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Nairobi County 90-90-90 Targets (2016) PLHIV: 171,510

77%

96%

86%

Source: Provided by Nairobi City County

Nairobi County HIV Care Continuum (2016) PLHIV: 171,510

77%

74%

64%

Source: Provided by Nairobi City County

Governor's Message

“On 1 December 2014, Nairobi joined 25 other cities around the world in signing the Paris Declaration – a key part of the global Fast-Track Cities: Ending the AIDS Epidemic campaign. We chose to be involved in this work – part of a broader effort to achieve the Fast Track Targets – because we understood that if we did not intensify our work to end AIDS, we risk losing the battle against the disease thus ultimately compromising our aspirations for socio-economic progress moving forward… My office will continue to support this crucial county-level effort, which directly supports the targets set out in the Kenya AIDS Strategic Framework (KASF) 2014/15 – 2018/19 and the focus areas highlighted in the recently launched Kenya-UN Joint Programme on HIV.”

Dr. Evans Kidero
Governor, Nairobi City County
FTCI Taskforce Members

Dr. Thomas Ogaro

Nairobi City County Director of Medical Services

tdogaro@gmail.com

Dr. Bernard Muia

Nairobi City County Executive Committee Member for Health Services

bmuia@nairobi.go.ke

Dr. Harriett Cherono Kongin

Kenya UNAIDS Fast-Track Focal Point

konginh@unaids.org

Dr. Carol Ngunu-Gituathi

Nairobi City County AIDS & STI Coordinator for Health Services

ngunucarol@yahoo.com

Dr. Samuel Ochola

Nairobi City County Chief Officer for Health Services

sochola06@yahoo.com

Dr. Elizabeth Bukusi

KOL

EBukusi@kemri.org

Community Messages

Ngara Medically-Assisted Therapy (MAT) Clinic

The Ngara MAT clinic opened on January 31, 2017 and enrolled 77 clients in the first three months. The clinic offers methadone and services for other medical conditions including NCDs and STIs, as well as provides referrals to other services as needed. The Ngara MAT clinic uses a model that works closely with civil society organizations (CSOs) to identify and track the progress of clients. Currently the CSOs SAPTA, Médicine du Monde, and NOSET facilitate identification and enrollment of clients into the clinic, and works with the clinic to monitor monthly progress of the clients.

  • Mary
    27

    Mary lived on the street where she was abused by men and started taking drugs. She has two children, ages fourteen and four years old. She has been on drugs for 14 years and has taken methadone for three months. She found out about the clinic when the CSO SAPTA went to the slums and sensitized people about coping with drugs. She decided to seek help at the clinic because she wanted to be able to take better care of her children. Mary has been a positive example in the community. Once people in her “street cell” noticed Mary’s improvements, many drug users were motivated to seek help for themselves. As a result of the methadone clinic, Mary has seen an improvement in her health and hygiene and is now able to care for her family. She is more accepted among society and has a desire to work. She is currently looking for employment and recommends that the clinic has a program about economic empowerment and employment opportunities.

  • Dennis
    38

    Dennis was a heroin addict for 12 years He started heroin because of peer pressure and kept it a secret for five years because of the stigma. He tried 5-6 times to get clean on his personal will, but relapsed each time. Through his friends, he heard about the NGO Médicine du Monde which was responsible for supplying syringes for harm reduction, clean water, and basic medical coverage. The NGO introduced him to the methadone program and he has now been clean for two years.

    Dennis saw this as a major turning point for him. He was unsure whether methadone would be successful, but was interested to try it. Médicine du Monde assisted with his transport to treatment at facility for a month and he has never looked back. As a result, Dennis has seen physical, psychological, and financial changes. He is eating better and now thinks about his life and future. He also now has better relationships with his family and friends. Although he hasn’t secured a job, he can manage finances though old jobs and can provide for his family. Dennis still faces some challenge finding transportation to the clinic, but says the best thing about the clinic is that it is free. He got to discover a lot of talents he had, but was using them for the wrong purposes. Now that he is clean, he is using them for a positive way. He is interested in event management, motivational speaking, market research, and DJs.

