By Dennis Koech
According to the Kenya HIV Estimates Report of 2018, the total number of people living with HIV in Kenya in 2017 is estimated at approximately 1.5 million. UNAIDS data indicates Kenya is one of the largest epidemics in the world, alongside South Africa (7.7 million), Mozambique (2.2 million), Tanzania (1.6 million) and Uganda (1.4 million). Kenya has been fighting hard to stem the tide of new infections.
The Kenya HIV Estimates Report of 2018 further shows that new HIV infections among all ages declined from 77,200 in 2010 to 52,800 in 2017. The country has continued to see a sharp decline in HIV incidence among adults aged 15-49 from 0.35% in 2010 to 0.19% in 2017, and 13,500 in 2010 to 8,000 among children in the same period. 28,200 people died of AIDS related causes in 2017 compared to 53,900 in 2010. These results are attributed to scale up of various prevention and treatment programs.
However, the outlook for those living in urban slums is quite different. A study by Madise Nyovani J, et al (2012) on Kenyan slum dwellers’ risk of HIV infection found that HIV was 12% among slum residents compared with 5% and 6% among non-slum urban and rural residents, respectively.
Cultural beliefs, misinformation, and unsatisfactory education still hinders HIV prevention in slums and those already infected face poor living conditions and lack of access to quality healthcare. Extreme poverty leads many young women to engage in transactional sex. And higher than average rates of sexual violence such as rape further increase vulnerability to the disease. According a study in Nairobi’s Kibera slum, over 36% of slum dweller women reported being physically forced to have sex, compared to 14% of all Kenyan women.
SHOFCO is tackling these challenges head-on. In 2012, our health program initiated women’s mentorship and support groups to assist HIV positive mothers and pregnant women with psycho-social support to help them cope with their situation.
A typical mentor mother support group brings together an average of 50 young mothers and pregnant women who meet monthly for two years, before graduating to a bigger mix-gendered group. These close-knit groups provide a safe and trusting forum for the participants. A woman in the support group says she shifted to SHOFCO’s clinic because she wanted more than the drugs. “I found out that there is a support group at SHOFCO clinic which brings together women to share personal issues. We did not have such a thing where I used to get the services before.”
The women are able to discuss various issues affecting them such as stigmatization and how to discuss their status with their husband or partner.
“Some people seek HIV treatment and care services from far clinics where they are not known, because they fear being talked about or victimized by those who see them seeking the services,” a woman in the support group said.
When a woman joins a support group, she also learns effective ways of handling antiretroviral drugs, both for herself and for her partner. Many women are afraid to disclose their status to their partners or to request that he also begins antiretroviral therapy. Support from other women in the groups make these conversations easier and in many instances lead to men beginning antiretroviral therapy as well.
Most of the women in SHOFCO’s support group learn of their HIV status as part of routine screening at our Maternal and Child Healthcare clinic. All mothers visiting the clinic are enrolled to receive full access to prenatal, postpartum, and infant care. SHOFCO’s clinics in Kibera and Mathare slums are providing continuous prenatal services to approximately 1,000 women, increasing the chances that pregnant women are tested and treated before passing the virus to their babies.
HIV positive mothers and pregnant women are not only enrolled into the mentor support groups but also into the HIV Comprehensive Care program where they access free antiretroviral therapy, prevention of mother to child transmission services, and mentor mother support groups. All pregnant women are tested for HIV, and HIV- affected children receive post-exposure prophylaxis.
The program has yielded good results – mother to child HIV transmission in SHOFCO clinics is 2%. This is attributed to the support groups and a host of SHOFCO social workers who trace HIV positive mothers and pregnant women who abscond support groups and or HIV comprehensive care services.
The women also are also linked with SHOFCO Sustainability Program and external partners where they are trained on business skills, seamstressing, beadwork and catering, and later offered jobs.This provides sustainable income to the women to cater for their family needs. Women in the support groups also raise money to assist each other through table banking.