{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T23:42:32Z","timestamp":1778629352737,"version":"3.51.4"},"reference-count":48,"publisher":"University of California Press","issue":"1","license":[{"start":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T00:00:00Z","timestamp":1741219200000},"content-version":"vor","delay-in-days":64,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,6]]},"abstract":"<jats:p>Gay and bisexual men and other men who have sex with men (GBMSM) are at elevated risk for HIV, especially in rights-constrained settings such as Kenya, where stigma and discrimination have impeded access to HIV prevention. This article describes the development and pilot run of a theory-based and culturally relevant peer-led program called Shauriana (\u201cwe counsel each other\u201d), which combines health education and integrated Next Step Counseling (iNSC) to promote sexual and mental health and well-being. Shauriana was developed using participatory methods in collaboration with GBMSM community members using the ADAPT-ITT framework and tested through an initial pilot run with 10 participants to refine and finalize program materials and procedures. The team monitored attendance and obtained participant feedback through quantitative evaluation and in-depth exit interviews that were thematically analyzed. The majority of participants (90%) attended all 4 core sessions and completed study visits on time. All participants completed an exit interview, providing feedback on program content and format, challenges\/barriers, recommendations, impact, and recommending Shauriana to others. We identified key elements for positive engagement with the program, including being peer-led, maintaining privacy and confidentiality, using iNSC to provide guidance while maintaining autonomy, and taking a holistic approach by focusing on mental health and issues affecting GBMSM\u2019s lives. We share modifications made in response to feedback and an overview of the final program sessions and structure. Pilot participants reported positive experiences engaging in Shauriana and shared that the program was highly relevant to their lives. Refined intervention procedures and materials are being tested in a subsequent randomized controlled trial. Lessons learned throughout the participatory development process and confirmed in exit interviews center on the importance of community engagement, local GBMSM leadership, and holistic, autonomy-supporting programming for young GBMSM in Kenya.<\/jats:p>","DOI":"10.1525\/agh.2025.2442813","type":"journal-article","created":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T16:03:43Z","timestamp":1741277023000},"source":"Crossref","is-referenced-by-count":1,"title":["Participatory development and initial pilot run of the <i>Shauriana<\/i> program to integrate sexual health and mental health support for young gay and bisexual men and other men who have sex with men in Kenya"],"prefix":"10.1525","volume":"4","author":[{"given":"Laura","family":"Jadwin-Cakmak","sequence":"first","affiliation":[{"name":"1Department of Health Behavior & Health Equity, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary W.","family":"Harper","sequence":"additional","affiliation":[{"name":"1Department of Health Behavior & Health Equity, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elijah","family":"Ochieng","sequence":"additional","affiliation":[{"name":"2Nyanza Reproductive Health Society, Kisumu, Kenya"},{"name":"3Salina Youth Initiative, Kisumu, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. Rivet","family":"Amico","sequence":"additional","affiliation":[{"name":"1Department of Health Behavior & Health Equity, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teddy","family":"Aloo","sequence":"additional","affiliation":[{"name":"2Nyanza Reproductive Health Society, Kisumu, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Okutah","sequence":"additional","affiliation":[{"name":"2Nyanza Reproductive Health Society, Kisumu, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edwin","family":"Gumbe","sequence":"additional","affiliation":[{"name":"2Nyanza Reproductive Health Society, Kisumu, Kenya"},{"name":"4Nafasi Innovations, Tom Mboya, Kisumu, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kennedy","family":"Olango","sequence":"additional","affiliation":[{"name":"5Men Against AIDS Youth Group (MAAYGO), Kisumu, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Duncan O.","family":"Okall","sequence":"additional","affiliation":[{"name":"2Nyanza Reproductive Health Society, Kisumu, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fredrick O.","family":"Otieno","sequence":"additional","affiliation":[{"name":"2Nyanza Reproductive Health Society, Kisumu, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wilson","family":"Odero","sequence":"additional","affiliation":[{"name":"6School