  • Margaret
    22

    Margaret was introduced to heroin by her boyfriend who would roll it with marijuana, without her knowledge. When her mother found out she was doing heroin, Margaret was kicked out of the house and started struggling on the streets . She started by smoking heroin and later on began to inject it. When her boyfriend was arrested she moved to the city and was living on the streets. Margaret learned about the methadone clinic from friends who were benefiting from methadone, and decided to seek help for herself. As a result of the methadone program, she has seen many changes. Her mother took her back in the house and is now able to care for her. She is also motivated to look for a job and continue improving her life.

  • Sheila Ayuya
    Medical Officer

    Sheila’s role is to see clients as a clinician and make sure everything in the clinic is running smoothly. She enjoys working in this field and seeing the transformation of the clients. She believes that the clinic is successful because it provides respectful and stigma-free care to clients across all socioeconomic backgrounds and key populations such as men who have sex with men and sex workers. One challenge that Sheila faces in the clinic is caring for clients who have records of illegal activity. Particularly she strives to work with policy and the community to ensure that incarcerated individuals continue sustained therapy.

ISHTAR MSM Clinic:

ISHTAR was founded in 1997 and the clinic opened in 2014. It has 4,200 clients ranging from 15-67 years old, 220 of who are positive. Many minors also receive services from the clinic. Some of the most successful practices of ISHTAR are their peer-led model and their use of social media. The clinic’s outreach focuses on reaching MSM who are working and can’t come to the site including a mobile van clinic used to reach MSM.

  • Chom
    Nurse

    Chom has been working as a nurse at Ishtar for the past three years and focuses on prevention, screening, testing of STI and other ailments among MSM, as well as providing health education with one-on-one individuals and groups. Chom finds his work of treating and healing very gratifying. For the future, he would like the clinic to offer complete HIV treatment, lab services and PEP, as well as having satellite clinics.

  • Alvin
    24
    Field Officer

    Alvin was first brought to ISHTAR by a peer educator through the clinic’s outreach program in 2014. Before he got to ISHTAR, he was lonely and didn’t know other MSMs, so he was very closeted. While he started as a client in 2014, he became a peer educator in 2015 and a field officer in 2016. As a field officer, he interacts and organizes outreach with management educators. Alvin focuses on health education for clients and refers them to other services. He also identifies areas that are popular for MSM and works with cases on violence.

    Alvin is very gratified from his work and finds joy when helping others and giving advice. He says there is a lot of ignorance in the community, so it is rewarding to teach someone something new. Alvin thinks the clinic is successful because of its peer-educator model and the fact that the organization is led by MSM in the community.

  • Thiesty
    25
    PrEP Champion

    Thiesty learned about PrEP from the National AIDS and STIs Control Programme (NASCOP) and became eager for more information. He googled the medication, learned more about the medication and began taking it. Some friends have seen him take it and asked for more information, which then gets passed to the community. As a PrEP champion at Ishtar, he educates the community about PrEP, particularly emphasizing that PrEP is not for those who have HIV. Since PrEP was launched, he has mobilized four clients. Some of the challenges about his role are the rumors about the side effects with PrEP. For example, some believe that PrEP prevents individuals from getting pregnant.

  • Kelly
    25
    Advocacy

    Kelly got involved with ISHTAR in September 2013 as a volunteer. He became a receptionist in later that year 2013. Starting in September 2014, he switched to an administration and advocacy role. Kelly focuses and security of MSM by helping with health, finding a safe space, and helping them access justice. In his role, he meets with several clients, documents security incidents, educates patients, and advocates for patients.

    Some of the best practices Kelly has found include communication, commitment towards every client, and sharing experiences to help bond the clinic with the community. Kelly emphasizes that ISHTAR is a safe space. Every Friday, everybody comes together and spend time together singing, planning games, dancing, and having community parties.

