Addressing Economic Empowerment to Reduce HIV Risk among Adolescent Girls and Young Women in Kenya

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Project Summary Poverty increases HIV risk for adolescent girls and young women (AGYW) in Africa. AGYW experiencing poverty are more likely to engage in age disparate, transactional, and condomless sex, which increases their risk of HIV acquisition. The HIV incidence of AGYW is a public health concern in Kenya where AGYW (ages 15-24) account for 28% of new HIV diagnoses and nearly half of AGYW across the nation are living in poverty. To address the linkages between poverty and HIV risk, economic empowerment may be an essential strategy to reducing HIV incidence in this population. However, there remains gaps in how economic empowerment is measured and addressed in HIV prevention interventions for AGYW. Without valid and reliable tools to measure economic empowerment, there will remain a gap in how to design and assess the impact of economic empowerment HIV prevention interventions for AGYW in high burden settings. The goal of this Mentored Research Scientist Development Award (K01) application for Principal Investigator Dr. Margaret W. Gichane, PhD, MSPH is to improve measurement of economic empowerment to inform the adaptation of a combination cash transfer intervention for AGYW in Kenya. To achieve career and research goals, Dr. Gichane has assembled a multidisciplinary mentoring team with expertise in qualitative research, scale development, intervention adaptation, and economic empowerment. Her training aims are to: 1) Acquire foundational knowledge and skills in grounded theory to expand conceptualizations of economic empowerment; 2) Develop methodological expertise in scale development and validation; and 3) Cultivate expertise in participatory intervention development. Specific aims of the proposal are to: 1) characterize economic empowerment among AGYW; 2) develop and validate an economic empowerment scale for AGYW; and 3) adapt and pilot test a cash transfer intervention and measure the feasibility, acceptability and preliminary impact on economic empowerment and HIV risk behaviors. The proposed mentoring, training, and research plan in this K01 application will prepare Dr. Gichane for an independent research career focused on identifying and addressing economic determinants of HIV transmission among AGYW globally.