A decade and beyond: learnings from HIV programming with underserved and marginalized key populations in Kenya

Area of Science:

• Public Health
• Epidemiology
• HIV/AIDS Research

Background:

• Key populations (KP) disproportionately contribute to global HIV incidence.
• Prioritization and access to HIV programs for KP remain insufficient globally.
• Kenya's national HIV response has focused on scaling up programs for KP over the past decade.

Purpose of the Study:

• To evaluate Kenya's successes and challenges in achieving 2020 global HIV targets.
• To analyze the scale-up of the Key Populations (KP) HIV program in Kenya over the last decade.
• To identify areas for improvement in HIV prevention and care for KP in Kenya.

Main Methods:

• Review of Kenya's national HIV response strategies for Key Populations.
• Analysis of program coverage data for female sex workers (FSW), men who have sex with men (MSM), people who inject drugs (PWID), transgender people, and people in prison settings.
• Assessment of service outcomes and care continuum targets for KP.

Main Results:

• Significant scale-up of KP programs in Kenya, with high coverage for FSW (73%) and MSM (82%).
• Strong prevention outcomes noted, including high condom use among FSW (92%) and sterile equipment use among PWID (88%).
• Challenges persist, including low condom use among MSM (78%), low case finding for care continuum targets, and inadequate reach for transgender people and those in prison settings.

Conclusions:

• Kenya has made progress in scaling up KP HIV programs but has not yet met the 2020 global HIV targets.
• Sufficient coverage and quality of HIV programs for underserved KP are critical for achieving global targets.
• Further efforts are needed to address implementation gaps, improve data collection, and tackle structural barriers like stigma and violence.