DREAMS Initiative

The DREAMS Initiative is a multi-country program that helps adolescent girls and young women reach their potential and feel empowered. The DREAMS Initiative in Nairobi County, in partnership with SCASCO Kamukunji and Global Communities, supports adolescent girls and young women through three approaches. The first is a provision of services through safe spaces such as family planning, education, HIV testing, social asset building, cash transfer programs for households, and parental empowerment programs. The second approach is a men and boys community outreach program to educate and engage men in the health and wellbeing of their partners. The last approach focuses on systems strengthening by bringing together health institutions and supporting trainings for health professionals. There are currently 8,000 active DREAM girls, 45 male change agents and 44 parental supporters as part of this program in Nairobi. The program is also looking to integrate PrEP in the future. The DREAMS Initiative focuses on sustainability and building strong partnerships within the community.

  • Terry
    21

    Terry has been HIV positive since 2004 and at first faced fear and stigma. Since joining DREAMS, she has become more confident, particularly as a result of the classes at DREAMS. She feels empowered because she has more knowledge around family planning and increased financial capability. Terry advises other girls to be careful regarding HIV and family planning, especially at an adolescent age.

  • Yasmin
    21

    Yasmin joined DREAMS in October 2016. She lived with her step-father and mom who were very strict. Before DREAMS, she was abused by her step-father and did not feel like she could confront her mother about it. After joining DREAMS and through talking to a mentor, she was able to tell her mom and can now say “no” when her step-father makes advances. The clinic has also helped her improve her confidence and share her story with others. Yasmin also benefitted from financial training through the DREAMS initiative and was able to save enough money to start her own small cake business. She is looking forward to catering training in the future.

  • Akoth
    21

    Akoth lived in the Magengo slums as a single mom of a three-year-old. She was pregnant when she was 18 and felt humiliated to be pregnant at a young age. The father of the child denied any responsibility and her aunt kicked her out of the house so she went to live with her mother. A case worker went to Akoth’s to her house and introduced her to DREAMS. When she joined the program, she was put in a group of other single moms where she was able to discuss their problems and solutions in a safe space. She completed the entrepreneurial training and financial capabilities classes and had a business idea of selling peanut butter, which DREAMS helped start. Her mother used to give 50 Shilling per day for meals. From this, she managed to save 2.500 and used it to start her peanut butter business. On a good day, she now makes 1,000 Shilling and stays with her mom to help with rent and take care of her child. Her vision is to expand her business so she can employ other girls.

  • Kennedy Mbogo
    Program Officer, DREAMS Initiative

    Before DREAMS, Kennedy was working with an HIV program and reaching out to young people. He had an interest in prevention and engaging with young people. His day-to-day work at DREAMS includes empowering and building networks in the community. He consults with case workers and program officers that are working directly with the girls in the program. Kennedy has seen girls with no confidence and started their own businesses, girls that were not in school began going back to school, and girls who were engaged in risky behavior to sustain livelihoods find alternative safer options. He stresses the importance of girls being each other’s keepers and helping each other out.

Mentor Mothers

Mentor Mothers is a program in the Embakasi Health Centre which provides peer-led education and support for mothers.

  • Amina
    29
    Client and HIV testing and counseling (HTC) Counsellor

    Amina is a single mother of one. She worked as a mentor for Mentor Mothers for two years, and an HTC counselor for three years after getting a degree in psychology, and as a part-time saloonist. In 2007 Amina tested positive for HIV. However, she was in denial and gave birth to a baby boy who was also HIV positive and passed away.

    She found out in 2008 that she had herpes and went to the Embakasi clinic for treatment and also started ART at this time. During this time, she asked questions about getting pregnant while HIV positive and asked how she could have a HIV-negative baby. Amina got pregnant and learned about Mentor Mothers program at the clinic. They encouraged Amina and ensured her that the baby could be healthy. Amina also was introduced to a support group where she saw mothers with HIV-negative kids and was encouraged that she could also have a healthy baby and lead a happy life. Amina had her baby tested for HIV after six weeks, nine months, and 18 months. Her baby’s tests were negative each time. Her child is now seven years old and remains healthy. Amina’s favorite part of being a mother is telling other positive mothers that they too can have an HIV-negative child.

