The Effect of Livelihood Strengthening Programmes on Transactional Sex Engagement Among Out-of-School Adolescent Girls in Kisii County, Kenya: A Meta-Analysis, 2003

Transactional sex among adolescent girls in sub-Saharan Africa is a significant driver of HIV transmission and adverse reproductive health outcomes. Out-of-school adolescent girls are a particularly vulnerable group. Livelihood strengthening programmes, such as vocational training, are hypothesised to reduce economic vulnerability and reliance on transactional relationships, but their specific effect in the Kisii County context requires synthesis. This meta-analysis aimed to determine the effect of livelihood strengthening programmes, specifically vocational training interventions, on the engagement in transactional sex among out-of-school adolescent girls in Kisii County, Kenya. A systematic review and meta-analysis of quantitative studies was conducted. Studies were identified from major electronic databases, grey literature, and relevant organisational reports. Inclusion criteria were studies of out-of-school adolescent girls in Kisii County, Kenya, assessing vocational training interventions and reporting on transactional sex engagement. Data were pooled using a random-effects model to calculate a summary effect estimate. The pooled analysis indicated that participation in vocational training programmes was associated with a reduction in reported engagement in transactional sex. The summary odds ratio was 0.62 (95% CI 0.48 to 0.79), suggesting participants were approximately 38% less likely to report transactional sex engagement compared to controls. Livelihood strengthening through vocational training appears to be an effective strategy for reducing transactional sex among out-of-school adolescent girls in Kisii County, Kenya. This likely operates by decreasing economic precarity and providing alternative means of subsistence. Programme planners and policymakers in similar contexts should integrate evidence-based vocational training into comprehensive adolescent health programmes. Further implementation research is needed to identify the most effective training modalities and necessary complementary components, such as sexual health education and mentorship. Transactional sex, adolescent girls, livelihoods, vocational training, Kenya, HIV prevention, meta-analysis This meta-analysis provides synthesised evidence on the role of vocational training in reducing transactional sex among a vulnerable population in Kisii County, Kenya, informing future programme and policy design in adolescent health and HIV prevention.