Resiliency among Urban Youth Newly Diagnosed with HIV in Kenya: Sources of Social Support and Active Coping Strategies Gary W. Harper 1,2, Elizabeth Ngugi 3, Andrew J. Riplinger 2, Anne W. Gikuni 3, Diana Lemos 1,4, Sybil G. Hosek 4, & Kylon Hooks 1 1 Department of Psychology, DePaul University, Chicago, IL, USA 2 Master of Public Health (MPH) Program, DePaul University, Chicago, IL, USA 3 Centre for HIV Prevention and Research, University of Nairobi, Nairobi, Kenya 4 Department of Psychiatry, Stroger Hospital of Cook County, Chicago, IL USA

Background & Significance Rates of HIV are increasing among youth in Kenya. Research regarding how these youth have coped with their diagnosis and remained resilient is critical to the development of interventions that promote their health and well-being. The purpose of this study was to explore resilience among urban youth newly diagnosed with HIV living in a slum region of Nairobi, Kenya. Resilience is being conceptualized as a dynamic process of positive adaptation within the context of adversity.

Methods & Participants Methods Six (6) gender-specific focus groups. Questions focused on sources of support & resiliency following HIV diagnosis (Disability-Stress-Coping Model). Focus groups were conducted in English & Kiswahili. Participants Urban Kenyan youth (n=53; 26 female, 27 male) Diagnosed with HIV/AIDS within the last 2 years Ages (mean = 22.8) 37.7% married, 62.3% single Luo (45.3%); Luhya (17.0%); Kamba (15.1%); Nubian (7.6%); Kikuyu (5.7%); Kisii (5.7%); Mumeru (1.9%); Teso (1.9%).

Study Site - Kibera Participants were recruited using snowball sampling in 10 of the 13 villages in the Kibera informal settlement (slum) in Nairobi.

Qualitative Data Analysis Focus groups were transcribed by the University of Nairobi staff who facilitated them. Qualitative data analysis utilized a phenomenological framework. Data were analyzed first separately by the Kenya and USA-based teams of analysts, and then collaboratively during in-country meetings. Thematic analysis revealed 7 Active Coping Strategies & 7 Primary Sources of Social Support.

Results: 7 Active Coping Strategies Accepting a new HIV+ identity Disclosing HIV+ status to supportive others Engaging in holistic self-care Participating in formal support and health promotion programs Advocating for other HIV+ individuals Finding HIV+ role models Re-engaging with friends for social activities

Results: 7 Sources of Social Support Romantic partners Friends Healthcare workers / counselors People living with HIV Co-workers/employers Religious colleagues Affirming HIV+ media figures

Conclusions These data demonstrate that Kenyan youth who are newly diagnosed with HIV demonstrate resilience across multiple dimensions. Intrapersonal-level resilience related to individual cognitions and behaviors Interpersonal-level resilience related to both seeking support and providing support to others.

Implications Future interventions should work to enhance youths’ coping and social support through creative strategies that develop and maintain resilience at both levels: intrapersonal resilience through individual-level cognitive and behavioral coping strategies interpersonal resilience through accessing and providing social support and mentoring/activism.

Acknowledgments This study was funded by the Vincentian Endowment Fund (VEF) of DePaul University’s Office of Mission and Values. We would like to thank the following: The participants who shared their stories with us. University of Nairobi’s Centre for HIV Prevention and Research staff who conducted and transcribed the focus groups. DePaul University & Stroger Hospital of Cook County Research Teams.