Populations We Serve

Half of all new HIV infections in Kenya occur among adolescents and young people. Adolescent girls and young women (AGYW) account for one in every three new infections. HIV among AGYW is driven by gender based violence, poverty, low education among others.

To address HIV among adolescents and young people we provide:

1. Information on HIV, sexual and reproductive health and gender based violence (GBV) through one2one online integrated digital platform and using peer mentors in schools and community settings.
2. Comprehensive HIV services; HIV testing and counselling, evidence based prevention interventions and HIV care and treatment. We aim to make this youth friendly by involving youth in design and implementation.
3. We provide SRH services; family planning, cervical cancer screening, STI screening and treatment, pregnancy screening and referral for Ante Natal Clinics (ANC) alongside our services
4. Through the PEPFAR DREAMS programme we address structural interventions for adolescent girls and young women (AGYW), economic empowerment, cash transfers and education subsidies to minimize their vulnerability

We reached over 40000 youth, including 25000 AGYW with these services in 2017 and 3,380,458 through the one2one platform.

Men and women living in fishing communities across the world have been found to be between five and ten times more vulnerable to HIV than other communities. Inconsistent condom use, transactional sex and multiple sexual partnerships contribute to the high HIV burden among fishing communities. It is estimated that 24-30% of this population are living with HIV and the HIV prevalence is 4 times higher than the national average estimated at 5.6%.

To address HIV among the fishing communities we provide:

1. Risk assessment and risk reduction counselling
2. Peer education and promotion of adaptation of safer sexual behaviours
3. Information and provision of Post Exposure Prophylaxis (PEP)
4. HIV testing services -health education -knowledge of HIV status
5. STI screening and treatment, use of male and female condoms and lubricants
6. HIV care and treatment
7. Referral for Voluntary Male Medical Circumcision (VMMC)
8. TB screening and treatment
9. Entrepreneurship and income supplementation
10. Prevention and mitigation of Gender-Based Violence services (GBV)
11. Stakeholders’ engagement and mobilization for community level activities

In 2017, we reached 18,374 Fisher Folk in 42 beaches and landing sites in Migori and Kisumu counties. Of these 327 were HIV positive, 293 are on ART, attaining 82% Viral Suppression.

Sex workers and their clients account for 14% of all new HIV infections in Kenya. This population is often stigmatised and lacks access to responsive quality and comprehensive HIV and sexual reproductive health care.

To address HIV among the sex workers, we provide:

1. Health education for awareness
2. Comprehensive HIV services; HIV testing and counselling, HIV care and treatment for the HIV positive, provision of condoms, STI screening and treatment, provision of Pre-Exposure Prophylaxis (PrEP) and evidence based prevention interventions
3. A comprehensive package of sexual and reproductive health  (SRH) services; family planning, emergency contraceptives, Post Exposure Prophylaxis (PEP), cervical cancer screening, pregnancy screening and referral for Ante Natal Clinics (ANC) and post-abortion care
4. Post violence care and post rape care services
5. Structural interventions; advocacy for policy to reduce stigma and discrimination in HIV response, financial literacy and capacity building for self-advocacy

In 2017, there were over 23,832 FSW in 20 LVCT Health facilities and Drop in Centres (DiCES), in 5 counties. Of these 1,374 are on ART, and have 89% Viral Suppression among the Key Populations.

Unprotected sex between men is associated with higher HIV transmission and is estimated to account for 15% of all new infections. Men who have sex with Men (MSM) are stigmatized when health service providers lack the requisite knowledge, attitudes and skills to deliver quality services for this population.

To address HIV among the MSM we provide:

1. Health education for awareness.
2. Comprehensive HIV services; HIV testing and counselling, care and treatment for the HIV positive, provision of condoms, STI screening and treatment, provision of Pre-Exposure Prophylaxis (PrEP) and Post Exposure Propylaxis (PEP), referral for voluntary male medical circumcision (VMMC), and evidence based prevention interventions.
3. We provide Sexual Reproductive Health (SRH) services, Gender Based Violence (GBV) information, post violence care and post rape care services.
4. We provide structural interventions; advocacy for policy to reduce stigma and discrimination in HIV response, financial literacy and capacity building for self-advocacy.

We reached over 4269 MSM, across LVCT Health facilities with these services in 2017, with more than 90% of MSM achieving viral load suppression.

Use of alcohol and other recreational drugs has been shown to reduce judgement and increase sexual risk behaviour. Among the People Who Inject Drugs (PWID), HIV risk is markedly elevated when needles are shared. It is estimated that while less than 1 in 1000 (0.001%) Kenyans inject drugs, 4 of 100 (4%) new infections occur among this group. This population is among the Key Populations that we serve.

