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Pre Exposure Prophylaxis (PrEP) framework and HIV self testing operational guidelines launched in Kenya

According to National AIDS Control Council (NACC), Dr. Nduku Kilonzo, everything in HIV starts and ends with behavior. There is a need to start investing heavily to reach the unreached HIV infected people and link them to care and treatment. There- fore, it is vital to take these innovative products to the people. Making use of these products is the only way they will make the difference they are intended to make.

PrEP and HIV Self-testing were launched in Kenya at a very colorful ceremony at- tended by people from all walks of life from across the globe at a Nairobi Hotel on May 4th 2017. Kenya made history by becoming the first country globally to rollout HIV self-testing (HIVST) and the second in the continent after South Africa to rollout Pre Exposure Prophylaxis (PrEP).

This is no easy feat and Kenya has been lauded for showing leadership in the HIV prevention realm. The excitement was palpable in the room with many present feeling and sharing a sigh of relief after a long journey that has culminated in the addition of two incredible “spanners into the existing HIV toolbox”. These tools will enhance our ability to fight the epidemic to the end.

PrEP is an antiretroviral drug which a HIV negative person at high risk of HIV infection takes daily before an anticipated or possible exposure to prevent HIV infections. If we are to win the fight against HIV, we need to turn off the ‘tap’ that brings in new infections.

We need to reduce the new infections to zero and the only way to do this is by ensuring that the negative people remain negative. The use of PrEP as part of the HIV combination prevention will achieve maximum impact in the reduction of HIV infections. HIV testing is the gateway to knowledge of HIV status, and PrEP initiation and other novel approaches such as the use of HIV self-testing provide additional strategy for identification and establishment of ongoing eligibility for PrEP particularly for individuals at high risk of HIV infection, including couples in a HIV discordant relationship.

Dr. Nelly Mugo of KEMRI said that she dreamt of a future where the youth did not have to worry about HIV; a future where they can enjoy their sexual and reproductive lives without having to worry about a thing. People want pleasure and intimacy and want to feel safe while at it.

HIV self-testing is a testing strategy that allows people to use oral fluid or finger prick blood to discover their status in a private and convenient setting. Results are ready within 20 minutes. HIVST provides a safe space for people to test themselves. In the Kenyan population, there are about 500,000 people that are living with the HIV virus but are unaware of their status and hence not on treatment.

It is pertinent that we make use of these two brilliant innovations to realize our goals. The Director of Medical Services Kenya, Dr. Jackson Kioko reiterated that the two products aim to help Kenyans reduce the annual new infections. The rubber meets the road at the county level where the actual rollout and implementation will happen. The County Government representatives who were present at the launch pledged to work with the national government and communities to make these strategies a success.

Several other speakers extolled the initiative with many giving their commitment to work and support Kenya to achieve the set goals. ‘’This is a remarkable achievement as HIVST and other testing strategies are the gateways to treatment and care,” Dr. Rudolf Richard, WHO Kenya. In a similar manner, Rene Berger, USAID, highlighted that Kenya now had the data and evidence needed to move this project forward. Resources are available from the United States government starting today. “Both PrEP and HIVST are critical innovations. There is money for their rollout and we are excited to support Kenya in rolling out these strategies,” Ade Fakoya, Global Fund. A journey of a thousand miles starts with a single step; and Kenya has already taken the first step. Keep walking!!!!

By Lynda Keeru

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