Improving HIV services in a rural Kenyan setting

Abstract

Purpose of Study: The HIV epidemic in Kenya is particularly dire in the Kisumu district, due to widespread poverty and a prevailing sex trade. Amornkul et. al (2009) reported a 15.4% HIV prevalence compared to the national average of 7.4%. Since 2007, the Global Initiative for Village Empowerment (GIVE) has been addressing this problem in a rural community near Kisumu. We present an evaluation of this project's progress. Methods Used: GIVE set up a voluntary counselling and testing (VCT) center in 2007, and has since been working with the community clinic to build capacity for a full-time HIV Care Center and an antiretroviral (ARV) dispensary. In collaboration with the provincial government and Aphia Plus (USAIDfunded NGO), GIVE has been helping the clinic meet the requirements for ARV distribution; these include CD4 monitoring, proper documentation of patients, and prophylaxis for opportunistic infections. Furthermore, GIVE has worked to promote HIV awareness in the community, including HIV workshops at primary and secondary schools and the establishment of a community unit (a group of volunteers who visit village households to provide basic health education and referrals). Summary of Results: Since June 2008, 624 people have been tested through VCT, with 20.4% testing positive. The VCT set up the foundation for other NGOs to implement HIV services such as support group meetings and nutritional supplements. Testing rates have gone up since these services were implemented . With support from GIVE, the local staff completed the final requirements for a dispensary in July 2011, and the clinic received its first ARV supply in September. Household data collected by the community unit has shown that GIVE's efforts to raise HIVawareness and reduce the number of people unaware of their HIV status have been successful. Conclusions: Our multifaceted approach to HIV has so far been effective. Starting initially with a VCT and establishing a community unit and HIV education, we now have a community with realistic access to CD4 counts and ARV services. This was accomplished with a grassroots and collaborative effort with community members, health clinic staff, other NGOs and the government. Future goals include assessing the function and sustainability of the recently implemented CD4 count and ARV therapy services. We will review statistics on HIV services and make modifications accordingly.