Abstract
In comparison to European and American countries, Kenya has been less impacted by the COVID-19 pandemic in terms of reported cases and mortalities. However, everyday life has been dramatically affected by highly restrictive government-imposed measures such as stay-at-home curfews, prohibitions on mobility across national and county boundaries, and strict policing, especially of the urban poor, which has culminated in violence. This open letter highlights the effects of these measures on how three community-based organizations (CBOs) deliver HIV programs and services to highly stigmatized communities of men who have sex with men living in the counties of Kisumu, Kiambu and Mombasa. In particular, emphasis is placed on how HIV testing programs, which are supported by systematic peer outreach, are being disrupted at a time when global policymakers call for expanded HIV testing and treatment targets among key populations. While COVID 19 measures have greatly undermined local efforts to deliver health services to members and strengthen existing HIV testing programs, each of the three CBOs has taken innovative steps to adapt to the restrictions and to the COVID-19 pandemic itself. Although HIV testing in clinical spaces among those who were once regular and occasional program attendees dropped off noticeably in the early months of the COVID-19 lockdown, the program eventually began to rebound as outreach approaches shifted to virtual platforms and strategies. Importantly and unexpectedly, HIV self-testing kits proved to fill a major gap in clinic-based HIV testing at a time of crisis.
Highlights
On 11th March 2020, the World Health Organization (WHO) declared the spread of COVID-19 a global pandemic after it swept across 114 countries, causing more than 4000 deaths
Conclusion in terms of documented infections and mortalities, Kenya has been less impacted by the COVID-19 pandemic in comparison to other countries, our report of three community-based organizations (CBOs) struggling and persevering in their attempts to offer HIV services to highly stigmatized communities of men who have sex with men (MSM) helps to illustrate the profound disruptions taking place in HIV program delivery [ see 14] in a part of the world where HIV continues to
Despite the myriad challenges initially faced by the three Kenyan CBOs discussed in this report, especially in March and April 2020, towards the end of May program indicators showed a rebounding, greatly owed to the ingenuity and commitment of CBOs in their re-design of strategies for reaching their peers
Summary
Venkatesan Chakrapani , Centre for Sexuality and Health Research and Policy (CSHaRP), Chennai, India. Any reports and responses or comments on the article can be found at the end of the article. Proved to fill a major gap in clinic-based HIV testing at a time of crisis. This article is included in the Coronavirus (COVID-19) collection. The revised version includes feedback from the reviews. We have provided new data on Linkage to Treatment (Figure 3) as per the feedback. We have added recommendations for implementers and policy makers. We have added new information on criminalisation of same sex relationship in Kenya. Any further responses from the reviewers can be found at the end of the article
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