The goal of this study is to assess the effectiveness of the Key Population Programme funded by the Global Fund (in the last three years) in reducing the new HIV infections by 75%, AIDS related mortality by 25% and self-reported stigma and discrimination related to HIV/AIDS by 50% among Female Sex Workers (FSW), Men who have Sex with Men (MSM) and People Who Inject Drugs (PWID) in Kenya by 2025.

Objectives

• Examine, appraise, and evaluate the comprehensiveness of prevention programmes for Female Sex Workers (FSWs), Men who have sex with men (MSM) and People who inject drugs (PWIDs).
• Determine the literacy levels on human rights related to HIV and other barriers concerning access to health services and justice among Key Population.
• Assess prevalence of gender-based violence and effectiveness of response mechanism among Key Population.
• Appraise the extent to which the Global Fund programme has enhanced the capacity of the Key Population Networks in implementing KP programmes.

Project Initiated 2021

The study started in June 2021. The study population includes 46,425 FSW, 24,879 MSM, and 15,420 PWID who received comprehensive HIV prevention, treatment, care and support services from January 2018 to June 2020 across 20 counties in Kenya.

Partnerships

PHDA is partnering with The Circle of Concerned African Women Theologians, Kenya (CCAWT) and the Mathematical Consultation Research (MCR) for this study with funding support from The Global Fund through the Kenya Red cross Society.

The heart of stigma project aims to assess stigma and discrimination experienced by people living with HIV (PLHIV) and key populations (KP) in Kenya. It is a part of IAS’s global “Getting to the Heart of Stigma” project.

Objectives

• Contextualise, triangulate, interrogate, validate, and enhance the evidence base in HIV-related stigma
• Assess demand and supply side of the stigma equation, changes in stigma and discrimination in health care personnel and changes in perceptions and experience of the health care system from those populations who may be victims of stigma and discrimination
• Review current legal and policy situations and examine how stigma is addressed in governmental agencies such as the police, other uniformed services, the legal system, schools and universities, etc. who interact with stigmatised populations.

Project Initiated 2021

This study which began in March 2021 will be conducted through a) review of stigma literature in Kenya, b) interviews with policy makers, health care workers and members of the PLHIV and KP communities. The study has already produced some preliminary findings, which were reported at the National Maisha Conference in May, organised by the National AIDS Commission (NACC). 

The findings are as below

• There aren’t enough interventions in Kenya that could provide an empirical measurement of success, so it is not possible to identify “critical success factors”.
• Most literature and qualitative interviewees expressed their preference for service seeking options and community led initiatives wherein lay health care workers, and peer educators would provide support and help with navigating the system.
• The success in reducing stigma is largely based on the government support provided for the programmes and other supportive policies which act as a deterrent, allowing interventions to take place.

Some factors that impede include:

• Low investment of resources in Interventions addressing stigma.
• Slow implementation of laws and policies.
• Subtle forms of discrimination which are difficult to identify and hence challenging to intervene.

Partnerships

PHDA is partnering with HOYMAS on this project with funding support from the International AIDS Society (IAS).

This study aims at understanding the knowledge and preferences of Kenyan Gay and Bi-sexual MSM (GBMSM) and transgender women regarding the use of oral PrEP.  URCHOICE is a one-year multisite study targeting MSM on the preferred options for taking oral PrEP. 

Objectives

• The study intends to determine the preferences of men who have sex with men (MSM) towards reduce their risk of acquiring HIV in Kenya i.e.  their use of condoms, daily oral pre-exposure prophylaxis (PrEP), or use of prolonged acting PrEP.

Project Initiated 2021

The one-year study began in May 2021. It intends to target 150 GBMSM at each site and 500 across all three sites. The interview data was used to assess discrete choices between possible prevention options, reasons for different choices, and potential challenges in promoting the various PrEP options, through focus group discussions.
The study saw participation from 146 out of the 150 enrolled members for the information sessions and 98 out of the 140 enrolled participants for the interviews.

Partnerships

PHDA partners with the University of Illinois, Chicago, with funding from Merck, Sharp and Dohme.

This study aims to produce a solid evidence base to inform ongoing challenges in proactive responses to HPV-related health needs of MSM. MSM are at high risk for anal HPV-related infections and cancers, especially among those living with HIV. Though HIV prevalence in Kenya continues to be high, homosexuality is criminalized while HPV-related prevention and treatment needs of men (including MSM) are largely ignored.

