Meet Carol - a Friendly Rectal Microbicide Advocate

Check out this interesting mini-bio of Carol Odada, the latest in IRMA's "Meet a Friendly Rectal Microbicide Advocate" series on the IRMA website here.  Carol is one of six new bios just posted yesterday, including individuals from Thailand, Kenya and the US.  Each will be featured on the blog, and you can read all of them here right now.



Carol Odada
Nairobi, Kenya

"I stand out strongly as a women's rights champion, and am quite steadfast on the human need for rectal microbicides."

Carol received a Bachelor of Arts degree from the University of Eastern Africa. Since graduating, she has focused on social work, and has helped to develop and implement care and support programs for people living with HIV. She currently works in biomedical HIV prevention research advocacy, and enjoys advocating for women's rights and sexual health rights.

Carol became involved with IRMA when the topic of rectal microbicides was still a relatively new in Kenya. In December of 2011, Carol was one of a number of African leaders who joined IRMA for a two-day strategy meeting in Addis Ababa, Ethiopia that took place in advance of the 16th International Conference on AIDS and STIs in Africa. The meeting officially launched IRMA's Project ARM - Africa for Rectal Microbicides initiative. IRMA recently released a report from that meeting called "On The Map: Ensuring Africa's Place in Rectal Microbicide Research and Advocacy" recommending a set of priority actions for IRMA and allies to better engage Africans across the continent in rectal microbicide activities. Carol played a very important role in helping define those strategies. Learn more about Project ARM, and read the report, here.

She understands that different prevention strategies need to be developed to provide sexual health to the world's population and that rectal microbicides will provide a new tool for women and men regardless of sexual orientation. Specifically, she educates women, young and old, about anal sex.

Currently, Carol is working on a collaboration between AVAC and ATHENA Network called WHiPT - Women's HIV Prevention Tracking Project.

She will soon be a featured speaker in the satellite session "Rectal Microbicides: Making HIV Prevention Gel" at the International AIDS Conference in Washington, DC with other members of IRMA and allies. The session is taking place in the afternoon on Sunday, July 22, 2012 - more info on this event can be found here.

Carol encourages IRMA to keep pushing forward, and believes that a day will come when all of the group's collective work and efforts are fully appreciated.

HIV has taught her to value every person and every opinion. And her five-year-old daughter gives her a reason to wake up and work hard every day. Because of her daughter's influence, she strives to be a better person and tries to give back to the community as much as she can.

Thank you, Carol, for all that you do!


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*Join IRMA's robust, highly-active. moderated, global listserv addressing rectal microbicide research and advocacy as well as other interesting new HIV prevention technologies by contacting us at rectalmicro@gmail.com. Joining our listserv automatically makes you a member of IRMA - a network of more than 1,100 advocates, scientists, policy makers and funders from all over the world.

*Please look for us on Facebook: www.facebook.com/InternationalRectalMicrobicideAdvocates, and you can follow us on Twitter: @rectalmicro.

*Also, please note that shared news items from other sources posted on this blog do not necessarily mean IRMA has taken any position on the article's content.
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Married 'Heterosexual' Kenyan Men Who Have Sex With Other Men Form Support Group

via Identity Kenya

A new group of otherwise heterosexual men who engage in sexual activity with other men has been formed to create awareness on HIV and also fight blackmail that most of their members have fallen prey to.

The group, Married Men Initiative (MMI), so far, boasts of fifty to sixty married men who meet regularly in social places to talk and interact.

‘Over 90% of the members are married to women; some have children from their marriages and the other 10% consists of men with girlfriends or are live-in marriages,’ said Samuel Kabuga*, one of the members to Identity Kenya.

Most of the members are deeply closeted out of fear of being outed and to avoid blackmailing by those who take advantage of their marital status. Apart from the risk of contracting HIV through unprotected anal sex, most married men face also face extortion from some of their boyfriends.

‘One of the main reasons we formed the group was to offer support and aid to those members who had fallen prey to blackmailers. These are people, who after sex, demand for money and knowing that we are married or in the closet, take advantage of that,’ said Otieno*, a member said.

Read the rest.


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*Join IRMA's robust, highly-active. moderated, global listserv addressing rectal microbicide research and advocacy as well as other interesting new HIV prevention technologies by contacting us at rectalmicro@gmail.com. Joining our listserv automatically makes you a member of IRMA - a network of more than 1,100 advocates, scientists, policy makers and funders from all over the world.

