1. U O N CENTRE FOR HIV PREVENTION AND RESEARCH MARPS PROJECT VENUE: MAYFAIR COURT SOUTHERN SUN, NAIROBI PAPER:CHILDREN WORKING AS SEX WORKERS. JAN 27 TH 2014 BY JANET ROSE KAMAU Kamau J 1 Ngugi E 1 Pere M 1,,Kageni L 1, Nderitu M 1, Ndunge 1, Muigai J 1, Eshikimo P 1, Samburu N 1, Muguna A 1, Mwangi M 1, Magoko K 1 Muthiani N 1, Agwanda C 1 University of Nairobi Ministry of Health

2. I NTRODUCTION  The University of Nairobi- Centre for HIV Prevention and Research (UoN-CHIVPR) has been working with sex workers in Kenya since 1983. In addition, since 2010, UoN- CHIVPR started enhancing access to quality comprehensive HIV Prevention services for Key Populations (KPs) in 10Drop-in-Centres (DICEs) in Central and Eastern Provinces of Kenya under PEPFAR grant ( MARPS Project).

3. I NTRODUCTION CONT.  The Continuously Abused Children (CAC) program started on 1 st October 2013 through the MARPs Project, targeting children below eighteen years engaging in sex work.  This was after it was discovered that as much as there are many KPs (Female Sex Workers, Male Sex Workers, Men who have Sex with Men, Intravenous Drug Users and Truckers) there were also children working as sex workers, therefore continuously abused.  Although the MARPS project has 10 Drop in Centres (DICES), the CAC program is implemented in six DICEs in Makindu, Machakos, Mwingi, Kitui, Meru and Nyeri.  This is due to the high vulnerability of children in these areas and limited funds.

4. P URPOSE  To provide an opportunity for better lives to the CACs by providing them with the services that they require.

5. E NTRY P OINTS  Through peer leaders  Referral from teachers and concerned persons  Referral from Community and church leaders  Snow balling  Self referral

6. SERVICES OFFERED  Biomedical services ie, HIV testing & counseling, STI screening & treatment, TB screening and referral to treatment, emergency contraception, PEP and reproductive health, Cancer of cervix screening, drug abuse screening,  Behavioral interventions (Health Choices for a better future, My Health My Choice and Families Matter Program)  Education support for those who can go back to school and Vocational training for those who cannot go back to school.

7. A CHIEVEMENTS  The MARPS project has so far been working with the CACs for one year and 3 months ( Oct 2013 –Dec 2014) and is still on going.  Up to Dec 2014, the program had mobilized 750 children from all the 6 DICEs implementing the program.  Out of the 750 children 664 were/are working as sex workers while 86 are vulnerable children who are at risk of sexual abuse due to their risky environments.  The children are put into different children clubs where they support each other.  The children are very mobile and the clubs helps in retention.

8. ACHIEVEMENTS CONT ’ D  The CAC program has so far enrolled 70 children for formal education and 40 children for vocational training.  341 children have received My Health My Choice (HCII) training.  281 children have received Health Choices for a Better Future (HCI) training  250 parents and their children have received the Families Matter training.

9. N N(11 YEARS ) FROM MERU WHO T HROUGH P ARTNERS WAS SECURED A SCHOLARSHIP TO T IGONI FEP PRY SCHOOL. FEP WILL EDUCATE HER UP TO A 2 ND D EGREE IN THE UNIVERSITY IF SHE IS ABLE

10. HIV PREVALENCE  Unfortunately, some of the children have already contracted HIV and the prevalence among those enrolled is 3%  In addition we have 10 CACs who are pregnant.  They are an easy target who are not able to negotiate condom use.

11. L M AND L K[ SISTERS ] CHILDREN MOTHERS WHO ARE HIV POSITIVE. THEY HAVE ACCESS TO THE COMPREHENSIVE HIV PACKAGE AT THE DICE

12. C HALLENGES  Being illegal to employ children limits options for some of the girls who have kids. This makes them feel that they have no choice but to go into prostitution to be able to support their kids.  Some children are willing but not able to go back to school because they have kids and have no one to leave them with.  Children’s opinion’s are not valid because they are under 18 years and can easily be taken advantage of.

13. C ONCLUSION  It is possible and credible mobilizing and working with Continuously Abused Children and providing them with:  Comprehensive care package which is essential  Educational support for those who can go to school is mandatory  Vocational Training and subsequently Economic Empowerment is a feasible option  Linkage with the family kinship system works well with support counseling  The whole process prolong quality of life.

14. DISCLAIMER  The findings and conclusions in this are those of the author(s) and do not necessarily represent the official position of the funding agencies/U.S, Centers for Disease Control /Government of Kenya

15. A CKNOWLEDGEMENT  Study Participants, KP community and the MARPs Project staff  Stakeholders:- PEPFAR and CDC; Ministry of Health, Ministry of Education and NASCOP; County Governments and the University of Nairobi administration