Background: Human immunodeficiency virus currently affects the lives of over 36 million people globally. Given that 69% of these patients are located in sub-Saharan Africa, there is strong reason to consider the development of sustainable primary prevention tools. In the present proposal, we examine how an adapted skills-based education-based intervention may reduce HIV-related risk behaviors and prevalence among adolescent girls in the informal settlements of Nairobi, Kenya.

Aim: To assess the effect of a skills-based sexual health intervention on condom usage for 14 public middle school girls (school levels 6-8, ages 11-14) in Kenyan informal settlements in Nairobi compared to 14 cluster-randomized, matched-pair schools exposed to a health promotion control intervention unconcerned with sexual health over the course of a year.

Design: This is a two-arm, parallel, cluster-randomized matched-pair trial with clusters defined as schools within the settlements. Data collection will run through a one-year timeframe with follow-ups at 3, 6, 9, and 12 months. The study is being conducted in six informal settlements in Nairobi: Kibera, Mukuru, Huruma, Dandora, Kariobangi, and Korogocho. The primary outcome measured is self-reported condom use, with secondary outcomes of HIV incidence and mediator variables.

Partners: Local partners include three organizations, Sisters Saving Sisters (SSS), Ujamaa Africa, and Lancet Labs. SSS developed the intervention, Ujamaa will be on the ground implementing the intervention, and Lancet Labs will provide the diagnostic tools and medically-trained personnel to perform OraQuick tests on the participants (HIV incidence). Stanford University’s research team will be the external evaluator of the study. Stakeholder meeting of teachers, head teachers, and officials from the Kenyan Ministry of Education will be held before each round of data collection to answer questions and gain buy-in.