*Please look for us on Facebook: www.facebook.com/InternationalRectalMicrobicideAdvocates, and you can follow us on Twitter: @rectalmicro.

*Also, please note that shared news items from other sources posted on this blog do not necessarily mean IRMA has taken any position on the article's content.
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Kenya's HIV Challenge: Easing Stigma For Gay Men

via NPR, by Jason Beaubien

Health officials in Kenya say reducing the transmission of HIV among gay men is a central part of their national AIDS strategy. But they face serious challenges, including the fact that homosexuality is still a crime in the East African nation.

HIV rates among gay and bisexual men in Kenya are far higher than the national average.

Mutisiya Leonard, who runs an HIV prevention, treatment and support program for men who have sex with men in northwestern Kenya, says homosexuality is so stigmatized in Africa that many men don't want to refer to themselves as gay. This makes reaching them with safe-sex messages and HIV-prevention campaigns difficult. These men are reluctant to seek medical care for sexually transmitted diseases, he says, and they don't want to get tested for HIV.

Nationwide, roughly 6 percent of adults in Kenya are infected with HIV. But the rate among men who have gay sex is more than three times the national average. Among male prostitutes in the capital, Nairobi, 41 percent are infected.

In order to address HIV in any community, health workers need to be able to get people to talk frankly and honestly about their sex lives. But Leonard says gay men in Kenya face stigma, discrimination, violence and even jail if they come out of the closet. "The fear of the law, the fear of arrest makes it difficult for people to be open about it," he says.

Read the rest.


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*Join IRMA's robust, highly-active. moderated, global listserv addressing rectal microbicide research and advocacy as well as other interesting new HIV prevention technologies by contacting us at rectalmicro@gmail.com. Joining our listserv automatically makes you a member of IRMA - a network of more than 1,100 advocates, scientists, policy makers and funders from all over the world.

*Please look for us on Facebook: www.facebook.com/InternationalRectalMicrobicideAdvocates, and you can follow us on Twitter: @rectalmicro.

*Also, please note that shared news items from other sources posted on this blog do not necessarily mean IRMA has taken any position on the article's content.
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Meet Peter - A Friendly Rectal Microbicide Advocate from Kenya

Check out this interesting mini-bio of Peter Michira, the latest IRMA's "Meet a Friendly Rectal Microbicide Advocate" series on the IRMA website here.  Peter is one of six new bios just posted yesterday, including individuals from Thailand, India, the UK, the US and Argentina. Each will be featured on the blog, and you can read all of them here right now.




Peter Michira
Thika, Kenya

"Unprotected anal sex is one of the most efficent modes of HIV transmission, yet it is clouded by myths, stigma and silence."

Peter is an IRMA Advocate and works as the field coordinator for the Partners PrEP study in Thika, which is one of the nine sites located in East Africa. Peter loves working with his community and sharing and learning knowledge from his interactions with people. He also enjoys reading about new interventions and learning more about the best community practices. Peter socializes with his friends and family, and loves watching football.

Peter first became involved with IRMA after attending the Project ARM - Africa for Rectal Microbicides strategy meeting in Addis Ababa, Ethiopia. He was one of 16 individuals who received scholarships to attend, earning his spot to attend through a very competitive process that included 145 applicants. Using the new Project Arm strategy document, "On The Map: Ensuring Africa's Place in Rectal Microbicide Research and Advocacy," Peter works to sensitize various community and health workers on the need to integrate safe anal-sex communication into HIV prevention activities. He also informs the community about the importance of an effective rectal microbicide, something that could prevent many infections among men, women, and transgender individuals.

Peter's advice for IRMA is to keep the fire burning. Knowledge is power, and Peter insists on the continuous sharing of information.

Peter's biggest influence has come from the community's reaction and reception to new practical ideas. He has been inspired by the knowledge base and realization that communities are equal partners in HIV prevention.

Thank you Peter for all that you do!


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*Join IRMA's robust, highly-active. moderated, global listserv addressing rectal microbicide research and advocacy as well as other interesting new HIV prevention technologies by contacting us at rectalmicro@gmail.com. Joining our listserv automatically makes you a member of IRMA - a network of more than 1,100 advocates, scientists, policy makers and funders from all over the world.

*Please look for us on Facebook: www.facebook.com/InternationalRectalMicrobicideAdvocates, and you can follow us on Twitter: @rectalmicro.

*Also, please note that shared news items from other sources posted on this blog do not necessarily mean IRMA has taken any position on the article's content.
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Meet George Victor Owino: Our Newest Friendly Rectal Microbicide Advocate!

