Tiko Africa in collaboration with Bridges Outcomes Partnership, the Joint UN team comprising of, UNFPA, WHO, UNAIDS, SDGPP and CIFF, structured the Adolescent Sexual Reproductive Health (ASRH) programme to tackle new HIV infections and AIDS related deaths and teenage pregnancies in girls aged 15-19 years old in Kenya. The ASRH DIB programme is committed to empowering adolescent girls and young women to seek, increase utilization and access to quality and responsive ASRH services in public and private health facilities in 10 high burden counties in Kenya. This case study examines Calista’s* experience as a young lady living in Mombasa County, highlighting her engagement with the ASRH DIB program through the Tiko platform.
Calista** is a 19 year old young lady living in Mombasa County. As a female sex worker (FSW) and a single mother, she faces significant challenges due to crippling economic hardships. Calista wasn’t able to complete her secondary school education. She historically faced barriers to accessing reproductive health services and faced challenges in managing her sexual health due to the nature of their work. In light of the obstacles encountered, Calista has demonstrated proactiveness in advocating for her own sexual health and well-being, as well as that of her peers.
Casita** is a member of the Nkoko Iju Africa (NIA), a community-based organization in Mombasa that primarily advocates for the rights of sex workers in the surrounding community. Its purpose is to champion for the rights of young sex workers, respond to violence against sex workers and economically empower young sex workers. After successfully enrolling onto the Tiko platform through a Tiko mobiliser from the Nkoko Iju CBO, she then accessed HIV testing, PrEP and family planning services from a Tiko private sector facility, under the guidance of Tiko trained and youth friendly service providers. This decision empowered Calista to take control of her sexual health and mitigate the risk of HIV transmission, given her engagement with multiple sexual partners.
Regular HIV testing is a cornerstone of the ASRH DIB program’s approach to HIV prevention and care. Calista has embraced this proactive approach and regularly accesses HIV self-testing and PrEP services through a Tiko service provider. Through comprehensive counselling, Calista opted for a long-acting family planning method (5 year implant), which she is very comfortable and happy with. Her relationship with her Tiko service provider is very positive and she is very satisfied with the information given to her regarding PrEP, HIV testing and family planning. She never misses her PrEP refills appointments through the support extended to her by Tiko mobilisers and her service provider. Her Tiko service provider successfully addressed her concerns regarding PrEP and FP side effects and resolved the myths and misconceptions she had. Through routine testing and retention to PrEP, Calista not only stayed informed about her HIV status but also contributed to breaking the cycle of transmission by knowing her status and being retained on PrEP.
Calista** engages in sex work due to economic necessity and has often lacked alternative means of income. Economic vulnerability has exacerbated other challenges faced by Calista including exploitation and limited bargaining power with clients as well as abuse which sometimes takes a toll on her mental health. She has moments where she has struggled with depression and chronic anxiety. Acknowledging the significance of addressing mental health together with physical health, Calista took up a mental health offer which is offered on the Tiko platform specifically in Mombasa County. Through interpersonal therapy and group (IPTG) counseling sessions facilitated by Tiko Africa's trained IPTG facilitators, Calista has found a nurturing community and coping mechanisms to manage her anxiety effectively.
Calista's journey with the ASRH DIB program showcases the innovative impact of integrated family planning and HIV services tailored to the needs of vulnerable adolescent girls and young women . By accessing family planning, PrEP and HIV testing services, Calista took proactive steps to safeguard her physical health. Moreover, her engagement with mental health services provided her with the necessary support to address her depression and navigate her anxiety. The ability to access essential items as a reward for positive health seeking behavior is valuable to her and her family. She normally redeems food and hygiene items as well as diapers for her 1 and half year old daughter.
Calista's case emphasizes the importance of holistic and integrated approaches in supporting vulnerable girls living in multidimensional poverty. By offering a combination of HIV prevention, testing, and family planning services, the ASRH DIB program aims to empower and tackle poor health outcomes of girls like Calista so that they can to lead healthy, fulfilling lives and ensure they have access to free quality and youth friendly HIV and family planning services to secure their health and wellbeing. Through Calista's story, the ASRH DIB program reaffirms its commitment to advancing the health and well-being of adolescent girls and young women across the 10 ASRH DIB counties.
