Improved Access to Testing & Care in Kenya

Doctors Without Borders/Médecins Sans Frontiéres (MSF) recently released the results of a study showing that bringing quality HIV/AIDS testing and treatment closer to communities improved public health and significantly reduced the percentage of the people living with HIV in Ndhiwa sub-county in Homa Bay, Kenya.

Ndhiwa in Homa Bay has long had one of the highest HIV prevalence rates in Kenya and across Africa. To tackle this, MSF and its partners, including the Kenyan Ministry of Health, began working in 2014 to better provide HIV testing and treatment at a more decentralized, local level. Additionally, health workers began more immediately putting people who tested positive on antiretroviral therapy (ART), which helps keep HIV-positive people healthy while preventing further transmission of the virus.

The Ndhiwa HIV Impact on Population Survey 2 (NHIPS 2) was conducted between 2014 and 2018 and showed that, by 2018, 93% of the Ndhiwa’s population knew their HIV status (up from 59% according to a 2012 survey); 97% of HIV-positive people were receiving ART treatment (up from 68%). Ninety-five percent of people on ART had successfully suppressed the virus (up 11 percent from 2012). Additionally, between 2014 and 2018, the percentage of new infections per year among the population at risk decreased from 1.9 to 0.7%.

The NHIPS 2 study confirms that the “90-90-90” targets set by UNAIDS to bring the global HIV epidemic under control have been met and exceeded two years early in Ndhiwa. MSF and its partners, including the Kenyan Ministry of Health, boosted systematic testing through extensive engagement of the community, door-to-door health promotion campaigns, and household testing. They also expanded and improved HIV care in smaller, rural health facilities through better staffing and more regular supplies, including ARTs, often relying on a network of motorbike riders who collected blood samples in local health centers and transported them to the nearest lab facility.

“When applied to large numbers of people, HIV treatment equals HIV prevention,” Dr. Mohammed Musoke, MSF medical coordinator in Kenya, said in a prepared statement. “In practice, to achieve that goal, we worked to drive major improvements in the three main pillars of HIV care: increasing people’s awareness of their HIV status, maximizing the number of HIV-positive people on ART, and increasing the number of people on ART who have successfully suppressed the virus.”

Dr. Musoke cautioned that “The fight against HIV in Ndhiwa is far from over, and efforts to work on the main pillars of HIV care have to continue if these gains are to be maintained and improved upon.”

—Reporting by Hank Trout

Hank Trout, Senior Editor, edited Drummer, Malebox, and Folsom magazines in the early 1980s. A long-term survivor of HIV/AIDS (diagnosed in 1989), he is a forty-year resident of San Francisco, where he lives with his husband Rick Greathouse. Follow him on Twitter @HankTroutWriter.