“You should try being an IRMA advocate; you will love the energy and drive you get from it. If you can say rectal microbicides to over 100 people, you can sell anything to anyone on this earth!”

George is an IRMA advocate from Nairobi, Kenya. There he is the Project Coordinator and Health Educator at Ishtar MSM - a community based organization whose mission is to attain full sexual health rights and social well being for MSM in Kenya. He is also a Board Member at GALCK - the Gay and Lesbian Coalition of Kenya. His passions are to advocate for and research issues surrounding access to stigma and discrimination free healthcare for the LGBTI community, environmental conservation, and human rights in general. He also loves to watch horse racing!

He first became familiar with IRMA when a colleague sent him the application to apply for a scholarship to the Project ARM - Africa for Rectal Microbicides meeting in Addis Ababa this past December, in conjunction with ICASA. He was one of 16 people chosen and was surprised to see how vibrant the rectal microbicide movement in Africa had become! He had heard of rectal microbicides and IRMA before, but said he was not aware that such support existed for them in Africa.

George believes rectal microbicides are important to include in a comprehensive approach to combating HIV. He frequently hears stories of condoms bursting and allergies to latex in his work, and he thinks rectal microbicides would be able to help a lot in these situations. “A rectal microbicide would give human beings the power to have safer sex, protect themselves and their partners from infection, and reduce new infection and re-infection,” he said.

He talks about rectal microbicides any time he has the opportunity. He believes that we all have to integrate them into open forum discussion more to help lessen the stigma that surrounds them. The best way to deal with stigma is to face it head on.

Thanks George for all that you do!


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

MSM in Africa: Highest Risk Group?

via Aidsmap, by Gus Cairns

Men who have sex with men may now be at considerably higher risk of acquiring HIV than other at-risk groups such as female sex workers or young people of either sex, if findings by the International AIDS Vaccine Initiative (IAVI) of HIV incidence at two centres in Kenya can be generalised to other populations.

The study, which compared the Kenyan populations with a largely heterosexual group from South Africa, also found lower-than-expected HIV incidence amongst female sex workers and their clients. The researchers also found that recruiting MSM into the study was easier than expected, but note that there was a particularly high dropout rate in MSM.

They comment that while MSM “need urgent risk reduction interventions, and may be a suitable cohort for future HIV prevention studies,” because African MSM face considerably legal and social hurdles in coming forward, “careful consideration of the counselling and clinical needs, follow-up schedule and social support is vital to ensure continuing research participation.”

The study

The aim of the study was to collect data on HIV and STI incidence and risk factors in three populations in Kilifi, a district north of Mombasa, and the Kangemi district of Nairobi, both in Kenya, and from Gugulethu township in Cape Town in South Africa, the better to target HIV vaccine trials.

The researchers recruited 716 people in Mombasa, 653 in Nairobi and 465 in Cape Town, The researchers primarily used participants to recruit their peers in South Africa, where background HIV prevalence at 28% is ten times higher than in Kenya, but in Kenya recruited attendees at HIV testing centres, via outreach work in bars and brothels, and via ‘snowball’ sampling (asking members of a particular group to recruit others from the same group). The original idea had been to collect data on high-risk heterosexuals including sex workers but, as the researchers comment, “it quickly became apparent that MSM were willing to come forward and participate in HIV prevention research”.

Somewhat different monitoring and follow-up criteria were used in the three centres. In Cape Town participants were monitored monthly and followed up for one year while in the two Kenyan cohorts participants were monitored quarterly for two to four years. In Mombasa participants were examined for STIs at every visit but in Nairobi and Cape Town only examined if they had symptoms. As a result annual STI incidence was much higher in Mombasa (23%) than in the other two centres (3.7% and 4.4%).

The average ago of participants was mid-20s (slightly older in Nairobi); nearly 70% were women in Cape Town, 50% in Nairobi and 36% in Mombasa. Participants in Capt Town were almost entirely heterosexual men and women and were not sex workers.

In Mombasa 56% of men (36% of the study population) was an MSM; 63% of men said they had sold sex (mainly to other men) and 54% had bought it.  Three-quarters of female participants said they were female sex workers while one in 20 women said they had bought sex.

In Nairobi nearly all women defined as a sex worker and 85% of the men had bought sex; 22.5% of the men had had sex with other men and 33% defined as a male sex worker.

