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Standard Digital: How ‘medicines first’ HIV policy is changing sex in Kenya

The World Aids Day observed yesterday also marked the fifth year since the US adopted a ‘medicines first’ HIV policy for Kenya and other donor recipient countries. Titled ‘Dollars to Results’ the policy has led to what doctors are calling over medicalisation of sex through HIV. The policy overseen by USAid since 2013, champions a model where pharmaceutical commodities represent top priority followed by treatment in which category fall health workers and medical infrastructure. At the bottom are behaviour change HIV prevention activities, which were anchored on abstention and faithfulness. The policy has partly been instrumental in doubling the number of Kenyans on antiretrovirals to more than one million in the last five years. According to the American NGO called AVAC, today about 9,000 Kenyans are on the daily HIV prevention pill initiative called Pre-Exposure Prophylaxis or PrEP. The US President’s Emergency Plan for AIDS Relief (PEPFAR) alone plans to bring another 5,000 Kenyans into the programme next year. By 2022, the Ministry of Health targets having 500,000 Kenyans on PrEP at a cost of Sh32 billion. The US driven PrEP was launched in May by the Ministry of Health alongside a home HIV testing kit. “Our work has never been so complicated,” says Ms Karen, 43, a sex worker and a peer educator with the Sex Workers Outreach Programme (SWOP) in Nairobi. SWOP is a project of the National Aids and STI Control Programme  (NASCOP) and the University of Manitoba Canada attending to more than 27,000 male and female prostitutes in Nairobi. “Unlike in the past where a condom was the much you need to report to work, today you prepare as you are going for war,” Karen said at her operational base, a bar along Luthuli Avenue in Nairobi. Karen explains despite many regrettable but necessary on the job risks, she is HIV-free but on PrEP to be on the safe side. Every day, she has to swallow a pill for protection against HIV infection. Read more at the Standard Digital.