Document is current

Article History

Received: 25 November 2019

Accepted: 7 May 2020

First Online: 29 May 2020

Ethics approval and consent to participate

: Ethical approval was obtained from the Human Research Ethics Board at the University of Manitoba in Canada (HS16557 [H2013:295]), the Kenyatta National Hospital/University of Nairobi Ethics and Research Committee (P497/10/2013), and the Research Permit Committee of the National Commission for Science, Technology and Innovation, in Kenya. Participants provided written, informed consent prior to participation in study. The rationale for including participants from age 14 years onwards was the early age at which female sex workers reported selling sex for the first time [] and thus the importance of measuring vulnerabilities and risks experienced during the early period of sex work. The <i>Transitions</i> study was approved by the above ethics review committees to obtain written, informed consent for participation directly from individuals age 14 years and above without the consent of participant’s guardians because participants were considered mature minors. The rationale for defining the study population as mature minors included the following: to ensure confidentiality and access to HIV testing and counselling services, the consent procedure for <i>Transitions</i> was in accordance with the Kenya National HIV testing policies which supports HIV testing and counselling to “all or most adolescents under several conditions including showing maturity, of reproductive age, married, pregnant, or engaged in high-risk behavior” []. Furthermore, the <i>Transitions</i> study uniquely sampled sexually active individuals who frequented sex work venues (hotspots) and did not sample households; eligible participants may live independently or on the streets and often do not have a legal guardian. Where a legal guardian is present, the guardians may be unaware of participants sexual behaviour and requiring guardian consent may potentially place participants at greater risk of further isolation or harm. As per the <i>Transitions</i> study protocol, participants (and those who declined to participate) were referred to local programmes and clinics, including programmes that tailored services for adolescent girls and young women and those that provided services for female sex workers.

: Not applicable.

: SM is an associate editor for BMC Infectious Diseases. The rest of the authors declare no conflicts of interest.