There was a high dropout rate in the study: 13% did not return after their enrolment visit, 37% altogether left the study prematurely. Annual attrition rates were 22% in Cape Town, 20% in Mombasa and 10% in Nairobi.

Read the rest.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Identifying at-risk populations to enroll and maintain in HIV prevention trials

via PubMed, by Price MA, Rida W, Mwangome M, Mutua G, Middelkoop K, Roux S, Okuku HS, Bekker LG, Anzala O, Ngugi E, Stevens G, Chetty P, Amornkul

"Finding, enrolling, and retaining risk populations for HIV prevention trials is challenging in Africa. African MSM are not frequently engaged for research, have high HIV incidence, need urgent risk reduction counseling, and may represent a suitable population for future HIV prevention trials."

Objective

To identify and describe populations at risk for HIV in 3 clinical research centers in Kenya and South Africa.

Design

Prospective cohort study.

Methods

Volunteers reporting recent sexual activity, multiple partners, transactional sex, sex with an HIV-positive partner, or, if male, sex with men (MSM; in Kenya only) were enrolled. Sexually active minors were enrolled in South Africa only. Risk behavior, HIV testing, and clinical data were obtained at follow-up visits.

Results

From 2005 to 2008, 3023 volunteers were screened, 2113 enrolled, and 1834 contributed data on HIV incidence. MSM had the highest HIV incidence rate of 6.8 cases per 100 person-years [95% confidence interval (CI): 4.9 to 9.2] followed by women in Kilifi and Cape Town (2.7 cases per 100 person-years, 95% CI: 1.7 to 4.2). No seroconversions were observed in Nairobi women or men in Nairobi or Cape Town who were not MSM. In 327 MSM, predictors of HIV acquisition included report of genital ulcer (Hazard Ratio: 4.5, 95% CI: 1.7 to 11.6), not completing secondary school education (HR: 3.4, 95% CI: 1.6 to 7.2) and reporting receptive anal intercourse (HR: 8.2, 95% CI: 2.7 to 25.0). Paying for sex was inversely associated with HIV infection (HR: 0.2, 95% CI: 0.04 to 0.8). 279 (13.0%) volunteers did not return after the first visit; subsequent attrition rates ranged from 10.4 to 21.8 volunteers per 100 person-years across clinical research centers.

Conclusions

Finding, enrolling, and retaining risk populations for HIV prevention trials is challenging in Africa. African MSM are not frequently engaged for research, have high HIV incidence, need urgent risk reduction counseling, and may represent a suitable population for future HIV prevention trials.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Kenyan ex-pat (and IRMA Steering Committee Member) aims to help gay countrymen

[We are so proud of IRMA Steering Committee Larry Misedah - shown on the left in the pic below. His compelling story is a must-read. Of note, Larry will be joining a group of IRMA members in Addis Ababa this December for Project ARM - Africa for Rectal Microbicides organizing and strategizing activities taking place in advance of the ICASA 2011 conference.]


via Bay Area Reporter, by Heather Cassell

Excerpt:

Until recently, Kenyan LGBT individuals were isolated, believing they were the only ones in their community; some expressed the desire to take their own lives, said Misedah. Older gay and lesbian individuals were forced to marry people of the opposite sex. Younger queer Kenyans felt comfort from their problems with alcohol, said Misedah, who also felt the cold hand of isolation until he came out.

Coming out liberated Misedah, he no longer suffered from the isolation and instead became a beacon for others.

"I felt sort of obliged in order to speak for those who did not have a voice," said Misedah. "I just felt that we needed to speak more and let the society know the challenges that LGBTI people were facing."

He worked first with Ishtar MSM, one of Kenya's first organizations to provide health services to men who have sex with men. He served as the spokesman for Sexual Minorities Uganda's first media campaign. Misedah, in collaboration with IGLHRC, drafted the first Declaration on Transgender Rights for Central and East Africa in 2007 and continued to work on capacity building in Africa with IGLHRC. He spoke at the African AIDS conference in 2009.

Misedah, among others, risked the threat of up to 14 years of imprisonment under Kenya's penal codes sections 162 and 165 for attempted or homosexual behavior under "carnal knowledge against the order of nature."

Misedah, who came from a well-to-do family, found himself banished from his family and cut off from his educational support at the university, where he eventually obtained his bachelor's degree in environmental planning and management, he said.

Usually, families look the other way in regards to their LGBT family members who have financial resources and contribute to their families. Poor queer Kenyans, however, often find themselves in "deep trouble," said Misedah.