Objectives

• Produce new health services knowledge, including knowledge on HPV vaccination acceptability.
• Generate social scientific insights related to experience of illness and the role stigma plays in the late presentation of HPV-related diseases.
• Contribute new evidence towards enabling a community-based programme that can effectively confront a health crisis and respond to the global health alarm over emerging cancer epidemics in African contexts who are the hardest hit with respect to the HIV epidemic.

Project Initiated 2018

The study based in Nairobi started in June 2021 and will continue for four years. It will focus on men who have sex with men.

Partnerships

PHDA is partnering with the University of Manitoba on this project with funding support from Centre on Health Insurance Reforms (CHIR).

The study aims to evaluate the incremental benefit of the community-based implementation of HIV Self Testing (HIVST) strategies as a part of existing HIV and sexual health interventions with MSM in Kenya.

Objectives

• Reducing the overall size of the undiagnosed MSM population and
• Reducing time for linkage to prevention, treatment, and care following HIV testing.

Project Initiated 2018

The HIVST study which commenced in November 2018 undertakes a programme science approach. The study which is being implemented in Mombasa, Kisumu, and Kiambu, uses a mixed-method approach to conduct this evaluation. A baseline and an end-line survey were conducted with 1200 MSM respondents sampled from physical and virtual sites. Qualitative longitudinal in-depth interviews were conducted with respondents at three-time points. Sexual network mapping was also conducted at baseline. The end-line data is being currently analyzed to answer some of the key research questions. The study also completed a costing sub-study to estimate the cost of integrating HIVST within HIV prevention programmes for MSM.

Partnerships

PHDA partners with the University of Manitoba, NASCOP, G10, Men Against AIDS Youth Group (MAAYGO), Kisumu, Mamboleo Peer Empowerment Group (MPEG), Kiambu, and HIV & AIDS People’s Alliance of Kenya (HAPA-Kenya) in implementing this project with funding from the Bill & Melinda Gates Foundation.

Download the HIV ST evidence brief (Click here)

Download a paper on  Kenyan Men Contextualizing HIV ST Technologies (Click here)

The study aims to examine the associations between violence against women, mental health concerns, alcohol and drug use, biological changes to the immune system, and the risk of HIV infection.

The research study aims to estimate the HIV incidence, retention, and assess the uptake and adherence to PrEP among at-risk Men who have sex with men (MSM) and Transgender people enrolled at the 3 partnering clinics in Kisumu, Nairobi, and Kilifi.

Objectives

• To determine the HIV incidence, retention, and the correlates of HIV acquisition among 800 MSM and Transgender people
• To assess uptake and adherence to PrEP administered as per National AIDS and STI Control Programme (NASCOP) guidelines.
• To determine the prevalence of acute HIV infection in participants reporting symptoms that are compatible with the acute retroviral syndrome at scheduled or interim visits.

Project Initiated 2019

This study commenced in October 2019 and is ongoing, despite challenges posed by the COVID-19 pandemic. PHDA is responsible for the Nairobi site and has enrolled 300 participants. The study ultimately hopes to also demonstrate that young MSM and Transgender people can be engaged and followed for 1 year at 3 counties, by 3 different research groups using standardized procedures.

Partnerships

PHDA is working with the Kenya MSM Health and Research Consortium (MHRC) and the Kenya Medical Research Institute (KEMRI) with funding from the International AIDS Vaccine Initiative (IAVI).

This project aims to develop an ethics and integrity framework to support rapid and effective research during global crises.  It brings together 16 partner teams from three continents.

Objectives

• Come up with an interdisciplinary, accessible, and jargon-free code of conduct for research during global crises
• Develop ‘how to’ guidelines to support the needs of research teams, 
• Develop engaging training and capacity-building materials to be disseminated across the Globe epidemic.

Project Initiated 2022

The study started in September 2022 and will continue for three years. It will focus on developing a range of tools for the promotion of high levels of ethics and integrity during accelerated research.

Partnerships

PHDA is partnering with UCLan Cyprus on this project with funding support from the European Union.

Video:

Trust and Prepared Global Research Ethics