After having focalized for more than a decade on fighting HIV-transmission among the general population in Sub-Saharan Africa and advocating for access to antiretroviral treatment (ART) in this context, Médecins du Monde France (MdM-F) considered that encouraging prevention, treatment and care for and with most-at-risk-populations (MARPs) such as men who have sex with men (MSM), People Who Use Drugs (PWUD) – and esp. Injecting Drug Users (IDUs) – and sex workers (SW) was becoming more and more a priority - both from an epidemiological and a political point of view.
An exploratory mission and situational analysis has been led in November 2011 in Kenya. Findings have been somewhat similar to the Tanzanian context, Despite a decrease in the overall HIV/AIDS prevalence which affects 6% of the Kenyan population, it appears that the prevalence among the most-at-risk-populations is alarming. According a study done in 2004 in Nairobi among 156 IDUs, the HIV prevalence was 36% (68% for women) and the HVC prevalence was 42% (48% for women femmes). Recent assessments have found similar results. IDUs have thus a considerably higher HIV prevalence than the general population. More generally MARPs are estimated to contribute an estimated 33% of cases of all new HIV infections. Moreover, the criminalization and stigmatization of MARPs and especially PWUD remains important and they don’t have sufficient access to health care.
However, comparatively little funding is channelled into prevention, treatment and care services for MARPs. The proportions of Kenya’s and total AIDS spending directed to HIV prevention among these key populations is 0.35% and almost all is from international sources.
Fisrt responses on community level targeting PWUD have been developed and adapted harm reduction responses are slowly starting to be implemented and supported by the national and international stakeholders. The responses remain nevertheless insufficient in the moment.
In that context, MdM is willing to implement a high quality Harm Reduction program according to international standards in Nairobi. This project is a second section of the MdM Kenya’s mission which is already acting in supporting health structures in the Ditrict of Dadaab in order to reduce the mother and child mortality and morbidity. The program will be implemented with a Kenyan partner that has already experiences in the field of harm reduction.
The Program Coordinator, in collaboration with the General Coordinator and the Medical Coordinator will be in charge of the implementation of the HR program.
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