Building Partnerships,
Transforming Lives
Increasing Access to HIV Services – Case of
LVCT
Nduku Kilonzo, PhD
Executive Director
Acknowledgements:
Stephen Lewis Foundation; CDC;
LVCT colleagues; disability programme
LVCT – an indigenous Kenyan NGO
country led, country managed, country
priorities
Quality assured HTC
VCT; home-based, mobile, workplace,
couple HTC; 526,000 tested in 2011
Linking testing to care/ART /SRH
models for effective linkages & retention
Vulnerable & at risk populations
MSM/Prisons (since 2006) - 26,000 tested ;
Disability - 25,000 tested through award
winning Deaf VCT; Youth - one2one youth
hotline - PPP with Safaricom (Kenya’s
largest telcoms co. – 3,000 monthly calls);
1.6M youth tested; GBV/Post Rape Care:
15,000
survivors seen
2
outputs
Research/
Piloting
-innovation
-new service delivery models
TA for
policy
reforms
(GoK)
Evidence-based policy reforms:
-national strategies, standards
for processes, personnel,
commodities, scale up with
costs, performance indicators
Systems
strengthening
-sustainable human resource
(training)
-quality assurance &
supervision mechanisms
-M&E, data & reporting
-CSO coordination frameworks
Facilitating
scale up
-South to South TA: sub-granting
& capacity building for
implementers, special needs gps
-direct service delivery
-demand creation & advocacy
outcomes
Coverage - access, equity (in both delivery
and uptake); Strengthened health systems;
New knowledge;
GOAL: UNIVERSAL ACCESS
Technical, financial and human resources;
partnerships
HIV testing & counselling; linking testing to palliative
care & ART; HIV/SRH to vulnerable/at risk populations
3
LVCT - inputs
The relationship between HIV and
disability has not received due attention;
persons with disabilities are found
among all key populations at higher risk of
exposure to HIV
Where are we in the HIV response in Kenya
Where is disability? Persons With Disability?



4

The LVCT response
What do we need to do differently
Setting the context – HIV in Kenya
•
•
•
•
Population – 40M
52% female
60% youth i.e <35yrs
Mixed epidemic
• Generalized (concurrent
relationships, couple
discordance)
• Most at risk (sex workers,
• Geographical disparities
• Gender disparities e.g.
females aged 15-24yrs 4x of male prevalence
•
No disability data
Kenya 7.4%
KAIS 2007
5
HIV testing and counselling services?
Females Males Total
1
Gap in HIV status knowledge -testing gap
56.2%
43.3%
35.6%
25.1%
48.2%
39.9%
13.1%14.3%13.7%
0
2003
6
2007
2009
2003 – KDHS
2007 – KAIS*
 New HTC guidelines,
Focus on routine
HTC at all service
points
2009 – KDHS
 HTC roadmap focus on outreach
services
 Data dissagregation
not inclusive of
disability
HIV care and treatment
- KAIS data – 2007
- Currently 70% coverage (of
needed 500,000 individuals)
- PMTCT – 73% coverage
No data on disability
Did Not Report Status
Need
CTX, on
CTX,
12%,
Need
CTX, do
not
know
status,
84%,
Need
CTX,
Know
status,
not on
CTX,
4%
2%
Never
Tested
16%
Correctly
reported HIV
positive
56%
26%
7
Believed themselves
uninfected based on
last test
82% of those HIV+ did not know
their HIV status
Financing..
8
LVCT response ?

Responding to vulnerabilities rather than just ‘HIV risk’

Vulnerable groups
– Ltd access to HIV information & services
– Challenge to identify & serve
– Hard to reach – limited documented knowledge
– Face potential stigma and discrimination

Persons with disability
– Less literacy
– Assumptions that they do not have sex
– Exposure to sexual violence/coercion - younger girls
9
LVCT response?

Our mission

Peer- led programming
– with a funded programme, coordinator,
– providers are persons with disabilities (15 LVCT staff)

Willing to invest
10
LVCT response – policy reforms action
The Kenya National AIDS Strategic Plan (KNASP) III
2009/10-2012/13 (NACC, 2009)
“I want to particularly acknowledge the work of the team from
Liverpool VCT, which, as a voice for civil society, helped to
integrate the concerns of people most at risk, as well as
importance of gender and human rights across the Plan’s
four pillars”

Mr. Michel Sidibe, the Executive Director of the UNAIDS who was a
special state guest at the launch of the KNASP III by the Right Hon. Prime
Minister, Raila Odinga on 12th January 2010

Disability task group of North-South on international
advocacy for disability & HIV
11
LVCT response – systems strengthening

70 hearing HIV service providers trained on basic Kenya
Sign Language (KSL)

Partnership with 20 organizations of persons with disability
and built their capacity

Development & dissemination of “Signs for Sexuality and
Reproductive Heath Manual”
Partnership with VSO, produced “A Handbook on the Best
practice regarding HIV/AIDS for people with disabilities” to
assist in advocacy, policy formulation and programming
for PWDs. Copies are also available in Braille and audio for
12the blind.

Services

LVCT established the first deaf VCT sites in Kenya

Initiated a national Deaf (now disability) Mobile VCT
campaign (2009)
– Over 300 Mobile VCT targeting persons with disabilities

HTC to over 24,000 disabled clients including over 12,000
deaf clients

7 support groups established in 2 regions, for persons with
disability living with HIV
Partnership with Kenya Institute of Special Education
13(KISE) for a Disability friendly HTC site

Services
2,500
Graph showing number of PWDs tested :Period 2009 2012
2,190
2,010
2,000
1,500
1,000
832
665
500
575
535
295
0
14
Period:Oct 2009-May 2012
494
HTC services by gender
Graph showing number of PWDs tested by sex
Period:2009-2012
1,800
1,600
1,578
1,460
1,340
1,400
1,200
1,000
800
730
789
686
670
600
343
400
200
0
2009
15
2010
2011
Period:2009-2012
2012
Male
Female
Graph on Prevelence rate(%)
Period:Oct 2011- May 2012
8.7%
9

HIV prevalence
– similar to
national levels
from VCT data
(not national
survey data)

50 on
treatment???
8
7
5.8%
6
5
4
2.4% 2.6%
3
2
1.7%
2.3%
1.5% 1.8%
1
0
16
Period:Oct 2011-May 2012
What do we need to be doing?

Invest! Invest! Invest!
– Provider training
– Service delivery processes
– Outreach services

Respond to vulnerability before we have to respond to
most at risk populations

Deliberately put in funds into material production in
reachable format
17
Thank You!

Contacts
Website:
www.liverpoolvct.org
Email:
enquiries@liverpoolvct.o
rg
18
Building Partnerships, transforming
lives