Background

Key populations (female sex workers, men having sex with men and people who inject drugs) in Kenya have disproportionately higher prevalence of HIV (29.3% among female sex workers, 18.2% among men having Sex with men and 18.3% among PWID).  The National AIDS and STD Control Program (NASCOP) recommends a balanced approach of Biomedical, behavioral and structural interventions for HIV prevention and promoting SRH among KP in Kenya. Out of the estimated 133,000 FSW and 18,000 MSM in Kenya, there are about 10,000 FSW and 3,000 MSM in Mombasa County, 4,000 FSW in Kilifi County and 1200 FSW in Kwale.

ICRHK interventions

From January to September 2019, ICRHK implemented the Linkages across the Continuum for HIV care for Key Populations affected by HIV (LINKAGES) project in Mombasa, Kilifi, Kwale and Taita Taveta Counties. LINKAGES was a USAID–funded project in 19 different counties. ICRHK led implementation in the four coastal counties.

The project began in April 2016 and concluded in September 2019. It aimed to provide comprehensive HIV/AIDS prevention, care and treatment, and other sexual and reproductive health services to FSW and MSM through a peer-led demand creation approach with clinical services offered at specialized sex worker clinics (drop-in service centers) and through outreach.

ICRHK strategies and activities in 2019

• 8 specialized sex worker and MSM clinics in four counties – Mombasa, Kilifi, Kwale and Taita Taveta.
• 414 integrated clinical outreaches conducted, offered comprehensive HIV testing, FP, cervical cancer screening, STI screening and treatment and general medical care to FSW, MSM and transgender in Mombasa, Kwale and Taita Taveta Counties
• SGBV response system set-up to prevent and respond to sexual and gender-based violence to FSW and MSM.
• Supported the three Counties to implement Structural interventions including technical working groups for coordinated services to FSW and MSM
• 220 peer were educators engaged and trained in health education and community engagement
• Strategies to improve HIV case identification and linkage to care included – Assisted partner notification services (aPNS), Risk network referrals (RNR) and targeted outreaches at hotspots with high proportions of HIV positive FSW and MSM
• PrEP, ART, FP commodities, and STI drugs were sourced from the County Health Department and provided to KP free of charge.

Key achievements

1. 11,244 female sex workers in Mombasa, Kwale and Taita Taveta Counties and 2907 in Kilifi County reached with HIV prevention interventions at hotspots through peer educators. This represents about 90% of the total FSW population in the four counties. 66% of the sex workers reached were tested for HIV and received their results.
2. 3,288 men having sex with men received health education, information materials condoms and lubricants, in Mombasa and Kwale Counties. 83% of the MSM received HIV testing services
3. 750 FSW and 138 MSM initiated and continued oral PrEP in 2019. In total, more than 3,000 FSW and 800 MSM initiated PrEP at ICRHK-supported sites between February 2017 and December 2019.
4. 793 female sex workers were offered family planning for the first time in 2019. 708 female sex workers were screened for cervical cancer and those with suspicious lesions referred for further management.
5. Supported the county-level technical working groups for key populations in Mombasa, Kilifi and Kwale Counties. TWGs make decisions on key elements of KP programming.
6. The linkage to ART for HIV positive FSW was 92% (169/183), that among MSM was 100% (23/23) and among transgender (TG) was 95% (19/20).Apart from strengthening pre-and post-test counseling by building the capacity of the engaged service providers, ICRH also relied on peer navigators to provide peer psychosocial support to newly identified positives to encourage them to start ART as well as facilitate follow up for those not immediately linked. Consenting newly diagnosed positives were escorted by peer navigators to link facilities for same day ART initiation and attached the KP desk (mostly virtual) in the linking facility. ICRH engaged 11 peer navigators.

Conferences

In 2019, three abstracts were accepted for presentation at the 13th International Conference on HIV Treatment, Pathogenesis, and Prevention Research in Accra, Ghana, the 20^th International Conference on AIDS and STIs in Africa in Kigali, Rwanda and at the Mombasa Annual HIV collaborative meeting. Manuscript writing for publication is currently ongoing. 

ICRHK at the Key Population Technical Working Group in Voi Town in September 2019. TWGs coordinate KP programs within the counties drawing participation from various partners, KP communities and the County Governments

LINKAGES Project 2019       info@icrhk.org     +254 20 2179519 / 179521