  • Stella
    23
    Peer Educator (3 years)

    Stella first tested positive for HIV when she was ten and didn’t believe the test results. At 13, she went with her sister to get tested again and once again tested positive. Her sister also did not believe that she was HIV-positive because she did not look sick. When her doctor gave her medication, she threw them back and left. At 15, Stella unsuccessfully attempted suicide three times. When she got pregnant at 17, she went to the clinic and tested positive, where she again did not believe the results. She was put in a support group and given ART, but did not take it. She started taking double doses of medication as an attempt to kill herself. After 2-3 days taking high doses, she got extremely ill and was admitted to the hospital for 2-3 weeks. Luckily, there was no miscarriage. After she was discharged, she went to stay with her sister, who warned her that her baby would also be HIV positive if Stella did not take her medication.

    Stella continued coming to the clinic and their support groups, where she received support from service providers who did home visits and counselled her and her sister. She finally accepted her status in 2012 after her baby was born and her life changed. She continued coming to Mentor Mothers was asked to be a peer educator. As a peer educator, she encourages youth and adolescents to get tested. For those who are HIV-positive, she continues to encourage them that their life will go on. She hosts monthly support groups for pediatrics and adolescents. Her favorite part is encouraging them to live a better life. For example, 15 of the adolescent clients she supports have gone back to school and some have gone to college, other clients have been able to discuss their HIV positive status with their families and get support. Stella stresses the importance of supporting PLHIV and reducing stigma. In 3-5 years, she would like to become a nurse.

Voluntary Medical Male Circumcision Clinic

The Edarp Mathare clinic provides Voluntary Medical Male Circumcision services. The clinic is a faith-based organization that opened in 2009 as a community health center and through community health worker referrals. Other free services include HIV counseling and testing (HCT) antenatal services, HIV/AIDS treatment and care, and TB diagnosis and treatment. To recruit men at VMMC, antenatal mothers are asked to bring their partners to also get tested. They also have community mobilizers that go to churches, schools, and other gatherings to spread awareness about their services. Around 80% of uncircumcised men that come VMMC learn about VMMC when they come for HCT or other services.

  • Gideon Omondi
    32

    Gideon learned about VMMC after being tested for HIV. He decided to get circumcised because he knew it was one method of HIV prevention and it helps reduce cervical cancer. He recommends men in the community to come get the procedure as well, even if they are scared and have to wait several months without engaging with partners. Gideon expresses a need for an increase of education in the corporate sector and work place.

  • Samuel
    VMMC Coordinator

    Samuel coordinates 14 facilities: seven have major operation theaters for circumcision and seven are outreach facilities. He works with the community at the clinic to prevent HIV/AIDS. VMMC has been his interest since his clinical officer training in college. When he left, he started working immediately to work at VMMC. He used to be a surgeon for VMMC and now has become a coordinator. He does mentoring and training for providers on medical male circumcision.

Mathare North Health Centre PrEP Services

The Mathare North clinic began providing PrEP when Kenya rolled out PrEP in April 2017. The clinic, which now has 69 clients, offers several services including voluntary counseling and testing and PrEP. The clinic uses TV advertisements and community health workers to advocate PrEP in the community. There are many incidences of women that have remarried or are with spouses that may have multiple partners who feel empowered from taking PrEP. The client population also includes several sero-discrodant couples and female sex workers.

  • Elizabeth
    Clinical Officer in CCC and PrEP Provider

    Elizabeth started working at the clinic in 2012 working with capacity building. She works with discordant couples, female sex workers, and the general population. Much of her work revolves around facility sensitization and training for community health workers to advocate for PrEP in their respective communities. She also does community outreach regarding other services, such as family planning and cervical cancer. She believes that community is responding well to PrEP and that it has helped empower women to protect themselves.

  • Winnie
    35

    Winnie heard about PrEP from a woman talking about it in the community. Once she learned about it, she went to the clinic and was screened for cervical cancer and tested for HIV. Now that she has started taking PrEP, she is always happy and doesn’t feel stressed because she knows she is protected from HIV. Winnie now educates people in the community about PrEP and encourages them to take it.

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