Addressing the Unique Needs of Emerging Male Adults in HIV Prevention in Rural Kenya. A Qualitative Study

Abstract Emerging male adults continue to be disproportionately affected by HIV compared to other age groups in Sub-Saharan Africa (SSA). Recent demographic data indicate that AIDS related illness is currently the leading cause of death among young people in SSA. Emerging adulthood is critical when it comes to sexuality because it is marked by the formation of identity and the establishment of more mature and intimate relationships which might increase vulnerability to sexually transmitted infections including HIV. Understanding HIV prevention and testing needs in emerging male adults in rural settings is essential to developing prevention efforts. This descriptive qualitative study was conducted to understand the HIV prevention and testing needs for emerging male adults in rural Kenyan setting. 30 in-depth interviews and 3 FGDs were conducted with emerging adults in rural Ainabkoi sub-county in Uasin Gishu county in Kenya. Findings pointed out that emerging adults in rural settings experience unique challenges in HIV testing and prevention influenced by socio-cultural, economic, political, and legal factors elevating their risk to HIV infection compared to other age groups. The study underscore that HIV is still the greatest threat among emerging adults in SSA and will require innovative approach to develop and implement youth and young adults’, especially males, sensitive interventions across multiple sectors that influence HIV prevention knowledge, service use, and treatment options for youths. Author Summary In our study, we explored the challenges of preventing HIV among young adult men in rural Kenya, a region where traditional health services often struggle to reach effectively. I, along with my colleagues, conducted interviews and discussions to understand what these young men need and how they perceive existing HIV prevention efforts. We found that factors like limited healthcare access, societal norms, and economic conditions significantly influence their risk and ability to receive proper HIV education and services. The young men expressed a strong desire for more accessible and relevant HIV prevention strategies that respect their unique cultural and social settings. Our research underlines the importance of creating tailored HIV prevention programs that go beyond conventional methods. These programs should engage with the community’s specific needs and leverage local resources to enhance effectiveness. By focusing on these areas, our work contributes to a broader understanding of how to tackle HIV prevention in similar rural settings globally, suggesting that interventions need to be as diverse as the populations they aim to serve. This approach could inform future strategies not only for HIV but also for other health issues faced by isolated communities. Competing Interest Statement The authors have declared no competing interest. Funding Statement His research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors conducted this study as part of their academic and professional responsibilities at their respective institutions, which provided the necessary support for the research, analysis, and preparation of the manuscript. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The research described has been reviewed and approved by the Ethics Review Board of University of Wisconsin Milwaukee. This study was conducted in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability All data generated or analyzed during this study are included in this published article and its supplementary information files. The raw data supporting the conclusions of this manuscript will be made available by the authors, without undue reservation, to any qualified researcher. The qualitative data derived from in-depth interviews and focus group discussions are stored securely with the research team at University of Wisconsin-College Of Nursing. Due to the sensitive nature of the information collected and the privacy promises made to the participants during the consent process, the data are available from the corresponding author upon reasonable request and with approval from the University Of Wisconsin Institution Ethics Review Board. Researchers interested in accessing the data can contact the corresponding author, Dr. Augustine Kiplagat Bingat, via email at augustine_kiplagat{at}bshsi.org. Requests for access will be reviewed by the University of Wiscinsin Ethics Review Board] to ensure they comply with the ethical standards and privacy protections outlined in the consent agreements.