My name is John Mathenge, and I live in Kenya. I identify as gay. About fifteen years ago, I was diagnosed with HIV. I’ve been working as a sex worker in Kenya for many years. I would regularly meet other male sex workers informally in bars where we discussed our work and supported each other – that’s how we got the idea of founding an organisation. In 2009, HOYMAS was officially registered. A great achievement! Now, I’m the Director of HOYMAS. I’m passionate about sex workers’ rights and HIV activism.
Some 1.6 million Kenyans are living with HIV
My country is one of the six African ‘high-burden’ countries. In Kenya, some 1.6 million people are living with HIV. Most infections occur among key populations. For example, HIV prevalence is estimated to be 19 times higher among gay men and 49 times higher among transgender people, compared to the rest of the adult population. To me, it’s clear that we need to target and mobilise members of key population groups in combating HIV.
Men who have sex with men fear accessing healthcare services
Criminalisation of same-sex relations
In Kenya, male sex workers and other men who have sex with men face many challenges, such as criminalisation of same-sex relations. Due to anti-gay laws, they are targets of arrest, prosecution and blackmail. Moreover, there is stigmatisation attached to being gay, being a sex worker and being HIV-positive. Most government hospitals are not in a position to give free, non-discriminatory services to men who have sex with men. And some clinics that offer HIV services are not fully equipped to handle cases of police harassment, rape and attacks on members of this group. Also, in Kenya, doctors and nurses stigmatise men who have sex with men; meanwhile there is lack of medication. As a result, most men who have sex with men fear accessing healthcare services, particularly in government hospitals, and being open about their sexuality.
Customised HIV services
Providing much-needed HIV services – this is what gets me out of bed in the morning. My organisation, HOYMAS, offers a full menu of customised HIV services to male sex workers and other men who have sex with men. The majority of our target group is living with HIV. We’re constantly developing creative ways of reaching out to at-risk people. HOYMAS provides HIV medication, as well as PrEP, condoms and lube to help prevent new HIV infections. Moreover, clients can receive wart treatment, general health medications and counselling at HOYMAS.
Advocacy to uphold rights
We’re aware that our members work in criminalised environments – due to laws and homophobia – so we support them in many other ways as well, like giving post-trauma help and reporting crimes to the police. Moreover, we advocate to the government to uphold the rights of men who have sex with men, and we draw attention from the media. Another important activity is sensitising police officers, lawyers and healthcare providers on HIV and human rights.
Living in denial
HOYMAS’ work is illustrated by the story of one of our clients: the man was diagnosed with HIV back in 2008 and had been living in denial ever since. He went back to his village to stay with his family. His health deteriorated, and his friends and family members asked him many questions: why he didn’t work? why he wasn’t married? Stigmatisation at the local clinic was another challenge. He even came to the point where he wanted to commit suicide. However, in 2018, he entered HOYMAS and was enrolled in treatment. From then on, his health has quickly improved, and he began to enjoy life again. His viral load is undetectable now, which is proof that the HIV medicines work. Nowadays, he’s a peer educator at HOYMAS and no longer hides his HIV-status. This brave man is an inspiration to many.
Providing much-needed HIV services –
this is what gets me out of bed in the morning
HOYMAS has welcomed over 5,000 people
In addition to men who have sex with men, HOYMAS also welcomes other groups at risk of HIV, such as people who use drugs, young people, adolescent girls and vulnerable women. They can walk into our clinic where they’ll find non-discriminatory, free and easily-accessible services. So far, we’ve reached over 5,000 people with comprehensive sexual and reproductive health and rights services. I’m extremely proud of that. It shows the need for our work. Being a director of HOYMAS is a very fulfilling job. I wish to expand the organisation and serve locations where there is no access to HIV services, like rural areas of Kenya.
Collaboration with government agencies
Despite existing criminalisation laws, the Kenyan government provides HIV services and needed materials to key populations. HOYMAS is uniquely positioned to offer assistance to the government in reaching out to hard-to-reach groups. Collaboration with the government, both at the local and national level, is vital to ensure better access to HIV services for Kenyans at risk of HIV. HOYMAS is a member of the Technical Working Group of the Kenyan Ministry of Health, and various government hospitals are referral points where our members can access health services.
I’m thrilled that community-based organisations are making change happen in Kenya. The government, the private sector and grassroots organisations together successfully respond to HIV and AIDS. Now, more HIV services are available, as well as new prevention methods like PrEP and dental dams. And there is an interest in changing laws, like those regarding criminalisation of drug use, which will affect the spread of HIV. Another encouraging development is the changing media narrative on HIV, which has moved from stigmatisation to acceptance and positive living.
are making change happen in Kenya
Reducing people’s vulnerability
Still, much work needs to be done for individuals and society at large. I believe in changing the root causes of people’s vulnerability to HIV, like social and political structures. We must invest in interventions that create conditions in which people can adopt safer behaviours and fulfil their human rights. We note that, over the years, HIV funding has significantly decreased, putting our efforts at risk. The support of Bridging the Gaps is indispensable for a community-led organisation like HOYMAS. The programme has empowered us to defend human rights and collaborate with governments. This way, we’re enabled to contribute to ending HIV and AIDS in Kenya.
Text: Anna Maria Doppenberg
Photos: Adam Mwero