Peer educators promoting oral pre-exposure prophylaxis (PrEP)

 Peer educators promoting oral pre-exposure prophylaxis (PrEP)

By Daniel Kyalo and Geoffrey Njenga

Nairobi, Kenya – You cannot talk about the successful implementation of PrEP in Riruta Health Centre without mentioning Julia, Mary, Diana, and Magdalene. The four have a lot in common, they are single mothers, active sex workers and are peer educators linked to Riruta.

Harassment by customers, condom bursts and contracting STI’s was the order of the day for the four. PrEP couldn’t come at a better time as they were constantly worried of getting HIV and they were tired of being on PEP due to condom bursts.

Having been on PrEP for the last two years, they have seen the benefits and were motivated to become strong advocates of PrEP as they desired to see their fellow sex workers healthy and worry-free from the fear of contracting HIV and leaving behind their children.  “I have seen many people infected with HIV, others have died as a result of it and many children orphaned, it makes me sad knowing they could have taken PrEP to prevent HIV. This motivated me greatly to become a peer educator” says Magdalene.

The number of sex workers in Nairobi County is estimated to be 29,494 and they are among key populations that contribute a third of all new HIV infections in Kenya. The HIV prevalence rates among sex workers is 29.3% yet they have the least access to prevention, care, and treatment services because their behaviors are often stigmatized. By using peer educators to reach out to hot spots with information on HIV prevention a positive attitude by service providers at Riruta and a combination of services such as family planning, cervical cancer screening, STI treatment, condom, lubricant supply and counselling, female sex workers feel at ease going for PrEP services at Riruta, a public health facility.

The four are among 428 peer educators sensitized by Jilinde on HIV prevention methods including PrEP, condom negotiation/use and how to identify those at risk and in need of PrEP. They create awareness of PrEP at the hotspots and in the community linking those at risk of HIV infection to Jilinde supported sites for PrEP services. They have reached 9,256 female sex workers with PrEP messages.

Reaching sex workers is not always easy, the four peer educators confess. Most sex workers don’t want to take a daily pill they would prefer to take just one pill that protects them for an extended period of time. “Sometimes we get abused during outreaches and following up clients on PrEP for refills is not easy as most of them are mobile” says Julia. These challenges have been addressed by correcting the myths with correct information and ensuring a strong referral system.

“PrEP is not for sex workers only, it’s for anybody who is at risk of HIV infection. “Anybody can take it as long as they are at ongoing risk. “says Mary

Riruta Health Centre is a shining example that, if sex workers are trained as peer educators, facilitated to do their work and a nice rapport between them and the health workers is ensured, public health facilities can increase PrEP uptake and reduce HIV transmission.