Date of Conferral



Doctor of Public Health (DrPH)


Public Health


Shanna Barnett


Sub-Saharan Africa (SSA) has a great burden of human immunodeficiency virus (HIV) and high new HIV infection rates among youths age 15-24 years. Suboptimal practice of HIV risk-reducing sexual behaviors among youths threatens to reverse the gains made in preventing the spread of HIV in SSA. The purpose of this quantitative cross-sectional study was to investigate the effects of comprehensive knowledge of HIV transmission and prevention, on individuals’ attitude toward people living with HIV, and ability to obtain condoms (if needed) on practice of HIV risk-reducing sexual behaviors, in adolescents age 15-19 years and young adults age 20-24 years in Kenya and Lesotho. The information-motivation-behavioral skills model was used to frame the study. Secondary data were collected from the demographic health survey in Kenya and Lesotho using responses from 11,120 individuals. Statistical analyses included chi-square and multinomial logistic, bivariate, and multiple regression. Findings indicated that individuals with comprehensive knowledge of HIV were more likely to report having one sexual partner and using a condom with them (p < 0.05). Those with negative attitudes toward people living with HIV were more likely to report abstaining (p < 0.05), and those not able to obtain a condom were more likely to report abstaining (p < 0.05). Adolescents were more than 3 times more likely to report abstaining than young adults. There were no differences noted between Kenya and Lesotho. Results indicate providing age-appropriate information to stakeholders and increasing youth-friendly condom distribution points, which may enable adolescents and young adults to practice sexual fidelity and use condoms, may result in reduction of new HIV infections in Kenya and Lesotho.