Youth and HIV in Mombasa

Youth between 15 – 35 years account for 51% of new HIV infections in Kenya. In particular, youth with intersecting vulnerabilities and who live under challenging socio-economic circumstances are at risk.

In their daily work, Muslim Education and Welfare Association (MEWA) encounters young people who poly-use substances like khat/muguka, benzos (and other prescription drugs), crack and possibly meth. Their use takes place in a context where young people have poor chances of getting an education or finding employment and where rates of violence – including gang violence – are extremely high.

Youth

Crime is one of the few (perceived) means of generating income for young people in Mombasa. The impact of these circumstances is exacerbated by drug use. Many young people who use drugs suffer from serious mental health problems and encounter heavy stigma. All of this increases their risk of contracting HIV and other STIs. MEWA’s program data (2022) shows that mental health disorders already increase the risk of HIV by four to tenfold. HIV treatment outcomes for this group are poor. MEWA’s regular harm reduction program does not fit the many needs of these YPUD and there is limited knowledge of their exact backgrounds, drugs of choice and using patterns and risk behaviors, including about risky drug use in a sexualized setting.

Innovating programmes

This project – that runs between 2023 and 2025 – plans to boost young people in Kenya’s Coastal region, to motivate them and gain knowledge on self-employment and entrepreneurship. MEWA, Mainline and Elton John Foundation will support mental well-being for youth at risk or affected with drug use in the context of HIV prevention, treatment and care.

With our project, we hope to improve the mental, sexual, and general health of young people who use drugs, including those who use stimulant drugs and those who use drugs in a sexualized setting. We ultimately aim to reduce HIV, mental problems, and (self-) stigma among youth.

The programme works on various levels: data collection via community assessments, direct service delivery to young people who use drugs, establishing a learning hub and training materials to disseminate what we learn and an advocacy plan to make sustainable changes.

Community Assessment

Stimulant use – especially in sexualised settings – has become increasingly normalized in some parts of Kenya. To better understand these dynamics, Mainline in collaboration with the Muslim Education and Welfare Association (MEWA) conducted community-led research on stimulant use for sexual activities in Mombasa and Lamu.

‘When I have money, I buy more. When I don’t, I steal – it’s the only way to cope,’ one participant said. Another said: ‘Seeing posts about stimulants makes it seem like everyone’s doing it. You don’t think about the risks.’ These quotes reflect the complex social and economic realities many young people in Kenya face today.

The study, which is part of a joint project funded by the Elton John AIDS Foundation, aimed to explore the health and service needs of young people who use stimulants in sexualised settings in Mombasa and Lamu.The report sheds light on stimulant use – especially the use of Muguka and Miraa – particularly among unemployed youth. The substances are cheap and widely available and are used to enhance sexual performance or to cope with economic hardship. But among those already marginalised youth, the use can result in job loss, health problems, and social isolation, creating a cycle of further marginalisation. Access to care is severely limited due to stigma, fear of legal consequences, and a lack of tailored services.

The report recommends expanding stimulant-specific harm reduction services, integrating sexual and mental health care, and launching economic empowerment programs such as vocational training. More attention must be paid to holistic support. MEWA continues to advocate for youth-led, community-rooted harm reduction strategies that respond to the complex realities of stimulant use among Kenyan youth.

You can request more information about this project via Ancella Voets.

Support and finance

This project is implemented in partnership with MEWA and funded via Elton John AIDS Foundation.