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Fighting HIV prevalence among vulnerable populations

Peter Ngila @peterngilanjeri

Key populations (sex workers, people who inject drugs and men who have sex with men (MSMs)) are more prone to contracting HIV.

The Kenyan key populations and the civil society have joined hands towards reduction of HIV and TB, as a pathway to achievement of the Universal Health Coverage.

To that end, a four-pillar communique was recently launched by 35 organisations including Kenya Sex Workers Alliance, the Kenya Aids NGOs Consortium (Kanco), Sauti Skika, Transgender Alliance and Network of People Living with HIV/Aids in Kenya. 

Financial constraints

United Nations Programme on HIV/Aids considers gay men and MSMs, sex workers, transgender people, people who inject drugs and prisoners as the five main key population groups that are vulnerable to HIV and frequently lack access to relevant services.

Grace Kamau, 32, has been a sex worker living with HIV for the last 20 years. When her parents faced financially constraints, going to school became a struggle. She was forced to start vending ice cream around Kiambu when she met men who took advantage of her.

That was the beginning of Grace’s career as a sex worker. She was lucky enough to be educated by a well-wisher from secondary school to Catholic University of Eastern Africa – where she took Sociology and Political Science.

“After some time, I started falling sick, and when I visited a health facility, I realised I was HIV-positive,” says Grace.

Grace, who currently works as the national co-ordinator of the Key Population Consortium of Kenya, talks to her fellow sex workers on the risks involved about HIV. She says that, at the consortium, they work with key populations to demystify the stigma involved. 

“I think my sex work escalated at university. Together with the former college friends we visit students in schools to discourage them from engaging in sex work.So far, we have 150 members,” she says.

Grace had never disclosed her HIV status to a client.

“I cannot disclose because of the violation that might come as a result. Also, if the client is HIV-positive, chances of me adding to his viral load are high. Only my close peers know of my HIV status. We educate our fellow sex workers on the importance of taking ARVs, and also consistent condom use,” she says.

Grace’s movement also involves other key populations.

“Because of the nature of our jobs, we are discriminated against by the general society. We took advantage of that discrimination to start a community,” she says.    

“As key populations, we would like the government to decriminalise us. We feel underrated. The current size estimates of key populations is cut by half,” Grace says. She  concludes by saying that sex work pays – especially because she lives in her own house.

Available statistics

A report titled “Everyone Said No”: Key Populations and Biometrics in Kenya in 2018, estimates sex workers in Kenya to be around 130,000 with 13,000 (18.2 per cent) being MSMs and 18,000 (18.3 per cent) being people who inject drugs. The number of transgender people and prisoners is unknown.    

When Marcus (not his real name), 19, a psychology student at a Kenyan university first discovered he was gay, he wondered whether he was the only male with feelings for other men.

“I could not stand girls! Because I was in a lot of denial, I kept quiet about my being gay, until when I went on Google at the age of 13 as a form one boy in high school. I realised there were so many other men who loved men sexually; and I even managed to get into a relationship with a man older than me.”

Marcus, who is HIV-negative, says he takes protection seriously.

Marcus has come to Kanco’s dropping centre in Rongai, because, as an orphan, he currently stays with his aunt nearby. Marcus says it is easier to visit the dropping centre for HIV testing.

He advises parents to have candid conversations with their children on sexuality.  He also encourages fellow MSMs to take their health seriously.

Kanco Kajiado County Regional Co-ordinator Fred Muturi, says that on average they receive 15 to 20 combined representatives of the key populations.

“Our dropping centre is conveniently situated close to Kware slums, where sex work is prevalent,” says Fred.

The dropping centre takes care of the needs of Key populations. The clients do not pay a coin to access services, which include HIV testing, provision of lubricants for MSMs, among others.

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