This archive report was first published on 19 July 2019.
Kenya: HIV in Kenya - High Risk Groups Need Targeted Attention ¶
On July 11, 2017, Kisumu County Health Minister Dr Elizabeth Ogaja launched Pre-Exposure Prophylaxis pills (Prep) at Acacia Hotel, aiming to reduce new HIV infections by at least 30 per cent.
However, efforts to manage the HIV epidemic in sub-Saharan Africa need to specifically target sections of the population that are most vulnerable to HIV infection, such as men who have sex with men and transgender women. In Kenya, same-sex relationships and transgender identities are criminalised, making it difficult for at-risk populations to seek preventive services in public health care facilities.
Our research, conducted between 2016 and 2017 in Malindi, Kenya, found that the risk for HIV acquisition in this cohort over a one-year period was 5%. However, in transgender women, this risk was extremely high at 20%. HIV acquisition was associated with factors including exclusive receptive anal intercourse and history of a sexually transmitted infection.
A majority (98.8%) of the participants were interested in initiating PrEP. Transgender women expressed concern that actual PrEP provision may cause them to engage in condomless anal or group sex more frequently.
Our findings confirm that transgender women would benefit most from PrEP. However, legal barriers and stigma mean that they are invisible and under-served in Kenya. We believe that our findings could be used to inform policy makers on the need to revise national guidelines to better target the intended recipients of the PrEP programme in Kenya.
