About 9000 Kenyans are on anti-HIV drugs

About 9,000 healthy Kenyans have so far taken up the daily HIV prevention pill that was launched in May by the Ministry of Health. Kenyans using the pill, a new update shows, include discordant couples, male and female sex workers and youth at high risk of HIV infections.

Prescription-only

Data on the pill uptake presented 10 days ago, estimates 8,500 to 9,000 Kenyans have taken up this latest HIV prevention method called Pre-Exposure Prophylaxis or PrEP. The method involves taking the prescription-only pill every day for as long as one is engaging in risky sexual behaviour.

The new data is presented by PrEPWatch, a global database tracking PrEP use and maintained by the American HIV advocacy NGO called AVAC. It says Kenya intends to recruit 50,000 to 55,000 users in the next few years.

However, this is still a long way from the targeted 500,000 PrEP users by the Ministry of Health by 2022.

Since May, PrEPWatch says the Pharmacy and Poisons Board has registered two generic versions of the original brand Truvada manufactured by the Gilead Sciences of the United States.

Launching the PrEP in May, Dr Martin Sirengo, Director National AIDS and STI Control Programme (NASCOP), said availability of generic versions would dramatically lower the cost of providing the pill.

In the private sector, Dr Jackson Kioko, the Director of Medical Services says it costs about Sh3,600 per month but is free in government facilities.

However, the estimated cost of Sh3,600 in private facilities does not include required continuous HIV, hepatitis and kidney tests for people on PrEP. Neither does it include hospital markup. An earlier estimate prepared for the Government by the US-funded Health Policy Plus showed it would cost about Sh48,667 to keep one individual on PrEP annually.

The 2017 National Framework for the Implementation of Pre-exposure Prophylaxis of HIV in Kenya estimates the project will require about Sh32 billion for a five-year period to 2022. Information from multiple sources shows the project is grappling with monumental social, technical and financial problems. “There are people saying PrEP does not work or they should use it without a condom and if they turn positive they should sue the Government,” says Mombo Ngua (a.k.a Mantully).

Ngua is a sexual minority activist affiliated with the Sex Workers Outreach Programme (SWOP), Nairobi, which is a project of NASCOP. Ngua, who has been on PrEP for two years says there is misinformation about use of the prevention pill. “There are people who say that PrEP finishes sexual feelings and adds a tummy. They are asking if PrEP works, what is the use of condoms?”

Data presented at the July Global HIV Conference in Paris showed the uptake of PrEP in Kenya even among sex workers at the SWOP clinics in Nairobi is excruciatingly slow.

Joseph Ouko of the Kenya AIDS Control Project said out of the 2,044 female sex workers whom they reached with information on PrEP, only 739 had visited the facility to enquire about the pill. Of these, 576 were found eligible and 346 were put on the drug, but only 148 are still on it. At the same conference, a study called SEARCH - by the University of California, US and Kenya Medical Research Institute - which investigates best ways to implement PrEP, reported similar challenges.

Carol S Camlin of the University of California said while young men view PrEP as the new vehicle to sexual adventure, girls think the invention is a license to freely engage with ‘sponsors’ in unprotected sex.

Among reported reasons for the low uptake of PrEP include complicated compliance procedures such as regular HIV, hepatitis and kidney tests.

Users are supposed to go for at least three kidney function tests per year, which the Ministry of Health says may prove expensive and a challenge to provide in public health facilities.