“Whenever I help her, I am also expecting her vagina in return”: a qualitative analysis to explore men’s and adolescent girls’ perceptions of the impact of the COVID-19 pandemic on the sexual behaviour and health of adolescent girls in rural western

Introduction: The COVID-19 pandemic caused school closures, which intensified the negative sexual and reproductive health (SRH) of adolescent girls in sub-Saharan Africa (SSA), including increases in transactional sexual partnerships, gender-based violence, risk of early pregnancy and sexually transmitted infections (STIs). We conducted a qualitative study to understand how adolescent girls experienced and reacted to the pandemic restrictions and perceived consequences on their schooling and sexual behaviours. In parallel, we sought community men’s perceptions and opinions on the same issues. Methods: Set in rural western Kenya, the study used six focus group discussions with adolescent girls and five with community males aged 19–41 years, conducted from June 2022 to January 2023. Results: Thematic analysis identified three key themes, parallel in girls and men: (1) impacts of COVID-19 on schooling: girls reported uncertainty around ever returning to education, consequently losing motivation to study, which was also observed by men; (2) drivers that increased sexual activity: transactional sex became a greater necessity due to acute poverty, while opportunity escalated through additional leisure time and (3) sexual behaviours and practices: girls increased the number of partners and frequency of sexual encounters, with power-imbalances reported. Men believed they were assisting girls through transactional sex but this was often conditional on receiving sex in return, viewing themselves as victims of girls’ seductive advances, and blaming girls for transmitting STIs. Conclusion: School closure jeopardised girls’ SRH through acute poverty and increased opportunity for sexual exposure. Mitigation methods are needed now to prevent girls bearing the brunt of ensuing societal disruption and acute poverty in future catastrophes. Deeper understanding of men’s attitudes and behaviours towards adolescent girls are needed to improve the foundation for working with them to reduce power imbalance and compulsion in sexual interactions with adolescent girls.