This is a study with 1,000 women recruited from all seven SWOP clinics using an agreed sampling frame. The purpose of the study is to examine the associations between violence against women, mental health concerns, alcohol and drug use, biological changes to the immune system, and risk of HIV infection as demonstrated in the chart below.

Maisha Fiti study will address the associations across different levels that are generally studied separately:

  1. Biological factors (genital tract inflammation and immunological changes)
  2. Behavioral factors (drug and alcohol use, mental health, HIV prevention, and treatment adherence)
  3. Structural factors (poverty, violence)
    Phase 1 results will show the association of HIV acquisition with high rates of violence and mental health disorders as illustrated below.

The preliminary key findings show high rates of violence and mental health disorders amongst our sex workers. Both are associated with HIV acquisition.


Phase II

During phase II which has started another 40 IDIs with the same participants will be conducted.


With data from the first and second visit, we will be able to compare the changes/differences in and between participants’ profiles at baseline and at the second visit. This information will also be able to establish the interactions between biological, behavioral, and structural factors in HIV acquisition and adherence to ARVs. We hope the data will help inform on the type and level of interventions that would reduce HIV infections as well as improve ART adherence.


Principal Investigators:- Dr Joshua Kimani/Tara