Why Busia records more HIV numbers and stigma

 Busia County Referral hospital in Busia County on May 4,2022. [File,Standard]

Busia Deputy Governor Arthur Odera notes that the county is confronting a troubling convergence of health and social crises ranging from rising HIV infections, soaring teenage pregnancies, and widespread gender-based violence.

The challenges form a dangerous “triple threat” that continues to undermine the well-being of young people and families in the border county.

“Teenage pregnancies remain high, HIV infections have been persistently high, and sexual and gender-based violence is widespread. As county leadership, these numbers trouble us deeply,” says Odera, also health and sanitation executive.

Despite this, Busia remains committed to aligning its HIV response with the national 95-95-95 targets, diagnosing 95 per cent of people living with HIV, initiating treatment for 95 per cent of those diagnosed, and achieving viral suppression in 95 per cent of those on ART.

To address the broader social factors driving infections and vulnerability, Busia has begun implementing a suite of progressive policies.

This includes a county gender-based violence policy, a children’s care policy, and a shift from traditional child protection to a more holistic model of child care.

A gender policy is also under development to streamline how institutions respond to issues of gender, GBV and child well-being.

But even with the policies,  Busia’s unique position as Kenya’s gateway to Uganda, hosting two of the busiest ports, Malaba and Busia creates additional layers of complexity.

“Being a border county comes at a cost. We host the largest ports, and with that comes epidemics, health challenges, and social pressures. Many people who pass through are not locals. Some are in transit for long periods, which fuels new HIV infections,” he says.

The county’s porous border also means its health system carries a double burden.

“A lot of patients managed on ART here are from Uganda. Our healthcare is superior, so they cross over for services, and while we cannot turn them away, it strains our resources,” adds Odera.

But he warns that if adolescent vulnerability is not addressed, the cycle will worsen.

“When you look at HIV infections, teenage pregnancies, and gender-based violence, you see the same underlying patterns. Normalisation of early sexual debut, normalisation of teenage pregnancies, it all spirals into early marriages, HIV infections, school dropout. The problem is endemic because society has normalised it,” he adds.

Nevertheless, powerful voices, including political leaders, often avoid confronting the issue for fear of becoming targets.

To counter this, Busia has established an Adolescent and Young People Committee, which leads countywide initiatives on sexual reproductive health, gender issues and HIV prevention.

The county also supports programmes that supply sanitary pads, a gender-based recovery centre at the Busia County Referral Hospital, and survivorship rehabilitation services, with partnerships with religious leaders complementing these efforts.

Ultimately, Odera believes the border can be a blessing rather than a burden, if managed well.

“Triple threat issues are driven by economic and commercial factors. We have men who impregnate girls and then run across the border to Uganda, where they have relatives. These are the realities we face. But the border can work for us if we do things the right way,” he says.