Resiliency among Urban Youth Newly Diagnosed with HIV in Kenya: Sources of Social Support and Active Coping Strategies

Gary W. Harper1,2, Elizabeth Ngugi3, Andrew J. Riplinger2, Anne W. Gikuni3, Diana Lemos1,4, Sybil G. Hosek4, & Kylon Hooks1

1Department of Psychology, DePaul University, Chicago, IL, USA2Master of Public Health (MPH) Program, DePaul University, Chicago, IL, USA3Centre for HIV Prevention and Research, University of Nairobi, Nairobi, Kenya 4Department of Psychiatry, Stroger Hospital of Cook County, Chicago, IL USA

Background & Significance• Rates of HIV are increasing among youth in Kenya.

• Research regarding how these youth have coped with their diagnosis and remained resilient is critical to the development of interventions that promote their health and well-being.

• The purpose of this study was to explore resilience among urban youth newly diagnosed with HIV living in a slum region of Nairobi, Kenya.

• Resilience is being conceptualized as a dynamic process of positive adaptation within the context of adversity.

Methods & ParticipantsMethods

• Six (6) gender-specific focus groups. • Questions focused on sources of support & resiliency

following HIV diagnosis (Disability-Stress-Coping Model).• Focus groups were conducted in English & Kiswahili.

Participants• Urban Kenyan youth (n=53; 26 female, 27 male)• Diagnosed with HIV/AIDS within the last 2 years• Ages 18-25 (mean = 22.8)• 37.7% married, 62.3% single• Luo (45.3%); Luhya (17.0%); Kamba (15.1%); Nubian

(7.6%); Kikuyu (5.7%); Kisii (5.7%); Mumeru (1.9%); Teso (1.9%).

Study Site - Kibera• Participants were recruited using snowball sampling in 10 of the

13 villages in the Kibera informal settlement (slum) in Nairobi.

Qualitative Data Analysis • Focus groups were transcribed by the University of

Nairobi staff who facilitated them.

• Qualitative data analysis utilized a phenomenological framework.

• Data were analyzed first separately by the Kenya and USA-based teams of analysts, and then collaboratively during in-country meetings.

• Thematic analysis revealed 7 Active Coping Strategies & 7 Primary Sources of Social Support.

Results: 7 Active Coping Strategies• Accepting a new HIV+ identity

• Disclosing HIV+ status to supportive others

• Engaging in holistic self-care

• Participating in formal support and health promotion programs

• Advocating for other HIV+ individuals

• Finding HIV+ role models

• Re-engaging with friends for social activities

Results: 7 Sources of Social Support• Romantic partners

• Friends

• Healthcare workers / counselors • People living with HIV

• Co-workers/employers

• Religious colleagues

• Affirming HIV+ media figures

Conclusions• These data demonstrate that Kenyan youth who

are newly diagnosed with HIV demonstrate resilience across multiple dimensions.

• Intrapersonal-level resilience related to individual cognitions and behaviors

• Interpersonal-level resilience related to both seeking support and providing support to others.

Implications• Future interventions should work to enhance

youths’ coping and social support through creative strategies that develop and maintain resilience at both levels:

• intrapersonal resilience through individual-level cognitive and behavioral coping strategies

• interpersonal resilience through accessing and providing social support and mentoring/activism.

Your attitude towards this condition matters so much. If you think it will kill you then it will kill you, you know AIDS is not a curse. It’s a disease you can decide either you fight it or else it will ground you. So your attitude towards your condition can take you places. -Male

I was taken to counselors who gave me advice and from then I started viewing life in a different way. I started taking the drugs; gained my health; I accepted myself; I felt I was like any other child and I accepted myself the way I was. -Female

Acknowledgments• This study was funded by the Vincentian Endowment Fund (VEF) of DePaul

University’s Office of Mission and Values.

• We would like to thank the following:• The participants who shared their stories with us.• University of Nairobi’s Centre for HIV Prevention and Research staff who

conducted and transcribed the focus groups. • DePaul University & Stroger Hospital of Cook County Research Teams.