HIV Prevention, food, housing and citizenship; working with selected key population sites in Kampala and Nairobi - 2013-2017

Study finds that differentiated HIV prevention if specific and targeted, maximizes intervention synergies which influences healthy outcomes.

A combination of specific interventions or activities including drag, educational, counselling and treatment events targeting LGBTIQQ increases key-population critical engagement in self-care. It went on to point out that further analysis of wider sexual and reproductive is needed to inform consolidation of services.

Countries in Southern and Eastern Africa have the highest prevalence of human immunodeficiency virus (HIV) infection in the world. Against the backdrop of being in the highest HIV prevalence region, a larger population of younger persons 15-25 years and where universal coverage is still low, we mapped out, identified and worked with health facilities where SRHR/HIV prevention were provided without user fees. These facilities had HIV testing and treatment. Primary prevention response composed of biomedical, behavioral and structural facets closely linked to treatment.

The study followed an N=293 sexually active beneficiaries. All trained as peer-educators and had negotiated safer sex skills certification with emphasis on PrEP, condom and lubricant demand and use. They were regularly provided: lubricant, condoms, drop-in cards with dates for follow up counselling and guidance, were regularly tested. 

The following were the skills-set or opportunities for employment: trained Boda-boda taxi operators, trained quick foods chefs and skilled hairdressers. A big number were self-confessed sex-workers and were trained in designated safer sex promoters. Those who were bisexual were aged 18-42 years. Some self identified as LGTIQ: intersex; Transgender; Gay; lesbian; non-conforming.  

Intervention synergies for those who were living with HIV and were aged 17-35+, included knowing exogenous social influences.  Between 2013-2014, all were enrolled at ART providing clinics. 27 candidates who successfully circumcised (VMMC) and 3 had HPV immunization. Between 2014-2017, some became refugees in Kenya. Some of the refugees were living with HIV and due to an unstable living condition developed drug adverse effects which led to some being enrolled on second line drugs. All of them were provided cash for attending clinics, purchase food and payments toward rent regularly.