ICRH Kenya

Control and Prevention of STD and HIV in Kenya

OBJECTIVES

  • To reduce the sexual transmission of HIV infection and STI and to decrease the complications of STI.

METHODS 

  • Improving service delivery in the field of STI, both curative and preventive in public health care facilities;
  • Enhancing the level of knowledge concerning HIV/AIDS/STI of health care workers and of thecommunity;
  • Operational research aimed at optimising the existing health systems.

RESULTS 

  • This project has, together with other interventions in Kenya aimed at improving STD/AIDS control, had a substantially impact on the prevalence and incidence of STD and HIV infections in the country.
  • Data have shown that there has been a decline in syphilis in pregnant women, a decrease in the number of patients attending STD services, a decline in prevalence of STD as chancroid, chlamydia and gonorrhoea and decreasing HIV prevalence among young women in the project areas over the recent years.
  • Outputs of the project include improved service delivery and physical infrastructure. STD case management including health education, HIV counselling and testing and laboratory strengthening, was improved at the STD referral clinic in Nairobi and Mombasa as well as in several peripheral health centres in both locations.
  • Syphilis screening among pregnant women in Nairobi as well as in Mombasa was implemented. Supervision and monitoring activities were enhanced.
  • Quality control of the syphilis test was initiated.
  • Renovation of the STC clinic and rehabilitation of the Ganjoni clinic were completed.
  • Another important output has been the improved qualification of health personnel managing the STD services. This has been achieved through an intensive training programme: specialised medical training in England was offered to staff of the STD referral clinic; the nursing staff of all clinics involved was trained in STD case management; a selected group ofnurses of both project sites underwent the intensive counselling training; training material as well as journals and books were purchased; laboratory staff attended refresher courses at the Department of Medical Microbiology, University of Nairobi; support staff was trained in computer use.
  • Two Regional Anglophone African AIDS/STD managers’ courses were organised in Nairobi in 1996 and 1998. Participants from various African countries attended. The facilitators and presenters were local as well as international experts in the field of STD/HIV/AIDS.
  • As part of the project, operational and clinical research was carried out in order to assess and improve the effectiveness of the interventions. Research was carried out on a) Aetiology of urethritis; b) Pattern of STD among women; c) Validity of the vaginal discharge algorithm; d) Health care seeking and sexual behaviour; e) Quality of STD care; f) Impact of the syphilis screening programme; g) Cost-effectiveness of syphilis screening; h) KAP on emergency contraception. The results of these research activities has been published in international journals: Int J STD AIDS. 1999 Jun;10(6):405-8; Int J STD AIDS. 1999 Aug;10(8):543-7; Int J STD AIDS. 2000 Apr;11(4):257-61; Sex Transm Infect. 2000 Feb;76(1):33-8; Sex Transm Infect. 2000 Apr;76(2):117-21; Sex Transm Dis. 2000 Aug;27(7):417-23;  Am J Public Health. 2001 May;91(5):705-7; Sex Transm Dis. 2001 Jul;28(7):367-71; Sex Transm Infect. 2001 Aug;77(4):271-5; Sex Transm Dis. 2002 Feb;29(2):106-11;  Acquir Immune Defic Syndr. 2002 May 1;30(1):69-72; JAMA. 2004 Jun 2;291(21):2555-62; AIDS Behav. 2005 Sep;9(3):335-9.