"PEPFAR gives capability"

PEPFAR Kenya gives hope and capability through....

equipping people to become peer educators and role models for their communities

To achieve HIV epidemic control in Kenya, fisherfolk remain a high priority population. According to a NASCOP study assessing attitudes and perceptions towards HIV, there was a high level of knowledge among fisherfolk in Kenya of HIV prevention measures and treatment for HIV infection. However, the study also found that knowledge did not equate to practicing protective behaviors like condom use, getting HIV testing, or adhering to antiretroviral therapy (ART) for treatment of HIV.

PEPFAR Kenya has worked collaboratively with the Beach Management Units in lakeside communities for targeted outreach to and follow-up of nearly 123,000 fisherfolk. The program works with health facilities near the fish landing beaches to address the unique sexual and reproductive health needs of fisherfolk; this includes provision of family planning services, sexually transmitted infections (STI) screening and management, and active screening for Pre-Exposure Prophylaxis (PrEP) eligibility and provisions of PrEP services. Along with peer educators like Wilson, PEPFAR Kenya continues to promote community ART initiation and mobile ART to assist individuals with migratory patterns and on isolated islands to adhere to their treatment regimens, as well as to provide behavior change communication regarding harmful practices like the fish-for-sex trade that often occur in fishing communities.

Wilson’s Story

When Wilson Oduori started his career as a fisherman and fishmonger in Samia some two decades ago, the area was notorious for ‘fish for sex’ transactions. Fisherfolk would engage in sex mainly in exchange for fish or cash; it was an accepted practice that became normalized, and there seemed to be little concern for sexually transmitted infections, including HIV. It did not take long for the dangers of this practice to manifest and the HIV pandemic struck the area. Bumbe beach, apart from its fame for good fish, also became a hotspot of HIV infections. “We started burying friends and beloved ones, and slowly realty started trickling in that something had to be done,” Wilson recalls. He chose to be the one to do it. “I had watched a close relative succumb to the disease,” he notes, and he felt compelled to take action. 

As a peer educator, Wilson benefitted from a raft of trainings from PEPFAR and county and national government that empowered him to take a lead role in educate his peer fisherfolk regarding responsible sexual behavior. Following his increased capability to teach and lead his peers with sound training, Wilson leads a team of peer educators at the beach who collaborate to sensitize their fellow fishermen.

Two decades on, through the collaboration of PEPFAR, the Government of Kenya, civil society organizations, and peer educators like Wilson himself, Bumbe Beach is no longer a hotspot that harbors infections from transactional sex. “Thanks to PEPFAR through implementing partners that currently include USAID Dumisha Afya, Bumbe beach is no longer a hot spot,” Wilson reflects, with satisfaction; “Our beloved ones no longer succumb to HIV AIDS.”

These days the area is not just a hub for sought-after fish like the Nile perch, it is also a hub for empowerment. With support from PEPFAR, through local partners, Wilson’s team of peer educators can access relevant information through trainings that they then share with others. For those within their circles who test positive for HIV, Wilson and his team link them with USAID Dumisha Afya to ensure they not only get treated, but also supported as required.

Through PEPFAR, USAID Dumisha has served over 20,000 fisherfolk like Wilson in Busia county alone since October 2021. The program promotes HIV prevention demand, referral to health facilities, behavior change communication, and provides linkage to microfinance institutions for shorter term financial support and long-term economic empowerment.

Wilson's photos © Silvano Ateka / US Embassy Nairobi