Invest more in behaviour change campaigns to reduce HIV infections

As Kenyans marked World Aids Day last Friday, the conversation was more centred on medication to reduce opportunities for HIV infection rather than the relatively stagnant infection rates. And although the national infection rate — hovering at about five per cent — has continued to concern health experts, there has been less emphasis on how quickly to roll our interventions to reduce risky behaviour.

Today, the emphasis is to provide preventive drugs than it is to offer treatment and develop health facilities. At the bottom of the chain are behaviour change HIV prevention activities anchored on abstention and faithfulness.

This is cause for concern. There must be a fine balance between devoting medical resources to vulnerable groups and providing reminders to regular folk about dangers of risky behaviour.

New research suggests that high-risk groups such as prostitutes and discordant couples are getting more medication to limit the rate of exposure to infections than ever before. One study says about 9,000 people are on the daily HIV prevention pill initiative called Pre-Exposure Prophylaxis or PrEP.

The US President’s Emergency Plan for Aids Relief (PEPFAR) plans to bring another 5,000 Kenyans into the programme next year. And by 2022, the Ministry of Health targets 500,000 people being on PrEP at a cost of Sh32 billion.  

Whether or not this is the best way to handle the pandemic is debatable. What is clear is that behaviour change interventions should not be discarded because science has introduced medical remedies to reduce infections. This is something health experts may want to think about in their quest to bring down HIV infection rates.

HIV, like other common diseases such as malaria and tuberculosis, continues to put a strain on our healthcare system and the national budget. If behaviour change can help ease the burden, then we must invest in programmes that will trigger social change. So even as we invest in the science, let’s put money in HIV prevention programmes that target larger groups of people such as youth.