2022 Impact Stories - Medically Assisted Therapy Clinic in Kenya Empowers Women | University of Maryland School of Medicine

October 03, 2022

In Nairobi, Ciheb’s PACT Endeleza program, with the assistance of the University of Maryland, Baltimore, and Nairobi City County, established medically assisted therapy (MAT) clinics to reduce the spread of HIV among people who inject drugs (PWID) and provide opioid substitution therapy (OST). These clinics in Mathari and Ngara were established with funding from the President’s Emergency Plan for AIDS relief through the U.S. Centers for Disease Control and Prevention.

Medical care vehicle in Kenya The 2014 rollout of MAT in Kenya began in Nairobi County, with its first client being female. The clinic has since enrolled 2,262 PWID, 10% female. The interventions provided at the clinics also encourage women to meet health, social, and economic milestones comparable to their peers who do not use drugs. This assistance is crucial to achieving an equitable future for these women.

The injection of drugs is linked to several adverse outcomes, such as an increased risk of blood-borne diseases, poverty, homelessness, increased crime, and risk of violence. PWID are amongst those most vulnerable to HIV infection and are 22 times more likely to acquire HIV compared to the rest of the general population. In Kenya, an estimated 10% of injecting drug users are women. Women who use drugs (WWUD) are more likely to conceal their drug-taking behavior because of societal discrimination, more likely to experience sexual violence, and less likely to access medical care and HIV services. The global HIV prevalence among women who inject drugs is 13%, compared to 9% among men. This risk has led to numerous efforts by civil society organizations to expand women's access to comprehensive harm reduction services.

Two clinicians having a discussion at the MAT Clinic in Kenya Referrals for MAT services prioritize those who are living with HIV and those who are pregnant. Interventions begin with WWUD receiving services, including harm reduction messaging, HIV testing and referral for antiretroviral therapy, condom distribution, needle and syringe exchange programs, OST with methadone, and sexual and reproductive health services, including family planning. Further linkage to drop-in centers allows for providing clinical and psychosocial services, education, and motivational counseling to increase the interest and readiness to enroll in MAT clinics for OST. WWUD are also provided with hygiene packs and have access to women-centered support groups at the drop-in center.

Referral for maternity services has seen 42 safe deliveries over a six-year period, with only 9.5% of all deliveries reporting neonatal abstinence syndrome. All HIV-infected women are on antiretroviral therapy as part of the integrated package of services with 100% viral suppression.

The provision of psychosocial support services has seen increased reintegration in women on treatment to stable employment with opportunities to engage in alternative employment. This is key given that more than 75% of WWUD on MAT engaged in sex work at least once over their course of drug use.

To support personal economic growth, the Nairobi County Women’s representative, Honorable Esther Passaris, through the National Government Affirmative Action Fund, provided funding for WWUD on MAT to acquire income-generating vocational skills. Thirty-five women are beneficiaries of funding and acquired hairdressing skills during the pilot of this initiative.

The clinics have continued to support women-centered MAT groups to address challenges in recovery. One such support group is the MAT mothers support group, composed of women who gave birth to children before and during MAT treatment. This support group enables clients to share experiences and learn skills that improve parenting.

Society benefits when women are supported and empowered to succeed and excel; Ciheb Kenya and the various community and facility stakeholders are making significant gains in the rehabilitation of women. With the employment of MAT clinics, women with opioid use disorder are provided with an integrated biomedical and psychosocial approach that is shown to reduce the harm associated with drug use.

Contact

Center for International Health, Education, and Biosecurity
Institute of Human Virology
Anthony Okoth
Regional Communications Specialist

Speaking during a pre-World AIDS day event in Nairobi, the Head of the National AIDS and STI Control Program (NASCOP), Dr. Rose Wafula, reiterated that the Ministry of Health, through NASCOP, commits to exploring and connecting the global and national efforts that focus on impact and progress towards the 95-95-95 targets to end the AIDS epidemic by 2030.