Read the rest.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Non-communicable diseases (NCDs) and HIV fight for resources in Kenya

via PlusNews Global

"NCDs are sexy now, last year it was maternal health; there doesn't seem to be a genuine commitment by government to fully address any of these issues... where are the results? The government must not forget about people living with HIV," said James Kamau, coordinator of the Kenya Treatment Access Movement. "Where is the 15 percent they promised - that way, we could improve treatment of all illnesses."

The crowd of health issues jostling for a share of Kenya's inadequate health budget is expanding, with activists calling for an increase in resources for the management of non-communicable diseases (NCDs), which account for more than 50 percent of hospital deaths and admissions.

"We need to see more commitment in terms of resources; we have policies and guidelines for the management of non-communicable illnesses, but we need strategic focus on operational implementation," said Andrew Suleh, medical superintendent of Mbagathi District Hospital in the Kenyan capital, Nairobi.

According to the NGO, NCD Alliance, NCDs are responsible for more than half of all hospital admissions and deaths; 13 percent of deaths are due to cardiovascular disease, while cancers account for 7 percent and diabetes for 4 percent of deaths, respectively.

Read the rest.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

New Guidelines on HIV Programming for MSM

Via IRIN.

HIV and gay rights activists say new guidelines released by the UN World Health Organization (WHO) on HIV programming for men who have sex with men (MSM) will not only improve health service provision for MSM, but will also act as an advocacy tool in the fight for the rights of this marginalized population.

"The document provides well-researched and evidence-based recommendations for HIV prevention and treatment of MSM, which will be useful for clinicians," said Kevin Rebe, a doctor with Health4Men, a South African health service provider which caters specifically for MSM. "The language of the paper is couched in human rights, and makes a strong call for decriminalization of same sex sexual activity, so it will also be useful for activists seeking to end discrimination."

The guidelines are designed for use by national public health officials and managers of HIV/AIDS and STI (sexually transmitted infections) programmes, NGOs and health workers. They contain MSM-specific programme activities such as the use of water- and silicone-based lubricant for the correct functioning of condoms during anal sex.

The guidelines do not advise medical male circumcision - a measure WHO recommends for HIV prevention among heterosexual men - for HIV prevention among MSM due to the lack of sufficient research on its effect of its use in MSM sexual activity.

They further recommend that health services adhere to the principles of medical ethics and the right to health, and ensure that MSM feel comfortable enough to seek medical care, with MSM-specific health needs catered for within national health systems.

"Like many other African countries, all men in South Africa are assumed to be straight, so health workers are not aware of the need to identify people of different sexualities during consultations; outside of centres like ours, there is little competency in providing health care to MSM," said Rebe. "By availing this knowledge, the guidelines will empower health workers to provide better care to MSM."


Wake-up call

In countries like Uganda, where homophobia is deeply entrenched both within society and the law, gay rights groups hope the new guidelines will serve as a wake-up call to the government about the need to include MSM in HIV programming.

"I hope the new guidelines will be an eye-opener to the government, who have so far ignored MSM within HIV prevention, treatment and support; it should show them that MSM exist in Uganda and are at high risk," said Frank Mugisha, executive director of the NGO Sexual Minorities Uganda. "They therefore cannot be ignored and urgently require HIV interventions."
 
Read the rest here.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

New Light Shed on Male Sex Work

Via PlusNews.

Commercial sex work, dominated by a focus on women, could be redefined as new research launched today in Nairobi, Kenya, sheds light on the complicated HIV prevention needs of what may be Africa’s most deeply underground group at high risk of HIV - male sex workers.

The report co-authored by the United Nations Development Programme (UNDP) and South Africa's Sex Workers Education and Advocacy Taskforce (SWEAT) seeks to better understand the social contexts, sexual practices and risks, including that of HIV, among these men.

The professional debut of many of the 70 male sex workers surveyed in Kenya, Namibia, South Africa, Uganda and Zimbabwe was often prompted by the family rejecting the men’s sexual orientation; for others, it was a way to survive in a foreign country.

Men reported being at risk of HIV in many ways, including the unavailability of speciality health services, the premium clients placed on unprotected sex, violence and the lure of substance abuse. Although the work often placed them at risk of substance and physical abuse as well as HIV infection, the researchers found that it also provided the men with a sense of freedom and empowerment.

The report cautions that mitigating these risks may require specialised HIV prevention services unlike those targeted at female commercial sex workers or men who have sex with men (MSM).

