Initiation to street life: a qualitative examination of the physical, social, and psychological practices in becoming an accepted member of the street youth community in Western Kenya

Abstract

BackgroundThe objective of this study was to describe the physical, social, and psychological initiation practices of street connected children and youths, in Eldoret, western Kenya.MethodsThis qualitative study was conducted from August 2013 to February 2014. A total of 65 SCCY aged 11–24 years were purposively sampled from the three referral points: 1) A dedicated study clinic for vulnerable children and youth at Moi Teaching and Referral Hospital (MTRH); 2) Primary locations in which street children reside “bases/barracks”; 3) Street youth community-based organizations. In-depth interviews and focus group discussions were used to collect data. All data were audio recorded, transcribed, translated to English, and a content analysis performed.ResultsThe overall median age was 18 years (IQR 14–20.5 years) and 69.2 % of participants were male. None had gone beyond primary level of education. The majority (81.5 %) reported to be sexually active. The street community had well-defined structures and rules that were protective of members and ensured survival on the streets. To be fully accepted children had to go through an initiation ritual that had important gender differences. Common rituals between males and females included interrogation, smearing of black soot, and payment of tax. Ritual practices unique to boys were physical abuse, theft of personal possessions, volatile substance use, being forced to eat garbage, and sodomy among the physically weak. Rituals unique to girls were being forced to ‘become a wife or sexual partner’, rape, and gang rape. Physical and psychological abuse during initiation was normalized and there were no clear mechanisms of dealing with these forms of abuse.ConclusionThere were important gender differences in the initiation practices of SCCY. Normalization of physical and psychological abuse during initiation contributes to the high health risks faced by these SCCY. Appropriate interventions need to be developed in collaboration with SCCY.

Eating sweets without the wrapper: perceptions of HIV and sexually transmitted infections among street youth in western Kenya

“…Girls on the street face unique sexual health challenges due to their need to engage in survival sex, their initiation rites, and the sexual and gender-based violence they sustain (Wachira et al 2015; Embleton et al under review). A novel finding in this study concerned the use of female condoms by girls.…”

“…Street boys sometimes seek sex for pleasure, power, and dominance in the street social hierarchy (Wachira et al 2015; Embleton et al under review). For girls, on the other hand, engaging in sex is a primary means of survival.…”

“…Street-connected young people in sub-Saharan African are often sexually active and tend to have an early sexual debut (Kayembe et al 2008; Wutoh et al 2006; Tadesse et al 2013; Mudingayi, Lutala, and Mupenda 2011; Anarfi 1997; Winston et al 2015). Research has revealed a variety of circumstances that place street-involved young people at high risk for contracting STIs including, sexual and gender-based violence, sexual street-initiation rites, transactional and survival sex, multiple concurrent partnerships, and inconsistent condom use (Kudrati, Plummer, and Yousif 2008; Lockhart 2002; Kayembe et al 2008; Winston et al 2015; Anarfi 1997; Wachira et al 2015; Embleton et al under review) Street-connected young people are also at risk of contracting STIs (Winston et al 2015; Kayembe et al 2008; Kaime-Atterhög et al 2007; Mandalazi, Banda, and Umar 2013). In Eldoret Kenya, Winston et al (2015) found street-connected youth had a high prevalence of STIs, with 28% of participants testing positive for at least one STI.…”

Implementing intensified tuberculosis case-finding among street-connected youth and young adults in Kenya

“…Many SCY distrust authority figures, including health care providers, given their histories of domestic violence and neglect, abuse by the police, and discrimination in the community. 4,16 Tumaini's outreach and service delivery to the SCY population had earned their trust and created the opportunity for the AMPATH TB Program to conduct screening. Furthermore, we were able to gain access to two different networks of SCY: the younger SCY at the drop-in center, as well as older, more entrenched SCY living in the barracks.…”

Piloting an evidence-based intervention for HIV prevention among street youth in Eldoret, Kenya

“…In Kenya, street-connected young people (SCY), for whom the streets play a central role in their everyday lives and social identities (Office of the United Nations High Commissioner for Human Rights 2017), engage in sexual practices that increase their exposure to HIV (Kaime- Atterhög et al 2007;Embleton et al 2015Embleton et al , 2016Wachira et al 2015Wachira et al , 2016. In Eldoret, Kenya, SCY have a STI and HIV prevalence that exceeds that of other young people in Kenya (Winston et al 2015;Shah et al 2018;Braitstein et al 2019).…”