Young People’s Experiences With an Empowerment-Based Behavior Change Intervention to Prevent Sexual Violence in Nairobi Informal Settlements: A Qualitative Study

This study indicates that an empowerment-based, behavioral intervention can contribute to equipping both adolescent girls and boys with concrete skills to recognize and resist sexual violence and can promote positive, nonviolent masculinities among adolescent boys. Key Findings A 6-week behavioral, school-based intervention can contribute to empowering adolescent girls to recognize and resist sexual violence and to exercise agency. The intervention can also promote positive, nonviolent masculinities among adolescent boys and encourage rejection of harmful stereotypes. Skilled, thoroughly trained local facilitators and interactive, adolescent-friendly relevant content were highlighted by the adolescent participants as key to intervention success. Key Implications Policy makers should consider integrating empowerment-based, behavioral interventions in standard school curriculums to prevent sexual violence and harmful gender norms. Policy makers should adopt legislation that will facilitate the implementation of comprehensive sexuality education that addresses topics such as sexual consent communication and guarantees access to adolescent-friendly sexual and reproductive health services. Public health practitioners and implementers should consider expanding similar interventions to include comprehensive sexuality education as well as directly targeting the broader social environments in which adolescents are socialized. More research is needed to better understand the longitudinal effects of the intervention and the strategies for sustainable implementation in different contexts. ABSTRACT Purpose: Young people in sub-Saharan Africa face one of the world’s highest burdens of sexual violence. Previous impact evaluations indicated that a 6-week empowerment-based behavioral intervention in Nairobi informal (slum) settlements can reduce sexual assault. This qualitative study investigated girls’ and boys’ experiences of the intervention to identify potential mechanisms of change. Methods: We conducted a qualitative study in Nairobi slums with students (aged 15–21 years) who had participated in 2 parallel school-based curriculums called IMPower (girls) and Your Moment of Truth (boys) at least 1 year ago. Data were collected via 10 focus group discussions (5 for boys, 5 for girls) with 6–11 participants in each and 21 individual in-depth interviews (11 boys, 10 girls) that explored participants’ experiences of the intervention and their suggestions for improvement. Findings were analyzed using thematic network analysis guided by empowerment theory. Results: Girls described how the intervention enabled them to recognize and resist sexual assault via verbal and physical strategies for self-protection, negotiate sexual consent, and exercise agency. Boys described increased ability to avoid risky behaviors and “bad” peer groups and to understand and respect consent. Girls also described how the intervention strengthened their self-confidence, and boys said that it boosted positive life values and gender-equal attitudes. Skilled facilitators and interactive and relevant content were highlighted as key to intervention success. Areas of improvement included expanding the curriculum to contain more content on sexual and reproductive health and rights and involving out-of-school youth, parents, teachers, and communities. Conclusion: Findings indicate that a relatively short, behavioral school-based intervention can empower both girls and boys to prevent various forms of sexual violence in a low-income setting where it is endemic. Incorporating multilevel support structures, such as involving communities and families, could further enhance young people’s long-term safety, health, and well-being.