Perceptions about the use of direct cash- transfers to increase housing stability and HIV services utilization among street-connected young women in Western Kenya

Abstract

Addressing homelessness is a critical component of HIV prevention; in high income countries, unconditional cash-transfer (CT) programs have been implemented for housing support with youth populations. Here we describe a pilot unconditional CT program for street-connected young women in western Kenya and stakeholder and beneficiary perceptions of its feasibility, acceptability, appropriateness, implementation and sustainabilit. Interviews were conducted with 17 participants, of which 9 were street-connected young women (median age 22 years) and 8 were key informants (policymakers, healthcare workers and community organization workers in two counties). Almost all street-connected young women were strongly in support of the CT program, citing numerous potential benefits, including general wellbeing and safety, improved community perceptions secondary to housing related cleanliness, the potential to create businesses and generate independent income, and finally HIV- related adherence benefits. In general, stakeholders were also supportive, with some indicating additional programmatic considerations were necessary related to the CT monetary amount, disbursement procedures, and sustainability and expansion. The CT program was found to be highly feasible, appropriate and acceptable; participants provided additional input on implementation and sustainability approaches.