAIDS related knowledge, attitudes
and practices and an evaluation of risky behavior following involvement in a
rehabilitation program. The participants will also undergo HIV testing and counseling.
The data will be entered using the Statistical Package for Social Sciences (SPSS) version
10 and analyzed using both descriptive and inferential statistics including mean standard
deviation and chi square. The results will be presented using bar graphs, frequency
distribution tables, pie charts and tables. The findings of the study will be used to offer
recommendations on how best to address the issue of HIV prevalence among street
youths. The study will be executed in eight months at a projected budget ofKshs 247,085
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