Association of Care Environment With HIV Incidence and Death Among Orphaned, Separated, and Street-Connected Children and Adolescents in Western Kenya

Abstract

Key Points Question What is the association of care environment with incident HIV and death among orphaned, separated, and street-connected children and adolescents in western Kenya? Findings In this cohort study of 2551 orphaned, separated, and street-connected youths in western Kenya, living in an institutional environment was not associated with either death or incident HIV compared with living in a family-based setting. However, living in a street setting was associated with a higher rate of incident HIV and death compared with living in a family-based setting. Meaning This study’s findings suggest that alternatives for orphaned, separated, and street-connected youths in low-income regions are needed when designing public policies for the care of vulnerable children, including deinstitutionalization, to ensure that the rights and well-being of children and adolescents are upheld.