Population Council Research that makes a difference

In Kenya, as in most of sub-Saharan Africa, estimates national HIV prevalence have been derived primarily from sentinel surveillance of women attending antenatal clinics and nationally representative population-based surveys with HIV testing, including Demographic and Health Surveys (DHS) and AIDS Indicator Surveys (AIS). While these surveys provide valuable information about the HIV prevalence rates among the general population, little is known about HIV infection rates among some most-at-risk populations (MARPs), such as men who have sex with men (MSM), injecting drug users (IDUs), and female sex workers (FSWs) as well as their HIV prevention, care, and treatment needs.

While absolute numbers of these MARP groups are small when compared to the general population, the overall contribution of MSM, IDUs, and FSWs to Kenya’s HIV epidemic may be disproportionately large. Epidemiologically, a focused representative survey similar to the Kenya AIDS Indicator Survey of these populations is needed to provide a better profile and understanding of HIV transmission dynamics in Kenya, which will inform current HIV preventive, care, and treatment pilot programs tailored to MARP-specific needs and risk factors.

In collaboration with the Government of Kenya, researchers from the US Centers for Disease Control and Prevention and the Population Council are using respondent-driven sampling to identify and recruit these vulnerable populations, measure the prevalence of HIV and selected STIs, and through interviews identify the key characteristics of these populations that place them at risk, and explore how these vulnerable groups may be identified, reached, and served by various health programs.

Data for the first round of surveillance were collected between July 2010 and March 2011. Preliminary study results were reviewed by a technical working group convened by NASCOP in August 2011, and the final report will be available at the end of February 2012. Results are currently being used by NASCOP and the CDC to inform program planning for MARP prevention projects.