Ethics approval and consent to participate
The University of Washington's Human Subjects Division approved this research, and all participants consented to participation. We obtained written informed consent for all participants in the qualitative portion of the studies, and written informed consent was obtained from the primary caregivers of the minors involved in the study. Additional assent was given by participants aged 13-14 years. Ethical approval for this study has been obtained from the Jaramogi Oginga Odinga Teaching and Referral Hospital and African Medical and Research Foundation (ID: AMREF-ESRC P545/2018, Approval Date: 2 November 2018) Institutional Review Boards (IRB) in Kenya, as well as the University of Washington (ID: STUDY00004861; Approval Date: 1 June 2018) and the University of Colorado Denver (ID: APP001-2; Approval Date: 3 October 2018) IRBs in the United States. All study procedures were performed in accordance with the Declaration of Helsinki.