A series of interviews with male sex workers at a five-country workshop in Johannesburg, South Africa, and country visits to Kenya and Namibia has produced a significant addition to the paucity of data on male sex workers, according to Paul Boyce, a UNDP researcher.

While data on MSM from Malawi, Namibia and Botswana indicated that about 17 percent were HIV positive - almost twice the national prevalence rates of their respective countries - not much has been written on the specific HIV risks of male sex workers, which may be higher than those of MSM.

While male sex workers reported working at a range of venues, including Namibian truck stops and Zimbabwean mines, most of the available information on male sex work has come from those operating in the sex tourism hot spot of Mombasa, Kenya, with limited data from a 2009 study in South Africa that showed male sex workers were twice as likely to engage in anal sex than MSM who were not selling sex.


Not necessarily the same old risks:

Unprotected receptive anal sex carries almost 20 times the HIV risk associated with unprotected vaginal sex.

Interviewees told researchers that the unavailability of water-based lubricant, which reduces the risk of condoms breaking during anal sex, and the higher financial reward of unprotected anal sex, made consistent condom use difficult.

Some clients forced unprotected intercourse on sex workers, while others admitted to practicing unsafe sex due to the disinhibition often brought about by the drug and alcohol abuse that is reportedly part of the social scene in sex work. Drugs and alcohol also helped the men mentally cope with the omnipresent risks of this lifestyle, including police harassment.

South African male sex workers said substance abuse - not HIV infection - was the greatest threat to their health.

Those who tried to access health services for HIV testing and treatment, or the diagnosis of sexually transmitted infections (STIs), reported being ridiculed and stigmatized by health workers, even in countries like Kenya, where the Ministry of Health has introduced new guidelines on MSM and sex work, and health and HIV.

"[At the] government hospital, the nurses just [stand] in front of everyone and shout out loud to the people waiting for assistance: 'If you have HIV, go to room nine, TB room 12, STD [sexually transmitted disease] room 8,'" said one man quoted in the report.

Read the rest here.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

KENYA: Rural MSM Too Afraid to Access HIV Health Services

Via PlusNews.

Discriminatory laws and a largely homophobic society mean that men who have sex with men (MSM) in Kenya generally find it difficult to access HIV-related information and health services, but rural MSM have an especially hard time.

When Kibet Kipsowen*, 30, a cattle keeper in Kenya’s Rift Valley Province, and his partner have sex, they use the oil-based jelly he applies when milking his cows; he’s never heard of a water-based lubricant, let alone used one. “Milking jelly is the only lubricant I have known for the last four years,” he told IRIN/PlusNews at his home in the village of Lanjuera.

Health practitioners discourage the use of oil-based lubricants for anal sex, as the oil degrades condoms, increasing the likelihood that they will break. Studies have found that most African MSM use oil-based lubricants, heightening their risk of contracting HIV.

According to a 2008 Modes of Transmission study conducted by UNAIDS and the government, MSM and prisoners account for 15.2 percent of new HIV infections in Kenya annually.

Kipsowen and his partner have been an item for a few years now, but dare not let anyone in their village know they are a couple. “Even people who have ‘normal’ sex do not speak about it - I can never reveal my sexuality or else I would risk being an outcast, or even be killed,” he said.

The only other person in the village who knows about his sexuality is Soita Wellapondi, a local nurse and social worker, and that’s only because Kipsowen visited her when he developed a sexually transmitted infection.

“At that time I had a lot of wounds in my anus; I felt so much pain that I thought I would die, yet I could not even confide to my own mother, brother or sister, and I could not visit a health centre,” he said.

He knew that by confiding in Wellapondi he risked his secret being revealed to the community, but he felt she was his only chance of accessing health care. “I bought him some antibiotics and pain killers; it was absolutely impossible to convince him to visit a health centre, even one far away where he is not known,” said Wellapondi.

Local health workers have very little experience and no training in dealing with MSM. A clinical officer at the Mogotio health centre near Lanjuera says he has only ever had one MSM client.

Even people who have 'normal' sex do not speak about it - I can never reveal my sexuality or else I would risk being an outcast or even be killed“He came here for treatment of injuries resulting from anal sex, and was advised to come for further treatment but he never came back,” said the clinical officer, who declined to be named.

Read the rest here.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

KENYA: Protest as government grapples with HIV funding shortages

via PlusNews

Hundreds of Kenyan AIDS activists held a protest on 18 May in the capital, Nairobi to demand that the government meet its commitment to increase annual health and HIV funding.