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Monday, August 15, 2022

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Monday, July 18, 2022

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Friday, July 15, 2022

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Wednesday, June 01, 2022

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Friday, April 29, 2022

CONNECT Program Targets Cervical Cancer

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Wednesday, December 08, 2021

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To combat the spread of COVID-19 in Kenya, Ciheb’s local partner, Ciheb-Kenya, received a five-year CDC-funded grant to support national and county activities towards rolling out COVID-19 vaccination. The Technical Assistance to Ready and Accelerate Capacity of public health programs in Kenya (TRACK) program is focused on supporting the development of national policies and training material on COVID-19 vaccination and teaching national trainers to cascade this training to counties.

Tuesday, November 30, 2021

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This World AIDS Day, December 1, UNAIDS is focusing on the HIV/AIDS epidemic in the context of intersectional global health and societal challenges. This year's theme — "End Inequalities. End AIDS. End Pandemics." — brings attention to the inequalities that are hindering progress in AIDS and COVID-19 pandemics.

Friday, October 29, 2021

PrEP used in the fight to end HIV in Kenya

In 2017, the Government of Kenya adopted a new policy called “A Framework for Pre-exposure Prophylaxis of IV in Kenya.” This framework directed the roll out of pre-exposure prophylaxis (PrEP) in Kenya, addressing the key focus areas of: availability, acceptability, accessibility of PrEP, and the holistic integration into the national HIV combination prevention strategy. To align with the government, Ciheb in Kenya’s PACT Endeleza program, which recently ended, also started offering PrEP that same year.

Wednesday, October 27, 2021

Kenya Country Programs Complete Five Years of Impact in HIV Services

September marked the close of Ciheb in Kenya’s two Partnership for Advanced Care and Treatment (PACT) programs, PACT Timiza and PACT Endeleza. Ciheb held closeout events in the three counties that it worked in – Kisii, Migori, and Nairobi City – to commemorate the two programs' accomplishments.

Tuesday, October 12, 2021

Differentiated Service Delivery Improves HIV Care in Western Kenya

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Monday, September 06, 2021

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HIV is a serious risk among adolescents in Kenya, and Ciheb has been helping address rising infection rates through Operation Triple Zero (OTZ). OTZ uses a contextual “asset-based approach,” whereby adolescents are considered as resources with potential answers to their challenges and are empowered to take responsibility and action for their health.

Wednesday, September 01, 2021

Data Demand and Information Use through STATA Training in Nigeria

Ciheb Nigeria, in partnership with the Federal Ministry of Health, recently facilitated a training to promote a culture of data demand among stakeholders to encourage the use of data on the National Data Repository (NDR) to track program outcomes and impact. The training also aimed to build the capacity of the stakeholders to maximize the use of data on the NDR for research.

Monday, August 16, 2021

In Kenya, Ciheb Efforts Recognized in Nairobi County CQI Awards

During the summer, the Nairobi Metropolitan Services (NMS) held its annual Health Service Delivery Awards to recognize best-performing health facilities in Nairobi County. Facilities supported by PACT Endeleza won awards in all categories they participated in. NMS evaluated facilities based on their performance in continuous quality improvement metrics.

Monday, May 24, 2021

Ciheb-Kenya on the Front Lines of the COVID-19 Vaccine Rollout

Ciheb-Kenya, our local Kenyan partner, has been working with the U.S. Centers for Disease Control and Prevention, the Kenya Ministry of Health, and the National Vaccines and Immunization Programme (NVIP) to support COVID-19 vaccine preparedness through the ongoing Technical Assistance to Ready and Accelerate Capacities of Public Health Programs in Kenya (TRACK) project. Kenya received its first shipment of vaccines several weeks ago and has been moving ahead quickly. As of April 21, a total of 721,509 persons have been vaccinated against COVID-19 countrywide.

Medically Assisted Therapy Clinic in Kenya Empowers Women