Gender-based violence, influx of migrant workers and poverty are among the factors contributing to the spread of HIV/Aids in Machakos, Makueni and Kitui counties, according to recent statistics from the National Aids Control Council (NACC).
According to Positive Life Kenya, a non-governmental organisation that supports HIV positive families living in the slums surrounding Mlolongo and Athi River; towns on the highway tend to have higher prevalence rates than interior towns.
It is noticeable in Mlolongo where the prevalence is 12 per cent instead of the average 7.4 per cent in the country.
“The HIV positivity rates in health facilities serving the highway and towns with major infrastructural projects is high compared to towns or centers with no ongoing projects,” said Catherine Wanza, the National Aids Control Council Regional HIV coordinator.
According to data from NACC, Machakos County some 30,095 people are living with HIV accounting for 3.8 per cent of the population, while in Kitui County has 28,661 people living with HIV which accounts for which is 4.5 per cent of the population. Makueni County has 24,581 infections equivalent to 4.2 per cent of the population.
Ms Wanza observed that migrant workers working on county and national government projects such as Thwake Dam and major roads were likely to engage in casual sex with the locals and sex workers especially in major towns along the transport corridor of Nairobi - Mombasa highway.
She also explained that the influx of migrant workers is associated with casual sex given that most workers leave their partners to look for opportunities in these projects.
“The highway is also characterised with sex work, men having sex with men and injecting drug use which contributed to the high HIV positivity rates,” Ms Wanza said.
Positive Life Kenya website cites prostitution as a main cause of HIV infections along the highway where multiple sex partners, the lack of education and knowledge about HIV, lack of prevention by using a condom and a lack of bargaining power to fight for reproductive and health rights are key factors that drive the high prevalence.
Ms Wanza said that adolescents and youth were also not spared by the scourge as over 10,000 youths were infected in the three counties, according to the 2018 NACC HIV/AIDS estimate data.
She said that the increasing trend of teenage pregnancies is a proxy indicator of unsafe sexual practices.
She observed that the uptake of health services by men was poor and a lot of advocacy was needed for men to take up services.
There is also limited knowledge on existing HIV prevention methods such as pre-exposure prophylaxis and condoms in the affected areas.
The NACC has mobilised and trained male champions who engage the locals on HIV prevention, care and management.
The programme is aimed at increasing health service uptake among men which is low compared to women, Ms Wanza says.
Ms Wanza also said that sexual and gender based violence was on the rise where Kangaroo courts were used to sort out the issues leading to limited access to justice and HIV prevention services.
Female sex workers are vulnerable, especially when relating with truck drivers, as these men are currently estimated to have the highest prevalence of HIV/ AIDS at 25 per cent, notes the website. Unfortunately along the Mombasa highway, 30 per cent of the female sex workers’ clients are truck drivers.
Hard conditions of employment for both truck drivers and road construction workers contribute to their high risk sexual behaviour.
Being away from home for long periods of time, earning a low income, isolation, and working for long hours all contribute to them being involved in the sex trade.
"There is also limited engagement by parents on sex and sexuality issues leaving the youths at the mercy of 'sponsors' where they engage in inter-generational relationships leaving the youth with limited bargaining power for safe sex," she explained.
Ms Wanza said her office continued to provide advocacy on prevention and treatment as well as providing data to counties to inform their programmes.