An assessment of the Lea Toto adolescent sexual and reproductive health education program in Nairobi, Kenya Open Access

Beckles, Satoya (Spring 2018)

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Background: Lea Toto Adolescent Program (LTAP) is a community-based HIV/AIDS treatment and care program, grounded in Roman Catholic teachings, located in eight semi-informal settlements of Nairobi, Kenya. It provides a comprehensive intervention for adolescents living with HIV. 


Purpose: This thesis assesses the perceived effects of LTAP’s comprehensive intervention on adolescents living with HIV in eight informal settlements in Nairobi, Kenya, drawing on feedback from participants and other stakeholders of the program.


Research Question/Aims:

1. How is the LTAP’s comprehensive intervention package perceived by its key stakeholders (adolescents, caregivers, graduates and staff)? 

2. How does a Roman Catholic faith-based organization negotiate teachings in Roman Catholic moral theology regarding contraception/condoms as it seeks to provide HIV prevention and sexual and reproductive health education for adolescent living with HIV?


Methods: A combination of qualitative and quantitative methods were used to collect participants’ perspectives on LTAP at all eight LTAP clinics across Nairobi, Kenya. A total of three hundred and sixty-three adolescents participated in this study:  three hundred and twenty current adolescents were surveyed, forty participated in focus groups discussions (FGD), and three were individually interviewed. Four caregivers of adolescents in the program were individually interviewed. Four graduates of the program were individually interviewed and eight participated in a FGD. Lastly, ten individual in-depth interviews were conducted with LTAP staff with various roles within the organization.

Results: Perspectives on the LTAP comprehensive program were generally positive. Adolescents reported better medication adherence and reported they had acquired several life skills needed to successfully live and cope with HIV. Caregivers had an appreciation for LTAP’s financial and education support for their adolescents and credited positive change in behavior of their adolescents to LTAP. Graduates ranked the Life Skills portion of the program highly but criticized the ways LTAP transitioned them out of the program. Staff expressed the need for a standardized curriculum to train adolescents on sexual and reproductive health, life skills and economic empowerment. Religious leaders described tension between Roman Catholic teachings and comprehensive HIV prevention models. Condom/contraceptive use and HIV disclosure to sexual partners remain a challenge for adolescents in the LTAP program.


Conclusion: Based on these findings, participants perceive LTAP’s comprehensive approach to treatment and care as valuable to its key stakeholders. However, the transition process of adolescents who graduate the program to adult facilities was identified as the area of the program that needs the most improvement.

Keywords: Adolescents, HIV, disclosure, ART, Kenya, Roman Catholicism.

Table of Contents


Chapter 1: Introduction. 1


Chapter 2: Literature Review. 7


Chapter 3: Methodology. 17


Chapter 4: Results 27


Chapter 5: Discussion. 54


Chapter 6: Conclusion. 60


Chapter 7: Implications and Recommendations 61


Chapter 8: References 66


Chapter 9: Appendix. 68


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