"The Minister of Finance promised an annual budgetary allocation increase of 10 percent to health and HIV - we demand that this promise be kept," Davis Njuguna, an AIDS activist with the National Empowerment of People living with HIV/AIDS in Kenya (NEPHAK), told IRIN/PlusNews during the rally. "We cannot pledge to end AIDS without increasing funding to it. Access to HIV treatment is a right and we are not accepting lip service any more."

Marching along Nairobi's busy Thika Road, protesters waved posters urging Finance Minister Uhuru Kenyatta and US President Barack Obama - who pledged during his presidential campaign to provide US$50 billion to fight HIV globally by 2013 - to keep their promises. Other placards read, "You Talk, You Talk, We Die!" and "Broken Promises Kill!"

Read the rest.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

LGBT activist talks challenges in Kenya

via Yale Daily News, by Mohammad Salhut

In Kenya, even some health workers who provide services to men who have sex with men are homophobic, LGBT activist Rachel Mandel said.

Mandel, a former employee for the International Center for Reproductive Health, spoke to 12 professors and graduate students in Luce Hall Wednesday about the difficulties of advocating for gay rights in Kenya through public health organizations.

While employees of these organizations aim to improve health standards for local communities, Mandel said often the employees do not support their patients’ sexual orientations and act in homophobic ways.
 
“The whole gay rights thing has a whole different place there than it does here,” she said.

Part of the problem, Mandel said, is the large chasm between what the administrators of non-profit organizations think is happening on the ground, and what is actually taking place.

Despite the organizations’ policies on equal treatment for patients, many employees at the two organizations Mandel worked for were “incredibly” homophobic, she said.

“The first time that I went I had tour of city of Mombasa by a staff member of ICRH,” she said. “At one point during the car ride he talked about homosexuality and referred to it as a psychological distortion. This same employee later became the head of the [Men who have sex with men] project.”

Read the rest.

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Kenya: Ongeri Warns Students On Homosexuality

Via allAfrica.com, by Henry Wanyama (reported April 19)

EDUCATION minister Sam Ongeri yesterday asked students to shun homosexuality. Ongeri said homosexuality is one vice that the ministry for education must stump out. He said: "I am not threatening anybody but you all know that homosexuality is illegal." Ongeri spoke at the Bomas of Kenya when he opened the third national students' leadership conference. The conference has attracted 1,500 student leaders from across the country who are deliberating on the theme: Education Reforms, Students Perspective.

The minister said, however, he had no clue on the extent of homosexuality but asked teachers, students and everybody in society to know one another so as to be able to fight the vice.

"Homo sexuality is unhealthy and does not add any value to your life. Those who practise are easily infected with HIV/Aids," Ongeri said. He told students that as leaders in their respective schools they should help defeat the vice and the Education ministry is ready to render support. Ongeri said the student leaders' contribution at the conference will be taken to account by the task force collecting views on how the current education system can be aligned to the new constitution.

The minister revealed that very soon the ministry will launch a management guide to extracurricular activities. He also called on students to act as a cushion to society as we approach the 2012 general elections and not to be incited by politicians.

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Kenya: Counselling, not alarm device, had best effect on ART adherence

Via aidsmap, by Carole Leach-Lemens

Patients in Nairobi, Kenya getting intensive early adherence counselling when starting antiretroviral therapy were 29% less likely to have poor adherence and 59% less likely to have virological failure compared to those getting no counselling Michael H Chung and colleagues reported in a randomised, controlled trial published in the March issue of PLoS Medicine.

The positive effects of counselling on adherence were seen immediately after starting antiretroviral therapy and maintained throughout the18 month follow-up period. Use of an alarm device had no effect on adherence or virological outcomes. Public health concerns that scale-up of antiretroviral treatment in sub-Saharan Africa would lead to poor adherence and widespread drug resistance have been proven wrong, note the authors.

The authors conclude “as antiretroviral treatment clinics expand to meet an increasing demand for HIV care in sub-Saharan Africa, adherence counselling should be implemented to decrease the development of treatment failure and spread of resistant HIV.”

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Fearing No Evil

Via Poz, by Regan Hofmann with Oriol R. Gutierrez Jr.

David Kuria works for the Gay and Lesbian Coalition of Kenya where he risks his life daily to provide safe sanctuary and advocacy for the rights of lesbian, gay, bisexual and transgender people in Africa and around the world.

