13 years old, pregnant and HIV-positive

In his 30 years as a pastor in Uriri in Migori County, Chrispinus has never found a practical solution to many of the problems facing his congregation.

He knows that, as a religious leader, he is expected to provide solutions that ease the pains of his people; but try as he may, the burdens keep growing.

For him, however, nothing could be more painful than the girl standing in front of him when we walk into his church for an interview.

She is 13, he tells us.

And pregnant.

And HIV-positive.

In revealing that information to us, he acknowledges that he is breaking a confidentiality that he shouldn’t, but what is the law of confidence when his people are living like this? Just two days earlier he had presided over the funeral of a girl a bit younger than the one standing before him now. She had died of birth-related complications.

He is sad, this pastor. Sad and angry. His sermons are no longer about salvation and “thou shall not”, but, like many other Kenyan parents, all about teenage sexual promiscuity and what it is doing to an entire generation. Parents are standing in between the bubble of curiosity that is their children, and Pastor Chrispinus is finding himself with a heavy cross to bear.

It is getting worse, sadly. Recent findings indicate that children have their sex debuts as early as eight years in Kenya, and most of them do not know what contraception is, leave alone how to spell the word.

The World Health Organisation, through its Global Health Observatory unit, ranks Sub-Saharan Africa as the most severely affected region in the world by sexually transmitted diseases, with nearly one in every 20 adults living with HIV. That number accounts for 71 per cent of the people living with HIV worldwide.

Then there are the unwanted teenage pregnancies that Chrispinus is dealing with in his community: of the 7.3 million girls giving birth between the age of 15 and 19 globally, 103 in every 1,000 are Kenyan, according to the Kenya Population Situation Analysis, released in October last year.

So, what is happening? Why are children as young as eight having sex? The answer is simple: in the current age, there are plenty of opportunities for them to act on their curiosity regarding sex; from the overnight church vigils and family get-togethers they attend to end-of-year parties, which are usually marked by drunkenness and what some observers have called “teen sex orgies”.

Faced with this predicament, Family Health Options Kenya last year proposed that contraceptives such as condoms be introduced in schools, alongside sex education. The proposal was met with vehement opposition, particularly from religious circles.

But that was expected; the National Council for Population and Development (NCPD), a semi-autonomous government agency that formulates and promotes population policy in Kenya, cites religious and cultural taboos as the biggest impediments to open dialogue about premarital sex at home and in schools, despite the fact that such sexual activity has become rampant.

And now sociologists, psychologists, parents and others who play a part in children’s development wager that it will take more than pills, condoms and information about sex to tame the situation.

Dr Charles Muga, a behavioural scientist and sociologist based in Kisumu who has studied human behaviour in urban and rural settings for over 20 years, says these ideologically driven restrictions will only make the situation worse.

“Christians, Muslims and any other religious group in Kenya must get involved in this discussion,” he says. “We cannot place so much value on virginity and piety with scriptural statements like sex is wrong before marriage. Explain to these children the responsibility that they are about to place on their hands by having sex, and tell them why you are saying sex is wrong because the media and the Internet are giving them all the wrong answers to the ‘why’ question, then ask them to go think about what you have said, and they will listen.”

Mrs Mary Wainaina, a mother of five and a counseling psychologist in Nakuru, agrees with Dr Muga’s observations, saying that the parenting methods in this generation have left a huge ‘developmental dent’ in the lives of children.

“Parents are giving their all chasing after money,” she says. “They are too busy with their own ambitions that they cannot notice that their children have reached the age when they know children are not bought from the supermarket.”

Yet, even as their young ones mature faster and learn stuff at an early age, parents still cling to their ultra-conservative roots. When Family Health Options proposed the introduction of contraceptives and sex education in primary schools last year, for instance, the reaction was so hostile that the organisation’s director refused to talk to DN2 about how they hoped to address the issue. Even gynaecologists and other health practitioners refused to comment on FHOK’s proposal as, they argued, they feared losing their patients on moral grounds should they be seen to support the suggestion.

But Dr Charles Muga says that, even though contraceptives work well, they may not, by themselves, solve the crisis at hand if the causes are not addressed. “It is important to understand the dynamics and determinants of a young Kenyan’s sexual behaviour within the social context of where his or her sexual encounters occur to design effective prevention interventions,” he says.

