An estimated 1.6 million people are living with HIV in Kenya. While we know that the majority of them are from Nyanza Province, the region in the country's southwest around Lake Victoria, there is much that we still do not know about HIV and AIDS in Kenya. For example, there are no clear records of the prevalence rate in urban slums, especially when many people likely do not know they are HIV-positive.
Concern Worldwide uses what we call "community conversations" in Nyanza Province as well as Mukuru, a slum east of Nairobi, to break down many of the barriers that keep people from getting tested, and if they are diagnosed, taking antiretroviral (ARV) medications. We first piloted the approach in 2010 as a way for people to talk about their challenges and find solutions. There are now 24 community conversation groups across Nyanza Province and in Nairobi's urban slums--all of which tackle HIV and AIDS head-on.
I spoke with my colleagues Belinda, Jane, and Julia, who are all community conversation facilitators in different areas of Mukuru. They said that community members see HIV and AIDS as one of their biggest challenges, with orphans and single parenting on the rise due to HIV and AIDS. Many are living in denial of their status, refusing to take ARVs.
This is exactly where community conversations come in.
Jane said that it was very difficult to get community members to understand that HIV and AIDS is a virus, not a curse. "We managed to take approximately 150 people to different centers to start taking ARV medication through community conversations," she said. "It is unfortunate that people are still living in denial--very few people are going for counseling and testing, while others have refused to take ARV medication because of the stigma around HIV and AIDS."
Community conversations also pushed 80 people from other parts of Mukuru slum to start taking ARVs. "We have established a support group for people who are HIV-positive," said Belinda. "We support them in what they do so that they can feel part of the society and I am happy to tell you that we don't have anyone who is bed-ridden because of HIV and AIDS in my community." Nyanza Province is no different, with stigma and discrimination keeping many from getting tested and on a treatment plan.
An estimated nine percent of people living in Nyanza Province are HIV-positive. Crippling poverty and deeply embedded cultural practices, like wife inheritance, drive the spread of HIV. Through community conversations, Concern is educating the community on HIV and how the virus is spread. We encourage mothers to get tested at ante-natal clinics (which are more discrete than a testing facility) and we worked with a local chief to discourage promiscuity and promote condom use.
Community conversations are where that dialogue begins--and silence will never put an end to HIV and AIDS. We need to keep talking.