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UNIVERSITY OF NAIROBI

CUTTING THE CHAIN OF HIV TRANSMISSION THROUGH KEY POPULATION INTERVENTIONS TOWARDS A KENYA FREE OF AIDS By Prof. E Ngugi, Director, UoN-CHIVPR and PI, MARPs Project.

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UNIVERSITY OF NAIROBI

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  1. CUTTING THE CHAIN OF HIV TRANSMISSION THROUGH KEY POPULATION INTERVENTIONS TOWARDS A KENYA FREE OF AIDSBy Prof. E Ngugi,Director, UoN-CHIVPR and PI, MARPs Project Author: Ngugi E1 . Co Authors: Muture B2 , Kageni L1 , Nderitu M1, Pere M1, Muigai J1, Kiraithe P1, Judith A1. Key: 1. University of Nairobi CHIVPR 2. Ministry Of Health UNIVERSITY OF NAIROBI MINISTRY OF HEALTH

  2. Introduction • HIV and AIDS continue to be a public health problem in Kenya. • In the 2012 Kenya AIDS Indicator Survey (KAIS), HIV prevalence among adults aged 15-64 years was 5.6%. • The Kenya Analysis of HIV Prevention Response and Modes of HIV Transmission Study of 2009 reported that about 30% of new HIV transmissions were attributed to Key Populations (KPs), namely sex workers and their clients (14.1%), men who have sex with men (15.2%), and people who inject drugs (3.8%).

  3. UoN -CHIVPRis implementing a programme on Access to Quality Preventive Comprehensive Services for Key Populations in Eastern and Central Provinces of Kenya since the year 2010. • The services offered to the KP including; • Male & Female condom and lubes education and distribution, Health communication • HTC and Linking to care, HIV care and treatment, Clinical and community PwP, Post Exposure prophylaxis • STI screening and treatment, Cancer of cervix screening and referral, TB screening and referral, Screening for alcohol and drug abuse • Family planning including Emergency contraceptive • Gender based violence • Health Choices II • Referral services.

  4. Purpose To demonstrate the importance of comprehensive and focused interventions for key populations in mitigating HIV and AIDs impact in Central and Eastern Provinces.

  5. Method • A retrospective study was carried out. • Various data collected by use of standard tools, starting from biodata, screening, enrollment up to follow up was reviewed. • This is from only one DICE (Thika) out of 10 DICEs. The DICE has 727 males and 4253 females. • Purposeful selection of those who availed themselves for all planned visits but also returned for non – planned visits as dictated by their needs was done. • Complete clients’ files were demonstrated in the records. That is those who availed themselves for all the planned return dates for various services including HIV testing and counseling and also came to get services in between scheduled visits needs specific.

  6. RESULTS • Data for 54 FSWs was reviewed. Mean age for the FSW was 33.4 years (minimum 18, max 60). • Demographic data shown in figure 1

  7. Figure 1: Age groups of the respondents

  8. Marital status, education Level, and duration in sex work • Half (50%) of the respondents are divorced, and 75.1% have attended school up to primary level. • Mean duration in sex work was 8.5 years (minimum 1, maximum 33 years). • This is shown in table 1 below

  9. Table 1: Marital status, education Level, and duration in sex work

  10. Table 2: Average weekly casual and Regular clients Sex with a known positive client

  11. Figure 2: Condom use % age that demonstrated correctly condom use

  12. Action taken after condom burst before enrolment (%) .

  13. Figure 3: HIV Status of the Study population

  14. Figure 4: Average years in sex work

  15. Table 3: Projection of Clients at Risk annually NB: when there is a condom burst the number at risk rises

  16. Figure 5: % HIV positive on care

  17. Conclusion: • Comprehensive and focused interventions offered to KPs are able to contribute towards zero HIV transmission in Kenya subsequently as they are able to increase proper condom use, avail themselves quarterly for HIV test and counselling, seek prompt treatment for diagnosis and treatment of STI’s adhere to ARVs, as well as come for PEP due to rape or condom burst. • This is preliminary data therefore • Deeper analysis will be done • Study population will be increased • All these health seeking behaviour cut the chain of HIV transmission individually and collectively. Thus underscoring just how crucial it is to work with KPs.

  18. DISCLAIMER • “The findings and conclusion in this abstract are those of the author (s) and do not necessary represent the official position of the funding agencies/U.S Centers for Disease Control and Prevention/Government of Kenya”.

  19. Appreciation • All the participants, stakeholders, UoN CHIVPR. • Ministry of Health and County Governments • Also CDC who supported and continue to support the programme

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