The drivers of sexual behaviour among older adolescents and young adults have been widely studied in Sub-Saharan Africa, but there is scarce information on sexual behaviour among very young adolescents. And, while the nature of the early sexual debuts is not clear, it is worth noting that a substantial percentage of these children engage in transactional or coerced sex.

Transactional sex means the children are having sex in order to earn money or food, while coerced sex occurs when the young children live in abusive environments or are influenced by peer pressure. Not all of the sexually active children, therefore, consented to it in the first place.

Among the first studies to examine a wide range of social, demographic and psychosocial predictors of sexual debut among 12–16-year-olds was conducted by the Guttmacher Institute, a US-based non-profit organisation that works to advance reproductive health. In the study, correlates of sexual experience included increasing age, low religiosity, having sexually active peers, substance abuse, and liberal attitudes towards premarital sex.

Other studies, such as one conducted by the African Population and Health Research Centre in 2012 in Brazil and Kenya, suggest that there are protective factors, such as having a father present in the home, that are associated with delayed sexual debut and fewer incidences of unintended pregnancy among adolescents in slum communities.

Kenyan parents, therefore, have so much on their plates, thanks to urbanisation and modernisation, says Dr Muga. And, to make matters worse, sexuality is today presented to young children in a manner that plants ideas into their curious minds.

“Also, because of economic challenges, urban parents share small spaces with their children, leaving them with little privacy for their own intimacy,” adds Dr Muga.

That observation is supported by the Guttmacher Institute, whose survey in Kenya shows that, among other factors in Nairobi’s informal settlements, the little spaces within which teenagers live with their parents contribute to earlier sexual debuts compared with those who live in bigger homes.

To make matters worse, “this is the generation that lives by the motto YOLO — You Live Only Once — so they place value on instant sexual gratification than responsible behaviour such as abstaining until marriage or being faithful to one partner, which has long-term positive results,” adds Dr Muga.

As a result of that YOLO attitude and the lack of communication between children and their parents, teenage pregnancy is now quite prevalent. The Kenya Demographic and Health Survey (KDHS) of 2003, carried out by the Central Bureau of Statistics in partnership with the Ministry of Health, revealed a daily abortion rate of about 800 and the deaths of 2,600 women every year. Fifty per cent of these involved girls aged between 14 and 24, and 57 per cent of them lived in urban areas.

These figures are raising a stink at the highest level of policy development. Dr Gottfried Hirnschall, the Director of WHO’s HIV/Aids Department, says adolescents “face difficult and often confusing emotional and social pressures as they grow from children into adults”, and therefore require health services and support tailored to their needs. His advice points to the role of parent-adolescent communication in taming the practice.

And he might be bang on the money; because parents or guardians who discuss with their children about puberty, relationships, delayed sex, impact of early sexual debut, teenage pregnancy and HIV report a lower likelihood of their children having early sexual debut as compared to those who do not. Parent-child communication is therefore an unexploited avenue for improving sexual and reproductive health outcomes for young people.

Access to education has also be an alternative to delaying sexual debuts, or enhancing responsible sexual behaviours among youth. The Kenya Demographic Health Survey of 2003 showed that the level of education was strongly related to age at first sex, with about 25 per cent of women aged between 15 and 24 years who had no education reporting sexual activity by age 15, compared to only four per cent among those with at least some secondary education.

But, even where communication is okay and teenagers are aware of what to do and what not to, opposition from religious and community leaders and policymakers often prevents young people from accessing the services they require, NCPD’s report indicates.

And providers’ negative attitudes about adolescent sexuality and the rights of young people create major barriers that prevent young people from accessing these services.

Surveys and all manner of reproductive health research continue to show that the youth no longer place much value on virginity as they used to, say, 20 years ago. That means that, if children are not raised in an environment that they are allowed to develop normally, where they are taught the dangers of their behaviours, and where their guardians take an active role in moulding their lives, soon or later those parents will have their 13-year-olds, like the one at the beginning of this story, standing before them crestfallen, pregnant and HIV-positive.

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