HIV/AIDS & TB

Working towards reducing new HIV & TB infections and HIV prevalence

PS KENYA’S HIV and TB program uses an evidence-based approach to increase access to affordable, sustainable and high-quality HIV and TB services in the private sector across five strategic areas:

  •  HIV self-testing kits;
  •  Social Behavioural Change Communication (SBCC).;
  •  HIV self-testing kits;
  •  Oral Pre-Exposure Prophylaxis (PrEP); and
  •  Social Behavioural Change Communication (SBCC).

For years, through the support of The Global Fund, TB Reach and PEPFAR, PS Kenya has been driving demand generation for TB services and delivering TB services through its social franchise network, Tunza. PS Kenya is also integrating TB screening and treatment into all the HIV treatment facilities we support in the private sector, with a focus on improving case detection among People Living with HIV (PLHIV) and their contacts.

The HIV and TB program works collaboratively with:

  • The National Government, through the Ministry of Health and its various channels including the National AIDS and STI Control Programme (NASCOP), the National AIDS Control Council (NACC) and the National Tuberculosis Leprosy and Lung Disease Program (NTLD-P) by providing communication and technical support.
  • County Governments and health devolved structures to support HIV and tuberculosis care and treatment and prevention services.
  • Our implementing and service provision partners across the country by creating demand for services, providing technical assistance and support.
  • Our franchise partners (Tunza, Transmission, Care and Treatment, Tuberculosis Treatment and Voluntary Medical Male Circumcision.

TB Reach

In response to the existing gap PS Kenya through support of Stop TB Partnership and National TB Program is implementing TB Reach Wave 8 project which has focus to enhance TB active case finding among private providers through public private mix (PPM) initiative. The aim of PPM initiative is to improve early TB diagnosis irrespective of where the patients first seek care, in the health system, and to establish mechanisms that allow for efficient and high-quality diagnosis and treatment.
The project is using several interventions which include;

  •  Engaging private health providers currently not offering TB services in provision of TB services
  •  Improving access to diagnostic services at point of care by strengthening sputum networking via hub and spoke model- sample referral system
  •  Improving routine reporting from private health providers
  •  Strengthening access to quality assured TB supplies and commodities

The project is being implemented in 7 Sub Counties in Nairobi County;

  •  Dagoretti South,
  •  Dagoretti North
  •  Langata
  •  Kamukunji
  •  Ruaraka
  •  Roysambu
  •  Kasarani

Activities are being carried out in over 300 registered private providers (Health facilities, Chemists, Stand-alone laboratories)

SBCC INTERVENTIONS ON HIV

PS Kenya implemented various social behavior change campaigns to reduce risky sexual practices among at risk and vulnerable populations. Evidence-based behavior change communication techniques promotes correct and consistent use of our products and to reduce high-risk behaviors. Campaigns are delivered through innovative and appropriate channels to reach those most at risk.

CONDOM USE CAMPAIGNS

These campaigns focused on increasing condom use amongst persons engaging in specific higher risk behaviors; for example, concurrent sexual partnerships are tackled through the – ‘Wacha Mpango wa Kando, Epuka Ukimwi ‘(Stop ‘spare wheels’ relations – Avoid HIV) and ‘Weka Condom Mpangoni’ (‘put a condom in that plan’) campaign. Condom negotiations among youth are targeted through the “Kuwa True” and previously “Nakufeel” and Pinh Place and Roll campaigns.

TEST AND START CAMPAIGN

PS Kenya also supportied NASCOP with a campaign to create awareness of the Test and Treat campaign that sought to create awareness of the need for one to get tested and if found positive, to start taking HIV treatment immediately to ensure reduced morbidity and reduced ability to transmit HIV to their partners. Those who are HIV positive and on treatment are also being educated on the need to adhere to their treatment to achieve viral suppression. The campaign was dubbed Anza Sasa.

HIV SELF-TESTING

HIV Self-Testing has the potential to contribute to universal knowledge of HIV status. Its appeal lies in that it offers people who are currently not reached with existing HIV testing services have an opportunity to test themselves discreetly and conveniently. PS Kenya with funding from Children’s Investment Fund Foundation (CIFF) is rolling out HIV self-testing targeting populations that currently have high HIV prevalence in a bid to reduce new HIV infections.

Oral Pre-Exposure Prophylaxis (PrEP)

Oral PrEP is one of the significant strides that Kenya has made in revolutionizing HIV prevention. The fight to reduce new infections cannot be won without addressing prevention among those who are HIV negative. The Ministry of Health introduced PrEP as an additional HIV prevention strategy for people who test HIV negative but are at on-going risk of HIV infection.
As part of a Gates funded project led by Jhpiego, PS Kenya rolled out PrEP in the private sector facilities as well as supporting demand creation efforts to ensure that there was clear awareness on PrEP as part of a combination of other prevention strategies including condom use, VMMC, PEP, Treatment as Prevention and others. The program was implemented in 3 main clusters of Lake Region (Kisumu, Kisii, Migori), Nairobi (including parts of Machakos and Kiambu) and Coast. Under the project that was dubbed Jilinde, PS Kenya was instrumental in supporting with development of national awareness creation campaign and launch of the national program.