of Public Health and School of Medicine, Maseno University, Kisumu, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan M.","family":"Graham","sequence":"additional","affiliation":[{"name":"7Departments of Global Health, Medicine, and Epidemiology, University of Washington, Seattle, WA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"408","reference":[{"issue":"18","key":"2025030616033013200_ref1","doi-asserted-by":"crossref","first-page":"2513","DOI":"10.1097\/QAD.0b013e3282f2704a","article-title":"HIV-1 infection in high risk men who have sex with men in Mombasa, Kenya","volume":"21","year":"2007","journal-title":"AIDS"},{"issue":"12","key":"2025030616033013200_ref2","doi-asserted-by":"crossref","first-page":"e339","DOI":"10.1371\/journal.pmed.0040339","article-title":"Elevated risk for HIV infection among men who have sex with men in low- and middle-income countries 2000\u20132006: a systematic review","volume":"4","year":"2007","journal-title":"PLoS Med"},{"issue":"Suppl 1","key":"2025030616033013200_ref3","first-page":"i49","article-title":"Epidemiology of male same-sex behaviour and associated sexual health indicators in low- and middle-income countries: 2003\u20132007 estimates","volume":"84","year":"2008","journal-title":"Sex Transm Infect"},{"key":"2025030616033013200_ref4","doi-asserted-by":"crossref","first-page":"e055783","DOI":"10.1136\/bmjopen-2021-055783","article-title":"Disparities in HIV\/STI burden and care coverage among men and transgender persons who have sex with men in Nairobi, Kenya: a cross-sectional study","volume":"11","year":"2021","journal-title":"BMJ Open"},{"issue":"1","key":"2025030616033013200_ref5","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s12981-023-00502-6","article-title":"HIV prevalence and associated risk factors among young tertiary student men who have sex with men (MSM) in Nairobi, Kenya: a respondent-driven sampling survey","volume":"20","year":"2023","journal-title":"AIDS Res Ther"},{"key":"2025030616033013200_ref6","unstructured":"U.S. President\u2019s Emergency Plan for AIDS Relief. Kenya country operational plan 2022: strategic direction summary. Washington (DC): Department of State (US); July2022. Available from:https:\/\/www.state.gov\/wp-content\/uploads\/2022\/09\/Kenya-COP22-SDS-.pdf."},{"issue":"3","key":"2025030616033013200_ref7","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.3390\/ijerph18031311","article-title":"Mental health challenges and needs among sexual and gender minority people in Western Kenya","volume":"18","year":"2021","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"2025030616033013200_ref8","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1186\/s12889-021-10314-w","article-title":"Experience of and factors associated with violence against sexual and gender minorities in nine African countries: a cross-sectional study","volume":"21","year":"2021","journal-title":"BMC Public Health"},{"issue":"4\u20135","key":"2025030616033013200_ref9","first-page":"630","article-title":"Kenyan religious leaders\u2019 views on same-sex sexuality and gender nonconformity: religious freedom versus constitutional 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Understanding fast-track: accelerating action to end the AIDS epidemic by 2030. Geneva (Switzerland): UNAIDS; 2015. Available from:https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/201506_JC2743_Understanding_FastTrack_en.pdf."},{"issue":"8","key":"2025030616033013200_ref24","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1080\/17441692.2018.1462841","article-title":"Queering the evidence: remaking homosexuality and HIV risk to \u2018end AIDS\u2019 in Kenya","volume":"13","year":"2018","journal-title":"Glob Public Health"},{"issue":"5","key":"2025030616033013200_ref25","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1007\/s10461-012-0182-5","article-title":"Supporting study product use and accuracy in self-report in the iPrEx study: Next Step Counseling and neutral assessment","volume":"16","year":"2012","journal-title":"AIDS Behav"},{"issue":"7","key":"2025030616033013200_ref26","doi-asserted-by":"crossref","first-page":"1812","DOI":"10.1007\/s10461-018-2291-2","article-title":"Integrated Next Step Counseling (iNSC) for sexual health and PrEP use among young men 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(sIMB-CIM): an IMB model based approach to understanding and intervening in engagement in care for chronic medical conditions","volume":"16","year":"2011","journal-title":"J Health Psychol"},{"issue":"1","key":"2025030616033013200_ref33","doi-asserted-by":"crossref","first-page":"38","DOI":"10.2307\/2137286","article-title":"Minority stress and mental health in gay men","volume":"36","year":"1995","journal-title":"J Health Soc