Programme Development & Delivery

PHDA and its partner, the University of Manitoba, have implemented programmes for more than three decades. The team was among the first to initiate HIV prevention and treatment programmes with sex workers in Kenya. Some of the ground-breaking work conducted by PHDA, the University of Manitoba (UoM), and its partners has had an impact on programme and policy in Kenya and other counties.

Some key learnings include:
  • The need for high coverage of key populations with comprehensive HIV prevention and treatment programmes to prevent acquisition and transmission of HIV. The SWOP clinics established by UoM and PHDA, being one of the first large scale programmes in Africa (reaching more than 35,000 sex workers), improved the country and the continent’s understating of how to scale up programmes with key populations
  • The feasibility of integration of HIV self-testing within existing HIV prevention and treatment programmes managed by the MSM led community organizations was established through the PHDA led programmes. This also included estimating the size of undiagnosed MSM and the testing approaches to reach MSM using virtual platforms

Summary of Current Programme Delivery Projects

PACT Endeleza Project

The PACT Endeleza project aims to strengthen the prevention and management of STI, HIV and AIDS by establishing sustainable community activities and quality services for key populations in rural and urban Kenya to better help them serve mobile populations at risk of poor treatment outcomes.

Integration of Key Population curriculum into the pre-service Police Training Curriculum

This project aims to improve policing practices and inclusion of the law enforcement agencies in Key Population HIV programming in Kenya.

Kieni Fighters of HIV/AIDS Resource Centre

The primary aim of the Kieni Fighters Resource Centre project is to reduce the rate of HIV/AIDS infection and increase health-care access for individuals with HIV/AIDS in the Kieni constituency of Nyeri county in Kenya.

Outcome Measurement in Global Fund-supported Adolescent Girls and Young Women (AGYW) Programmes

The Global Fund Strategy 2017–2022, “Investing to End Epidemics”, has committed to scale-up HIV prevention programmes, to support adolescent girls and young women (AGYW) in 13 focus countries in Sub-Saharan Africa.

Pilot Project with Young Key Populations

The project aims to reduce HIV risk and vulnerability among Young women who sell sex (YWSS) and Young men who have sex with men (YMSM) in Kenya.

Resources

PACT Endeleza Project

The PACT Endeleza project aims to strengthen the prevention and management of STI, HIV and AIDS by establishing sustainable community activities and quality services for key populations in rural and urban Kenya to better help them serve mobile populations at risk of poor treatment outcomes.

Objectives

  • Support transition of adult populations to more effective antiretroviral regimens and establish functional viremia clinics.
  • Scale-up differentiated care models for the various populations, including multi-month dispensing, institution of robust patient support systems, structure counselling, and patient tracking systems.
  • Provide voluntary medical male circumcision (VMMC) services.
  • Provide HIV prevention services to female sex workers and men who have sex with men.

The project provides services for Key populations (KPs) and Priority Populations in Kenya. This includes:

Female Sex Workers (FSW)

Adolescent girls and young women (AGYW)

Men who have sex with men (MSM)

The project implemented through PHDA managed SWOP clinics, deliver a wide range of sexual and reproductive health interventions aimed at meeting KP specific needs. This approach is augmented by their efforts to address structural barriers related to violence, stigma, and poverty.


Through the 7 SWOP clinics, the project continues to offer HIV prevention services to 45000 female sex workers, 3000 MSM, and 1000 AGYW. The clinics also offer HIV testing services (HTS) and linkage to ART for key population members living with HIV. This has ensured that we meet the UNAIDS targets of 90-90-90 by 2020.

Integration of Key Population curriculum into the pre-service Police Training Curriculum

This project aims to improve policing practices and inclusion of the law enforcement agencies in Key Population HIV programming in Kenya.

Objectives

  • Develop KP module within the Kenya Police pre-service.
  • Include law enforcement-specific critical indicators in the annual performance contracts of the senior law enforcers.
  • Train police recruits to understand key populations, their rights, and the link between policing practices, KPs, and HIV.
  • Increase law enforcers’ responsiveness towards violence, stigma, and discrimination against KPs.
  • Ensure institutionalization and sustainability mechanism of KP programming into the law enforcement agencies

The project uses a multi-sectoral approach by engaging the National Police Service as a key stakeholder through their AIDS Control Units (ACUs). The project expects to:

  1. reduce law enforcement perpetrated violence against KPs,
  2. improve access to health and justice services for KPs.

Kieni Fighters of HIV/AIDS Resource Centre

The primary aim of the Kieni Fighters Resource Centre project is to reduce the rate of HIV/AIDS infection and increase health-care access for individuals with HIV/AIDS in the Kieni constituency of Nyeri county in Kenya.

Objectives

  • During this pilot project (15 months), the project expects the programme to reach a minimum of 150 women and girls in Kieni. PHDA and the University of Manitoba are the evaluation partners in this project.
  • The evaluation method of the project will be a pre-test post-test quasi-experimental mixed-methods process evaluation. If this concept is deemed successful after being tested, we expect this initiative to be applied to communities across Kenya.

Outcome Measurement in Global Fund-supported Adolescent Girls and Young Women (AGYW) Programmes

The Global Fund Strategy 2017–2022, “Investing to End Epidemics”, has committed to scale-up HIV prevention programmes, to support adolescent girls and young women (AGYW) in 13 focus countries in Sub-Saharan Africa.

The goal is to reduce new HIV infections among adolescent girls and young women aged 15-24 by 58% by addressing the behavioral, biological, and structural factors driving HIV acquisition and transmission by and to AGYW. PHDA and the University of Manitoba are measuring outcomes of the Global Fund-supported AGYW programmes implemented in Malawi, Lesotho, Namibia, Cameroon, and Botswana

Objectives

  • Implement a rapid, simple, cost-effective, efficient, easy to administer approach and innovative method to gather sexual, behavioral and structural outcomes of AGYW programmes within a programme set up and not a research setting;
  • Design a method for collecting sexual, behavioral, and structural outcomes. This will include the development of tools, data collection, and analysis
  • Build the capacity of programme staff of SRs (sub-recipients) and an identified local organization so that it can replicate this approach to collect outcome indicators regularly

The outcome assessment will use the mixed-method approach for data collection. For the quantitative assessment, we will conduct “Polling Booth Surveys’’: a group interview method which has been used by the PHDA and the UM to measure sexual, behavioral and structural outcomes among key populations, adolescent girls, young women and the general population in several African and Asian countries.

Additionally, we will conduct “in-depth interviews or focus group discussions” with programme staff to develop an understanding of the programme package for the AGYW and understand factors leading to certain trends in outcomes

Pilot Project with Young Key Populations

The project aims to reduce HIV risk and vulnerability among Young women who sell sex (YWSS) and Young men who have sex with men (YMSM) in Kenya.

Objectives

  • To test the feasibility of implementing the National Guidelines for HIV programming with Young Key Population developed by NASCOP at the Ministry of Health, Kenya.

PHDA is leading the monitoring, and evaluation of the project.