HIV TESTING AND COUNSELLING CAMPAIGNS

These campaigns addressed barriers to the uptake of HIV Testing & Counseling, Voluntary medical Male circumcision among others. An innovative edutainment TV drama series dubbed ‘SIRI’ was also launched to support uptake of family planning and preventative behaviors of Kenyans related to HIV. Awareness was done mainly through mass media and community level small group and one on one sessions

ABSTINENCE CAMPAIGNS

The campaign had the following objectives:

  • Increase self-esteem and confidence among youth in regards to delaying sex
  • Continue portraying abstinence as a cool lifestyle choice
  • Reduce social norms and peer pressure regarding having sex
  • Address barriers to abstinence amongst youth

The campaign slogan “Ni poa Kuchill” was very well received and the style of the communication was perceived as highly acceptable based on feedback from the youth. The campaign also created safe language for youth to discuss sex or “chilling” with their parents and peers. According to tracking surveys done by PS/Kenya in 2005, 2007 and 2010, the Nimechill campaign, was widely seen by the urban and peri-urban 10 to 14-year-olds it targeted. Those with higher exposure were more likely to believe in their own ability to abstain and intention to abstain.

The proportion of youth reporting “never having sex” increased from 88 to 95 percent during the seven months of the campaign. Although it is impossible to attribute the increase to the campaign, the study does show that those exposed to the campaign’s messages were more likely to believe in their own ability to abstain than those who were not exposed. The primary conclusion was that the campaign, and its monitoring and evaluation, merit continuation.

HIV CARE AND TREATMENT IN THE PRIVATE SECTOR

PS Kenya’s vision is to support the development of sustainable quality HIV care and treatment in the private sector. PS Kenya worked with a network of 119 private provider ART (antiretroviral treatment) sites, 91 PMTCT (prevention of mother to child transmission) sites and 350 HTC (HIV testing and counselling) sites from both the Gold Star and Tunza networks to address these challenges with a focus on build provider capacity to offer quality HIV services through Continuous Quality Improvement (CQI) mentorship.

As part of the sustainability plan, PS Kenya also continued to support the franchise private providers to address sustainable private sector supply chain for drugs and diagnostics.

VOLUNTARY MEDICAL MALE CIRCUMCISION (VMMC)

Clinical trials conducted in Sub-Saharan Africa have shown that medically performed circumcision is safe and can reduce men’s risk of HIV infection during vaginal sex by about 60%. In Kenya, 2,784 men aged between 18 – 24 years joined a similar trial in Kisumu. Among those circumcised, HIV risk was reduced by about 53%. An ongoing follow-up study found that this protective effect was sustained over 42 months, reducing men’s chances of becoming infected with HIV by 64%. Male circumcision is practiced in many communities in Kenya and often serves as a rite of passage to adulthood. However, we have some communities in parts of Nyanza, Rift Valley and Western provinces that do not traditionally circumcise.

There is a strong relationship between HIV prevalence and male circumcision status with HIV prevalence being four times higher among uncircumcised men than among circumcised men aged 15 – 49 yrs (13% and 3% respectively) (2008/09 KDHS). Through Tunza Network of Clinics, men can receive safe circumcision surgery from our providers. In addition, PS Kenya worked with the Ministry of Health to promote VMMC as a HIV prevention tool in communities that do not practice the circumcision.

PREVENTION OF MOTHER TO CHILD TRANSMISSION

It is estimated that infant and children under 15 years account for 16% of all new HIV infections, mainly due to Mother to Child Transmission (MTCT). Prevention of mother-to-child transmission (PMTCT) has become a priority for the Government of Kenya in an endeavour to reduce HIV-related infant and child mortality. HIV testing and Counseling (HTC) of pregnant women serves as an important entry point to care and treatment for HIV positive mothers and their families.

Antenatal clinics (ANC) provide the greatest opportunity to carry out HTC on expectant mothers. HIV testing among pregnant women is currently at 70.5%. Of the HIV pregnant women, 33% access family planning services, 72.3% have access to ARV while 49% of infants born to HIV positive mothers are on ARV. Some 32% of women exclusively breastfeed their children for six months according to the Kenya Demographic and Health Survey (KDHS, 2008/09).

The main challenges facing successful implementation of PMTCT include:

  • Low coverage of PMTCT interventions amongst pregnant women is partly because of late ANC attendance and low skilled birth attendance of 44% (KDHS 2008/9).
  • Weak community engagement in PMTCT service delivery including high unskilled deliveries.
  • Male partner involvement in PMTCT interventions
  • OUR IMPACT

    In 1993, PS Kenya launched Trust condoms, the first socially marketed condom in Kenya aimed at increasing availability and accessibility targeting high-risk and sexually active groups. Since 1993, PS Kenya’s condom social marketing program, have made available more than 500,000,000 condoms.

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