Sexuality, stigma, and mental health of adolescents in western Kenya

Kenyan youth are sexually active and experience young pregnancy and HIV infection. They also experience high rates of mental distress, which is influenced by stigma related to their sexual and reproductive health (SRH). Adolescent SRH stigma is the judgment and devaluation of youth for their sexual behavior, contraceptive use, pregnancy status, and abortion access. The goal of this dissertation is to describe how adolescent SRH stigma impacts adolescent mental health in western Kenya.

The first study in this dissertation used a qualitative approach to learn about the impact of pregnancy stigma on the mental health of pregnant girls. The second study used survey data to quantify how much SRH stigma influenced mental distress. The third study in this dissertation used an interactive approach with youth to learn more about how they view sexual behavior stigma and what they imagine their lives might be like without stigma.

This dissertation found that SRH stigma is associated with the mental health of adolescents in western Kenya. Taken together, these three studies demonstrate that stigma related to pregnancy and sexual behavior is distressing, and the impact of SRH stigma on mental distress is different for boys and girls. Further, these studies show that youth are navigating many norms that influence negative beliefs about adolescent sexual behavior, and the potential of changing these norms is distressing. Overall, this work demonstrates that understanding the impact of SRH stigma on adolescent mental health is important for future programs aiming to improve adolescent SRH.