Now, he is running for Kenya’s Senate. A basic tenet of his work is showing that a global push for gay rights helps bolster the fight against HIV. His dream? A day when no LGBT person has to choose between being openly gay—or being killed.

In October 2009, David Bahati, a member of Uganda’s parliament, proposed an “Anti-Homosexuality Bill” (a.k.a. the “kill the gays bill”). It was an attempt to legalize a phenomenon spreading around the world: hate crimes against gay people.

Homosexuality is currently illegal in Uganda (and can result in up to a 14-year jail sentence); Bahati’s proposed bill intensifies the criminalization of homosexuality by introducing the death penalty for people who have previous convictions, are HIV positive, or engage in same-sex acts with people younger than 18. The bill also includes provisions for Ugandans who engage in same-sex relations outside the country—people can be sent back to Uganda for punishment.

Not that there are many safe places to go; laws against same-sex relations exist in nearly 80 countries. Finally, the bill outlines penalties for individuals, companies, media organizations or nongovernmental organizations that support LGBT rights. (As in, if you know your neighbor’s gay and don’t say so, you can get into huge trouble yourself.) It engenders nothing short of a witch hunt.

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[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Kenya: Testing the Integration of HIV and public healthcare

Via PlusNews

HIV could lose its "special status" in Kenya's health system if a new pilot programme integrating HIV care and public healthcare proves successful.

Traditionally, public hospitals in Kenya have a "comprehensive care clinic" (CCC) dedicated to people living with HIV; under the new system, these would no longer exist.

For more than six months, the Ministry of Health and its partners have been piloting the move in Western Province; senior government officials say it will not reduce the focus on HIV, but will ease pressure on an already overburdened and understaffed health system.

"Integrating HIV treatment with other outpatient services doesn't mean it has become less important; it only means maximizing on space and reducing the burden on healthcare personnel and to help increase focus on other equally important diseases like malaria," said Ibrahim Mohamed, head of the National AIDS and Sexually transmitted infections Control Programme, NASCOP.

Joshua Omoro likes the new system, stating, "I have come today to pick my [antiretroviral] medicine but nobody can know; people are just guessing what I might be suffering from just like I am also just guessing for other people," he said. "It puts you at ease... before when you went to a specific room, people just knew you had HIV."

"It is not only reducing stigma but is also easing the staff shortages that had been experienced earlier when too much focus was placed on HIV/AIDS," said Beatrice Misoga, HIV/AIDS integration officer for US government-supported AIDS, Population and Health Integrated Assistance II (APHIA II) in Western Kenya.

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[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

AFRICA: Need for systematic HIV drug resistance testing

 via PlusNews

HIV is a tough enough diagnosis, but when one contracts a strain of HIV resistant to some life-prolonging medicines, treatment options are limited. A new study has found that transmitted HIV drug resistance may be on the rise in Africa, and the authors warn that unless resistance surveillance is increased, the continent's treatment programmes could suffer.

The study, led by the International AIDS Vaccine Initiative (IAVI) in five African countries, found that the prevalence of transmitted drug resistance in Rwanda, Uganda and Zambia was considerably higher than previously reported. Of 408 people studied in Kenya, Rwanda, South Africa, Uganda and Zambia, 19 had transmitted resistance mutations. Resistance prevalence rose considerably during the study in Zambia and remained high throughout the study in Entebbe (Uganda).

"The message to take away from this study is the urgent need for regular drug resistance surveillance, which we currently do not have," said Omu Anzala, head of the Kenya AIDS Vaccine Initiative. "If we can see transmitted resistance in such a small study then there could be much more going around."

"We saw what has happened with malaria over the years, with resistance developing against several drugs. We need to move quickly to ensure governments are aware and are implementing drug resistance surveillance to prevent the same thing happening with ARVs," he added.

In 2009 Kenya launched a five-year national plan on HIV drug resistance, prevention, monitoring and surveillance.

A separate study in 2010 by PharmAccess African Studies to Evaluate Resistance (PASER), a project of the PharmAccess Foundation, a Dutch health NGO, found that nearly 6 percent of patients about to start HIV treatment for the first time already had resistance to standard first-line ART.

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[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

VIDEO: Melvin and his sister: A gay Kenyan's struggle to survive

via guardian.co.uk

As discrimination against homosexuals in Africa reaches a new murderous peak, Guardian Films travels to Mombasa, Kenya, to hear from a male prostitute who risks his life to support his younger sister.



[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]