HIV Prevention in Migrant

Population IRC’s Experience

AIDS2012 IAS ConferenceWashington DC, July 2012

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Life in Turkana

Life in Turkana

Kenya’s HIV prevalence at 6.4% (KDHS, 2008/9)

Turkana hosting refugees from Somalia, S/Sudan, Ethiopia and ALL Great Lakes countriesRefugee camps in existence since 1992Estimated Turkana population: >850,000 (KNBS, 2009)

Refugee population > 85,000 (UNHCR PHHIV Report, 2011)

Community reliant on food aid, mostly by external donorsCommunity in denial – “HIV problem of the urban” (2005)

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HIV Prevalence: Sentinel Surveillance – Turkana (Nascop, 2011). IRC started program in 2005

2006 2007 2008 2009 20100

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4

6

8

10

12 11.3

7.4

9

5.14.8

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IRC in Kenya

Started work in refugee programs in 1997Host population programs started in 2005 – HIV Prevention, WASHRefugee programs – direct implementationInevitable interactions, assimilation over time among refugees and their hosts at KakumaHost Population Programs- mainly with partners through enhancing capacity of Community Based Organization

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Through the Path…

2004/5 – HIV Program limited to small part of Turkana, no public disclosure in the region, denial of HIV at community, first HIV sentinel surveillance – 18% (Nascop)2006 – HTC services through mobile programs, mass awareness in the community/schools, HIV Care and Treatment at three facilities2007 – Decentralization of HIV care, treatment more facilities, trainings of health care workers and community health workers, first public disclosure

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…the Path

2008/9 – Rapid results campaigns, support CBOs on MIPA initiatives, complimentary programs2010 – Emphasis on Evidence Based Intervention,, decentralized supply commodity mechanism, target new HIV testing2011 – Severe drought slows down community activities, focusing on EBI – relevance, efficiency and sustainability

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Targeted HIV Prevention Approaches

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Families Matter! Program: Targets 9-12 year-olds through parent/child communication. Healthy Choices: Targets 13-17 year oldsCommunity HIV Testing: Home or family-based HIV testing Community Prevention with Positives: From clinical settings to the community

Hard Lessons

Program priority not community priority!

Very key: Program linkages, active community participation

Agreement on what constitutes evidence since many factors influence its acceptance 9

Taking services to the community

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Participation

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Anticipation, Emergency Preparedness

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Leadership

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Standards, Standards

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Acknowledgements

Centers for Disease Control and Prevention (CDC)Kenya Government through the Ministry of Public Health and SanitationTurkana Community and their leadershipOther donors for supporting other health programs

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16Thank You