Climate change is threatening the sexual health of young adolescents in Kenya

Climate change is worsening sexual and reproductive health risks for young adolescents in Kenya, according to a recent study published in BMJ Global Health. Children aged 10 to 14 are facing rising threats as food, water, and sanitation insecurities contribute to sexual violence, transactional sex, and exploitative relationships − factors closely linked to unplanned pregnancies and sexually transmitted infections.

“The adolescent has sex with the boy just to get one kangumu (half-cake) so that she can add to what the mother gave her. The boy will leave the girl and go to another and another. And in that state, they end up contracting the disease that causes cervical cancer… HPV… And all that is caused by the drought.” − Female elder, Naivasha

The study’s authors urge that climate change responses in Kenya − and across sub-Saharan Africa − must prioritise adolescent health, particularly sexual and reproductive health services. Programmes that focus solely on food aid or economic recovery risk overlooking the deeper vulnerabilities facing youth, especially girls. The findings call for urgent, climate-informed, gender-sensitive strategies to address overlapping resource insecurities and protect Kenya’s young adolescents.

The study

In Kenya, young people aged 15–24 represented 41% of all new HIV infections in 2022, with adolescent girls and young women making up 78% of these cases. Yet younger adolescents, those aged 10 to 14, remain largely overlooked in sexual and reproductive health research, despite being in a critical developmental phase that shapes long-term health outcomes.

Kenya is grappling with increasingly frequent and severe climate-related events − including flooding, drought, and erratic rainfall. Extreme rainfall and flooding reduce agricultural yields and exacerbate food insecurity. Nearly one-third of the country’s population rely on water that is not protected from contamination and almost half lack access to basic sanitation services.

The researchers believe that understanding the sexual and reproductive health experiences of young adolescents (10-14 years) in the context of climate change and extreme weather events is essential to designing effective, climate-informed health interventions. To address this gap, they conducted a multi-method qualitative study in six climate-affected regions of Kenya, each with its own environmental and social challenges: Mathare, an urban informal settlement in Nairobi; Naivasha, a flower-farming region; Kisumu, a fishing community on Lake Victoria; Isiolo, home to nomadic and pastoralist communities; Kilifi, with smallholder coastal farms; and Kalobeyei, a refugee settlement in Turkana County.

The study involved nearly 300 participants: 119 elders participated in focus groups; 60 adolescents took part in walk-along interviews, where they led researchers through their communities while discussing their daily challenges; and 118 adolescents joined participatory mapping workshops to visually document how climate change and resource scarcity affect them. The majority of the participants (51%) were boys. While elders contributed ecological and intergenerational knowledge, the adolescents offered personal, lived perspectives on how climate-related challenges impact their access to basic needs and sexual health.

Climate change and extreme weather events were found to have multiple effects on young adolescents’ access to food, water, and sanitation − consequences that ultimately shape their sexual and reproductive health outcomes.

Drought and heavy rains − two of the most frequently mentioned events − were linked with both food and water insecurity. Drought limited access to clean drinking water and water for crops. Heavy rains contributed to food insecurity by destroying crops, contaminating water sources, and forcing shop closures. Meanwhile, extreme heat made it harder for adolescents to walk long distances to markets and increased food prices.

Food insecurity

Food insecurity was described as a key factor driving a chain of vulnerabilities among young adolescents. Participants − both elders and adolescents − reported that food shortages led some youth to run away from home, engage in transactional sex, or enter exploitative relationships. These experiences were often linked to unplanned pregnancy and sexually transmitted infections. Several participants described how poverty and food insecurity made girls vulnerable to older men who offered them small amounts of money or food in exchange for sex.

“There are some girls who cannot fend for themselves and have possibly slept hungry, so it seems it is their only option. They end up sleeping with men so they can get some money in order for them to eat.” − Girl, aged 14, Mathare

“The girls will skip school and go to a man’s house − a man old enough to be their father or grandfather. And why is this the case? This girl probably lives in poverty. Just 20 shillings [about $0.15] to buy chips − and that’s enough to keep her going. Before we know it, this girl at the age of 14 or 16 will get pregnant. Poverty is really a great issue.” − Female elder, Mathare

In some cases, girls as young as eight or ten were reported to become pregnant, often after being deceived by men with small gifts such as mandazi (fried bread) or sweets. Food insecurity was also linked with early or child marriage.

“Some girls choose to get married so as to deal with such situations as food shortage and hunger.” − Girl, aged 11, Isiolo

Water insecurity

Participants described how lack of access to clean water interfered with school attendance, hygiene, and dignity.

“The girl, as she gets older, it’s important for her to keep clean. When there’s a lack of water, she is unmotivated to go to school. She will feel dirty, have low self-esteem, and prefer not to interact with others.” − Female elder, Mathare

Water scarcity was also linked to increased reports of sexual violence. Girls fetching water − especially in the evening − faced risks of harassment or rape. One boy recounted an incident in Kalobeyei where girls were attacked while collecting water.

“There are some girls who were going to Village 2 to fetch water. Some men captured them and raped them. It’s not a rare occurrence.” − Boy, aged 12, Kalobeyei

In several regions, participants reported that girls were forced to engage in transactional sex to access water, particularly during menstruation.

“They can’t shower because they don’t have water, and so they sell themselves so they can get water.” − Girl, aged 12, Mathare

Sanitation insecurity

Sanitation insecurity − lack of access to safe, private toilets and hygiene supplies − further compounded these risks. Drought and poverty meant that many families could not afford menstrual products, clean water, or adequate washing facilities. Girls were often unable to manage their periods hygienically, leading to school absences and social withdrawal.

Participants also described how lack of access to menstrual products could lead to sexual exploitation.

“Let me talk to you as a woman, and in fact as a mother. There are times our girls will come to us for pads, and we can’t even afford those. So what do they do? They run to those who can give it to them − because of the state of poverty we face.” − Female elder, Isiolo

“You will find that there are girls who have given birth when they are twelve or thirteen years old. They get pregnant to get soap; they go to have sex with men.” − Male elder, Kalobeyei

Conclusions

Based on these findings, the researchers developed a conceptual model showing how climate change, extreme weather, and resource insecurities intersect to increase sexual and reproductive health risks for young adolescents.

Climate change exacerbates food, water, and sanitation insecurity − and addressing these challenges requires solutions at multiple levels:

• Structural, such as inclusive food and water policies
• Institutional, including climate-resilient health systems
• Community-based, like equitable water management
• Individual, such as improving self-efficacy.

“Multilevel approaches that address resource insecurities, young adolescent-tailored sexual and reproductive health priorities, community-level sexual and gender-based violence reduction, self-efficacy and agency are needed for young adolescents in Kenya to realise sexual and reproductive health and rights,” the authors conclude.