Zulaika G, Nyothach E, van Eijk AM, et al. - In Kenya, researchers identified frequent harassment for sex among adolescent girls attending school and a high risk of pregnancy and HSV-2 infection among them; girls experiencing early menarche appeared particularly at risk.

• As part of the baseline assessment of the Cups or Cash for Girls (CCG) cluster randomized controlled trial in Siaya County, rural western Kenya, data were retrieved from 3,998 girls (median age 17.1 years) attending 96 public secondary day schools in 2017 and 2018.

• Of these girls, 17.2% were HSV-2 seropositive (n = 686), 1.7% tested positive for HIV (n = 66); and 27.3% girls (n = 1,090) reported sexual activity, of whom 12.2% had been pregnant (n = 133).

• Girls’ sexual and reproductive harms, such as pregnancy, HSV-2, and/or HIV acquisition, appeared to be significantly linked with biological factors including girls experiencing early menarche, having lighter periods, and body mass index; household level factors including being unhappy at home, being orphaned, and coming from poorer households; and social factors including experiencing harassment for sex both in and out of school or being touched indecently.

• To address girls’ vulnerability to sexual and reproductive health harms, targeted interventions, such as earlier sexual education programs, should be undertaken.