To address HIV among people who inject drugs we provide:

• Knowledge and skills in HIV prevention
• Change attitudes and motivate individuals to adopt healthier behavior
• Risk assessment, risk reduction counselling and skills building
• Distribution and collection of needles and syringes
• Preparation and linkage of clients to Medication-Assisted Treatment (MAT)
• Nutrition support to MAT clients
• Outreach and advocacy at dens
• STI screening and treatment
• HIV Prevention services
• HIV Testing and Counselling services
• HIV Care and treatment
• Gender Based Violence Screening
• TB screening and treatment
• Post Exposure Prophylaxis (PEP)
• Sexual and reproductive health services
• Cervical cancer screening
• Anti-retroviral therapy (ART)
• Pre-exposure Prophylaxis – PrEP

In 2017, 1949 PWID were on our prevention programme. Of those tested, 31 tested HIV positive (2.3% positivity rate) and 84% were linked to care and treatment. Of the Key Population on ART, 55% of the people who inject drugs were virally suppressed.

It is estimated that there are over 1.6 million people living with HIV in Kenya. Kenya’s Ministry of Health has set guidelines that state that all people living with HIV should be identified, initiated on treatment and provided with continuous care and support to prevent further morbidity and mortality. By September 2017, close to 1.1 million had been identified and initiated on antiretroviral treatment. Furthermore, there are an estimated 260,000 couples in HIV sero-discordant relationships (one partner is HIV positive while the other is positive). HIV sero-discordant relationships also contribute significantly to new infections.

There is evidence that violence against women and men is an indirect factor for increased HIV risk. It is a barrier to uptake of HIV services and poor treatment adherence and response, particularly in sub-Saharan Africa, where the epidemics overlap. Sexual violence is a known direct risk factor for HIV transmission both in children and adults.

Focussing on four main areas of GBV, we aim to address the HIV and Gender Based Violence (GBV) dual pandemic:

1. Violence against children – community prevention programs and post rape care services
2. Violence Against Women – intimate partner violence prevention and response programs within the community and at facility level
3. Post rape care services to all sexual violence survivors
4. Violence prevention and response services to the Key Populations including Men who have sex with Men, Female Sex Workers and People who use and Inject Drugs

We provide prevention and response services to survivors of violence:

1. Generate local evidence on GBV prevention and response through operational research and evaluation of innovative models
2. Provide technical assistance to the Government and partners for the development and institutionalisation of policies and standards for delivery of GBV services
3. Facilitate scale up of comprehensive GBV services at LVCT Health sites and Public health facilities

In 2017, we supported 66 public health facilities to deliver the nationally recommended comprehensive post violence services. 32,275 Key and Priority Populations were screened for violence and offered psychosocial support, out of which 7,403 were HIV positive. We trained 133 health service providers using the national training curriculum for managing survivors of violence, 81 County Health Records Information Officers (HRIO) on internationally recognised District Health Information Systems (DHIS2) data management and 375 non-medical service providers were trained/sensitised on GBV response (83 County law enforcers, 142 county duty bearers, 88 National Police Service Officers, and 62 community policing members).

According to WHO, over one billion people globally experience disabilities. This translates to 1 in 7 people worldwide. People with disabilities (PWD) have the same health care needs as others. PWD are twice more likely to find health facilities and health care providers’ skills inadequate. Although the relationship between HIV and disability has not received due attention, PWDs are among people at high risk of exposure to HIV. There is an assumption that persons with disabilities may not be sexually active, or do not engage in other risky behaviours such as injecting drugs.  At LVCT Health, we provide a comprehensive range of HIV, Gender Based Violence (GBV) and Sexual and Reproductive Health (SRH) services for the deaf using Kenyan Sign Language and for the Visually Impaired Persons (VIPs) using Braille and typing services, among others. In 2012 LVCT Health pioneered the first national Disability Sensitisation Conference in partnership with the Ministry of Health – MoH, National AIDS Control Council – NACC, NASCOP and Centres for Disease Control – CDC, national Disabled Persons Organisations (DPOs) and other stakeholders.

Over time, we have sensitized service providers on the health needs of the deaf and blind to address their HIV, GBV, SRH concerns;

• To ensure accessibility and ease in communication for PWDs for the deaf clients; we have deaf and hearing service providers who are trained in sign language
• We provide Information Education and Communication (IEC) materials with sign language, writing and typing services
• We provide IEC materials in braille for the visually impaired

In addition to provision of these services, LVCT Health partners with the Ministry of Health and works with DPOs to strengthen their organisational systems:

• To create demand for increased service uptake

• To undertake income generating activities (IGAs) for improved livelihoods and sustainability
• To undertake advocacy activities to increase access to health services that meet their needs
• Policy engagement and advocacy and meaningful engagement of their members
• Sensitization on: Leadership and management

In 2012, there were 260,000 sero-discordant couples (one partner HIV+) in Kenya. HIV prevalence is highest among women and men aged 25 to 44 demonstrating the increasing need of HIV treatment and care by age. Data shows the need to target HIV prevention among this population category to reduce infection resulting from discordant couples and inter-generational sex. Identification and categorisation of priority and bridging populations focusing on Key Population, people living with HIV and sero discordant couples is key. We recognize that UNAIDS 90-90-90 targets cannot be attained without investing in effective HTS strategies to identify HIV positive individuals (including discordant couples) who do not know their status and link them to care.