Brian and Joseph (not their real names) from a football match organized various lobby groups at Kokuoyo Primary School in Nyando.
The two are engaged in a deep conversation on oral pre-exposure prophylaxis drugs that are helping them avoid HIV infection, when we catch up with them.
They have been on contraceptives for the past two years.
In 2015, the World Health Organization recommended that people at high risk of HIV infection, like the two, get the drug.
Both Brian and Joseph were in the same secondary school but could not continue their education after Form Four because their parents did not have money.
As fate would have it, they both work as boda boda riders.
It is during this time that they got entangled with some sex workers.
“Initially, I did not know about the uptake of PrEP and only survived on condoms whenever I went out with a sex worker,” says Brian.
The decision to take PrEP he said, came when he accidentally engaged in unprotected sex with one of the ladies of the night.
“I was drunk that day and did not use protection,” he said.
Fearing an imminent infection, he decided to try PrEP and to his surprise, the results were encouraging.
A community mobiliser came here and tested us for HIV. I was shocked when I learnt I was negative. I called my neighbor and fortunately he also tested negative. It was a miracle to me because my wife and had been sexually active with other partnersJoseph
“I went for a test and I was negative. That’s how I chose to stick to the drug and I have never defaulted,” he said.
For Joseph, the decision to use PrEP started when he suspected that his wife was having an affair with other men.
“Despite sleeping with many sexual partners, she refused to undergo an HIV test and I took an early precaution,” recalled the father of one.
“A community mobiliser came here and tested us for HIV. I was shocked when I learnt I was negative. I called my neighbor and fortunately he also tested negative. It was a miracle to me because my wife and had been sexually active with other partners,” he noted.
Even after divorcing the wife, he continues to use PrEPs alongside other preventive measures.
High PrEP intake
Winnie Akinyi, a health record information officer at Nyakongo Hospital noted that the PrEPs uptake among the key population has shot up by a huge margin from previous years.
“We are sensitizing them on the benefits of taking the drugs and the results have been positive. A majority have adhered to PrEPs, which I find laudable,” she said.
But Akinyi raised concerns about stigma caused when people are seen visiting the facility which she said deterred some women from getting the product.
“We had more clients at the beginning of the project. The number has, however, gone down due to fear, because people are stigmatized whenever they visit the hospital,” she said.
With the youth engagements at the village level, Akinyi says it is now easier for the youth to access the services and avoid stigmatization.
In a bid to fight the stigma and discrimination of the youth infected or affected by HIV/AIDs, Zipline has partnered with the Elton John Aids Foundation (EJAF) and the County Government of Kisumu to take HIV Comprehensive Care and Reproductive Health Services directly to the youth in their safe places.
The safe places include football tournaments, organized every Saturday for both girls and boys within Kisumu County.
Zipline drones drop the required ARVs, condoms, and family planning pills at the nearest health facility where the tournament is taking place, while EJAF supports with the required resources, including capacity building.
There has been an increase in uptake of the HIV comprehensive care Services since this partnership was launched.
Before then, the youth would shy away from visiting health facilities within their localities for fear of stigma.
Over a period of three years, the project targets: 14,500 young people to routinely test for HIV, 8,000 at risk adolescents to start PrEP, and 1,000 adolescents living with HIV to start treatment.
Zipline Global CSM Sineka Samuel said the organization is aiming to reach out to the youths who fear to access sexual and reproductive health services from health facilities because of stigma and negative societal perception of them and their health.
“We have mapped various areas where we will be taking the community engagements to increase the uptake of the drugs,” he said.
With the 15th event rolling, he noted that the events have increased access to the drugs.
“As Zipline we are targeting to improve sexual health reproductive services and impact individual youths,” furthered Sineka.
His sentiments were echoed by community engagement leader at Zipline, Caleb Wanjala who said the program has boosted Sexual Health Care Services (SHCS) by use of the drone technology where they deliver drugs to the youth at the events.
“We realized that the youth love soccer so we decided to organize for these tournaments so that we take the free sexual health services to them, which include counseling, information dissemination and testing,” said Wanjala.
He further said the program will give youths the autonomy to control their sexuality and make it easy for them to make independent decisions and how to prevent themselves from unwanted sexually transmitted diseases.
We realized that the youth love soccer so we decided to organize for these tournaments so that we take the free sexual health services to them, which include counseling, information dissemination and testingWanjala
Christine Juma a nurse at Nyakongo Hospital noted that unlike the antiretrovirals, which are taken daily, one takes PrEP when they need it.
“When clients are not engaging in risky sexual behavior, they do not need to take the pill. We also ensure dual protection such as use of condoms to avoid STIs and unintended pregnancies,” she said.
She also noted that the county has recorded a decline in the past five years due to increased access to PrEPs.
Illustrating the effectiveness of PrEP, she said the positivity rate stood at 6.3 per cent.
Juma said the main challenge is often the high dropout rate of enrolls.
She attributed this to the stigma with PrEP, which is likened to antiretroviral drugs given to people who are already HIV-positive.
Zipline in Kenya
Zipline, which has been operating in Rwanda and Ghana since 2016 and 2019 respectively, launched its commercial deliveries in Kenya in February 2023, after signing a partnership agreement with the County Government of Kisumu, a member of the Lake Region Economic Bloc (LREB).
The agreement established a Zipline distribution hub in Kisumu City, which serves as the base of operations for its unmanned aerial system (UAS) and services, capable of serving health projects across the county and beyond.
Winfred Njeri, General Manager of Zipline Kenya, expressed her enthusiasm for the groundbreaking partnership, saying; “We are honored to join hands with the County Government of Kisumu and the Elton John AIDS Foundation to bring these innovative health services directly to the youth.”
She adds: “At Zipline, we believe in the power of innovation and collaboration to create a healthier and brighter future for all. Together, we are committed to making a meaningful impact on the lives of young people in Kisumu and beyond.”