Sexual Behavior Among Orphaned Adolescents in Western Kenya: A Comparison of Institutional- and Family-Based Care Settings

Abstract

Purpose: This study sought to assess whether risky sexual behaviors and sexual exploitation of orphaned adolescents differed between family-based and institutional care environments in Uasin Gishu County, Kenya. Methods: We analyzed baseline data from a cohort of orphaned adolescents aged 10 e 18 years living in 300 randomly selected households and 19 charitable children ’ s institutions. The primary outcomes were having ever had consensual sex, number of sex partners, transactional sex, and forced sex. Multivariate logistic regression compared these between participants in institutional care and family-based care while adjusting for age, sex, orphan status, importance of religion, caregiver support and supervision, school attendance, and alcohol and drug use. Results: This analysis included 1,365 participants aged

10 years: 712 (52%) living in institutional environments and 653 (48%) in family-based care. Participants in institutional care were signi fi - cantly less likely to report engaging in transactional sex (adjusted odds ratio, .46; 95% con fi dence interval, .3 e .72) or to have experienced forced sex (adjusted odds ratio, .57; 95% con fi dence interval, .38 e .88) when controlling for age, sex, and orphan status. These associations remained when adjusting for additional variables