Behav"},{"issue":"3","key":"2025030616033013200_ref34","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1177\/1524839909357316","article-title":"Youth empowerment solutions for peaceful communities: combining theory and practice in a community-level violence prevention curriculum","volume":"12","year":"2011","journal-title":"Health Promot Pract"},{"issue":"1\u20132","key":"2025030616033013200_ref35","first-page":"31","article-title":"Community-based organizational capacity building as a strategy to reduce racial health disparities","volume":"31","year":"2010","journal-title":"J Prim Prev"},{"issue":"5","key":"2025030616033013200_ref36","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1007\/BF02506983","article-title":"Psychological empowerment: issues and illustrations","volume":"23","year":"1995","journal-title":"Am J Community Psychol"},{"key":"2025030616033013200_ref37","article-title":"Integrated Next Step Counseling (iNSC): a discussion based sexual health promotion conversation to support men who have sex with men using PrEP in the iPrEx open label extension (80467)"},{"key":"2025030616033013200_ref38","volume-title":"Motivational interviewing: helping people change","year":"2013","edition":"3rd ed"},{"issue":"2","key":"2025030616033013200_ref39","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","year":"2006","journal-title":"Qual Res Psych"},{"key":"2025030616033013200_ref40","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1177\/1098214014536601","article-title":"Expediting the analysis of qualitative data in evaluation: a procedure for the rapid identification of themes from audio recordings (RITA)","volume":"36","year":"2015","journal-title":"Am J Eval"},{"key":"2025030616033013200_ref41","volume-title":"Naturalistic inquiry","year":"1985"},{"issue":"4","key":"2025030616033013200_ref42","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1037\/0278-6133.25.4.462","article-title":"An information-motivation-behavioral skills model of adherence to antiretroviral therapy","volume":"25","year":"2006","journal-title":"Health Psychol"},{"key":"2025030616033013200_ref43","unstructured":"Ministry of Health, National AIDS & STI Control Program. Kenya HIV Prevention and Treatment Guidelines, 2022 Edition. Nairobi (Kenya): NASCOP; Aug2022 [cited 2024 Aug 21]. Available from: https:\/\/www.differentiatedservicedelivery.org\/wp-content\/uploads\/Kenya-ARV-Guidelines-2022-Final-1.pdf."},{"key":"2025030616033013200_ref44","doi-asserted-by":"crossref","first-page":"18741","DOI":"10.7448\/IAS.16.4.18741","article-title":"Experiences of Kenyan healthcare workers providing services to men who have sex with men: qualitative findings from a sensitivity training programme","volume":"16","year":"2013","journal-title":"J Int AIDS Soc"},{"key":"2025030616033013200_ref45","first-page":"E234","article-title":"Improving HIV prevention and care for African GBMSM","volume":"6","year":"2017","journal-title":"Lancet HIV"},{"issue":"4","key":"2025030616033013200_ref46","doi-asserted-by":"crossref","first-page":"2825","DOI":"10.3390\/ijerph20042825","article-title":"\u201cYou\u2019ll be chased away\u201d: sources, experiences, and effects of violence and stigma among gay and bisexual men in Kenya","volume":"20","year":"2023","journal-title":"Int J Environ Res Public Health"},{"issue":"5","key":"2025030616033013200_ref47","doi-asserted-by":"crossref","first-page":"1517","DOI":"10.1007\/s10461-017-1941-0","article-title":"Depressive symptoms, alcohol and drug use, and physical and sexual abuse among men who have sex with men in Kisumu, Kenya: the Anza Mapema study","volume":"22","year":"2018","journal-title":"AIDS Behav"},{"issue":"Suppl 3","key":"2025030616033013200_ref48","first-page":"S261","article-title":"Resilience among gay\/bisexual young men in Western Kenya: psychosocial and sexual health outcomes","volume":"29","year":"2015","journal-title":"AIDS"}],"container-title":["Adv Glob Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/online.ucpress.edu\/agh\/article-pdf\/doi\/10.1525\/agh.2025.2442813\/862942\/agh.2025.2442813.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/online.ucpress.edu\/agh\/article-pdf\/doi\/10.1525\/agh.2025.2442813\/862942\/agh.2025.2442813.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T16:04:00Z","timestamp":1741277040000},"score":1,"resource":{"primary":{"URL":"https:\/\/online.ucpress.edu\/agh\/article\/4\/1\/2442813\/207802\/Participatory-development-and-initial-pilot-run-of"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":48,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,3,6]]}},"URL":"https:\/\/doi.org\/10.1525\/agh.2025.2442813","relation":{},"ISSN":["2689-9558"],"issn-type":[{"value":"2689-9558","type":"print"}],"subject":[],"published-other":{"date-parts":[[2025]]},"published":{"date-parts":[[2025]]},"article-number":"2442813"}}