Kenya | ICRH

Men who have sex with men are highly vulnerable to HIV/STI infection. The 2002 formative research by Horizons and ICRH revealed there are active Male sex workers in Mombasa and its environs and are increasing numbers and visibility. A capture- re-capture enumeration carried out early 2006 estimated over 739 MSW in Mombasa. Feedback from MSW indicated MSW are at high risk of HIV/STI infection and transmission due to their risky behaviours of multiple sexual partners, inconsistent condom use, and poor knowledge of STI prevention and high alcohol and drug use. Since the existing HIV/STI prevention programs have failed to reach MSW with information about MSW-specific prevention strategies, the intervention program overall objective was to address the sexual health needs of MSW within a highly stigmatizing and discriminatory environment and promote behaviour change among this population. 

Unsafe abortion remains a significant cause of maternal morbidity and mortality in much of the developing world. Its consequences place great demands on the scarce clinical, material and financial resources of hospitals in many developing countries. Studies have shown that abortion is widely practiced among sex workers which poses great health risks to the mother. In the just concluded Mombasa cohort study for estimation of HIV-1 incidence involving 400 FSW who were not pregnant at baseline, 27% (109/400) conceived within nine months of follow up. Informal discussions with these women revealed that many of these pregnancies were unintended despite continuous counselling and FP provision by the study staff indicating an unmet need for FP. The main aim of the study is assess the family planning needs and the consequences of unintended pregnancies among female sex workers in Mombasa, Kenya.  

Sex workers are commonly targeted for STI/HIV prevention interventions, but less attention has been directed toward sex workers’ contraceptive needs although they are at high risk of unintended pregnancy.  In addition to the health benefits of preventing unintended pregnancies, provision of contraceptive services to sex workers not desiring pregnancy is a means to reduce the number of unintended HIV positive births. This study identifies the contraceptive needs of Kenyan sex workers and the potential strategies for better meeting those needs.

There is an urgent need for female-controlled methods for HIV prevention. To date, candidate vaginal microbicides have been formulated predominantly as gels, films and suppositories. However, data suggests that compliance may be a critical factor in microbicides efficacy due to issues of gel acceptability and the fact that most gels are coital dependant.   The aim of the study is to assess the safety and acceptability of a silicone elastomer vaginal ring intended as a microbicide delivery method for the prevention of HIV infection when inserted in place for a 12 weeks period. .  

This study assessed health-related needs of people living with HIV/AIDS (PLWHA) who are not taking ARVs in Mombasa since there is little clarity on what happens to treatment-naïve HIV positive persons not accessing care and treatment services. This information is needed for the development of effective prevention services with positive people in the community. The study seeks to address the information gap with regard to identifying and accessing treatment-naïve HIV positive persons in the community. It explores attitudes, knowledge and access to prevention messages, sexual risk behaviours, stigma and discrimination amongst the treatment-naïve HIV positive people

The study prepares two sites (in Kigali and Mombasa) for Phase I, II and III clinical microbicide trials.

The overall objective of this project is to develop and apply dynamic epidemiological microsimulation models to assess the expected impact of microbicides on HIV incidence and HIV prevalence. These models will be applied in a population of female sex workers and their clients in Mombasa, Kenya. The expected impact of microbicides on HIV incidence and HIV prevalence is a function of the intrinsic efficacy of the modeled microbicide and the behavioral, demographical and epidemiological dynamics of the population in which the microbicides are introduced.

Topical microbicides are products designed to prevent the sexual transmission of HIV and other disease pathogens. Potentially, they can be applied vaginally to prevent both male-to-female and female-to-male transmission. They may also offer back-up protection in the event that condoms fail. In addition, they may be used by HIV-discordant couples who wish to bear children. Currently, approximately 20 products have been assessed in Phase I clinical studies, and five prod­ucts are being evaluated in large-scale safety and effectiveness studies. The aim of the study was to evaluate the feasibility of establishing a new site for microbicide clinical trials in Mombasa District, Kenya, by conducting a cohort study among women with high risk behaviour for HIV-1 infection. Previous planning efforts have indicated that microbicide effectiveness studies will require the participation of several thousand women at high risk for HIV infection. In addition to accruing large numbers of participants, research centers conducting microbicide effectiveness studies must retain participants for extended periods of follow-up in order to preserve the validity, as well as the statistical power, of the study. Also, to provide evidence that rates of new HIV infection among target populations for future microbicide studies will support the requirements for effec­tiveness trials, one step in site development is the conduct of a cohort study.