Why Young Sex Workers in Kenya Struggle to Follow Their HIV Preventive Treatment
In Kenya, young sex workers are particularly at risk of contracting HIV. In some regions like Kisumu, nearly one in five women lives with the virus, a rate much higher than in the rest of the population. To protect them, a preventive treatment exists: a daily pill that significantly reduces the risk of infection. However, despite its proven effectiveness, regular use remains a challenge.
A recent study compared two methods to help these women better adhere to their treatment. The first relied on peer support, with trained sex workers providing guidance and counseling. The second combined SMS reminders with a small financial incentive for each response sent. For one year, two hundred young women aged 18 to 24 participated in this study. The results showed that very few of them had traces of the medication in their blood after 12, 18, or 24 months, indicating irregular intake. Yet, most claimed to take their pill almost every day.
This discrepancy between what they report and reality can be explained by several factors. The COVID-19 pandemic disrupted their work, reducing client interactions and thus their perception of risk. Additionally, daily challenges such as forgetfulness or lack of time make it difficult to take a pill every day. The obstacles are not just individual: fear of judgment, lack of support from their environment, and difficulties accessing healthcare also play a role.
The study highlights the urgency of finding better-adapted solutions. Long-acting preventive treatments, such as injections or implants, could be a promising option. These alternatives would eliminate the need to take a daily pill and better meet the needs of these women. Their lives, often marked by precarity and instability, make strict adherence to a daily treatment complicated.
The findings also emphasize that prevention strategies must consider social and economic realities. Young and vulnerable sex workers need comprehensive support that goes beyond medication distribution. Their protection requires flexible, discreet, and accessible solutions that can adapt to their changing living conditions.
Bibliographie
Source de l’étude
DOI : https://doi.org/10.1007/s10461-026-05044-2
Titre : Behavioral and Structural Interventions for PrEP Adherence Among Young Female Sex Workers from Western Kenya
Revue : AIDS and Behavior
Éditeur : Springer Science and Business Media LLC
Auteurs : Kawango Agot; Domonique M. Reed; Matthew R. Lamb; Dan Omollo; Julie Franks; Jane Moraa; Joanne E. Mantell; Allison Zerbe; Timothy Okello; Maria Lahuerta; Lubbe Wiesner; Doris Naitore; Marylyn Ochillo; Wafaa M. El-Sadr