In Kenya, some 1.6 million people are living with HIV. And, every year, an estimated 71,000 new infections occur. One-third of the newly infected people belong to key populations, including sex workers and men who have sex with men. HOYMAS welcomes people at risk of HIV in their stigma-free clinic. The organisation is committed to removing barriers to HIV services, thereby reducing HIV infection rates in Kenya.
29 per cent of Kenyan sex workers are HIV-positive
Evidence indicates that key populations are the drivers of the HIV epidemic in Kenya – with a high infection rate of 29.3 per cent among sex workers, 18.2 per cent among men who have sex with men, and 18.2 per cent among people who inject drugs. While male and female sex workers are generally more vulnerable to HIV, in Kenya they face huge barriers to HIV prevention, testing and treatment services.
They fear being ridiculed by health workers
A key barrier to accessing HIV services is the criminalisation of same-sex relations and sex work. This breeds severe stigmatisation and discrimination of male and female sex workers within their communities and in healthcare settings. Sex workers often feel uncomfortable entering health facilities. They fear being ridiculed and denied healthcare by doctors and other health workers, particularly in government hospitals. In addition, sex workers experience social exclusion and human rights violations, such as sexual violence and illegal arrests and detention.
A key barrier to accessing HIV services is the criminalisation of same-sex relations and sex work
Improvements thanks to sex worker organisations
In spite of the challenges, the situation in Kenya is steadily improving. Thanks to the joint efforts of sex worker organisations, such as HOYMAS , barriers to HIV services are being dismantled. In 2009, Kenyan male sex workers and people living with HIV and AIDS formed HOYMAS, the first ever community-led clinic in Kenya registered by the Ministry of Gender, Sports, Culture and Social Services. The HOYMAS clinic ensures that male sex workers have access to quality HIV testing, treatment and care in an environment free of stigma and discrimination.
HOYMAS holds the Kenyan government accountable
Government recognition has been key in giving HOYMAS an official voice to hold the government accountable for delivering services to at-risk groups. HOYMAS paved the road for other sex worker-led groups in this respect. Around 2012, HOYMAS consulted with Kenyan sex worker leaders on the need to strengthen the national sex worker movement and started its fruitful partnership with KESWA, the national network of sex work projects.
The partnership of HOYMAS and KESWA has brought together different groups to draw up the agenda for joint advocacy to improve access to health services and protect sex workers’ rights. These groups include sex workers, sex worker organisations, policy makers, law enforcement officers, representatives of the judicial system and healthcare workers. A great achievement of this joint advocacy is the government’s development of a programming policy that focuses on sex workers and other key populations. This has ensured that interventions are implemented effectively within a combined public health and human rights framework. So, an overall national strategy for addressing issues that affect key population groups is now in place in Kenya. In collaboration with key populations, including sex workers, the Kenyan Ministry of Health has been implementing policies that guide HIV and human rights programmes for key populations.
The Kenyan government
involves key populations in HIV programming
Sex workers participate in policy design
Thanks to the joint advocacy of HOYMAS and KESWA, sex workers have the opportunity to participate in government-led policy-making processes. The two organisations have provided data for evidence-based decision making, engaged in research and also participated in policy dialogue, formulation and implementation. The advocacy activities by HOYMAS and KESWA have resulted in improved coordination between the government and sex workers for HIV programming and the creation of Key Population Technical Working Groups. Other achievements are the involvement of sex workers in conducting situation analysis, hotspot mapping, population size estimations and the development of programming tools.
Respect for human rights in HIV programming
The efforts of HOYMAS have definitely had a positive impact on the HIV response in Kenya. The Kenyan government now better understands the relationship between public health and respect for human rights in HIV programming for at-risk groups. That’s why they actively involve community-led organisations like HOYMAS in the design and implementation of national HIV programmes.
Strong sex worker movement in Kenya
The government will continue to work with key populations via Key Populations Technical Working Groups at the national and county level to ensure that they are able to engage in discussions, and make decisions, about improving service delivery to key populations. Moreover, key populations, including sex workers, have been involved in the development of guidelines, such as the ‘National Guidelines for HIV/STI Programming with Key Populations’. In the past few years, a strong sex worker movement has emerged in Kenya. Sex worker organisations’ advocacy work and participation in HIV programming contribute to a reduction in HIV rates and improvement in the health status of those infected.
HOYMAS has become a learning ground for organisations around the world and has been recognised for its uniqueness in HIV and human rights programming. The organisation is an example for others. Since 2014, over 240 sex workers from 25 countries have visited HOYMAS through the Sex Worker Academy Africa, initiated by the African Sex Workers Alliance (ASWA) and the Global Network of Sex Work Projects (NSWP).
About HOYMAS (Health Options for Young Men on HIV, AIDS and STIs)
HOYMAS reaches out to male sex workers and men who have sex with men. They offer quality HIV and other STI prevention, treatment and care services, education on human rights and economic empowerment. The organisation also advocates for better healthcare and the upholding of human rights.HOYMAS is a member of KESWA, the umbrella organisation of Kenyan sex worker-led groups. Collaboration significantly increases the impact of their work. Since 2016, they have been Bridging the Gaps partners through Aidsfonds’ sex work programme.
HOYMAS’ achievements – striking figures for 2016 and 2017
- 5,511 sex workers were reached with various services, such as HIV testing, education, legal support and counselling.
- 728 sex workers received ART, STI and TB treatment.
- 323 sex workers used legal support services.
- 591 service providers were trained.
- 292 human rights violations were acted upon.
Read more about HOYMAS on their website or Facebook page.
Text: Anna Maria Doppenberg
Photos: Adam Mwero