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September-October 2009

How the University of Manitoba revolutionized HIV care in Nairobi

Siena AnstisWebsite

John Mathenke, a Nairobi sex worker, was diagnosed with HIV in early July. He is working with the Sex Workers Outreach Program to educate other sex workers about HIV prevention. Photo by Siena Anstis.

John Mathenke, a Nairobi sex worker, was diagnosed with HIV in early July. He is working with the Sex Workers' Outreach Program to educate other sex workers about HIV prevention. Photo by Siena Anstis.

Blended into the colourful storefronts of Nairobi’s River Road area is the Sex Workers Outreach Program (SWOP), a discreet but accessible clinic offering HIV and STD testing and treatment to the estimated 7,000 prostitutes who work in the central business sector of Kenya’s capital city.

While the clinic was created in close consultation with Nairobi’s sex workers, its origins are the result of a partnership between the University of Nairobi and the University of Manitoba that dates back to 1980.

Shortly after the two schools first collaborated to start exploring the murky world of HIV-AIDS transmission through prostitution. Despite being a whole continent away and exploring a disease that was not yet a “hot topic,” the University of Manitoba was determined to continue the research it had started in Canada in the 1970s on STDs, and later HIV. The school’s initial findings attracted the attention of Herbert Nsanze, the then-new chair of medical microbiology at the University of Nairobi, who invited the U of M to work from Nairobi’s streets.

This partnership has resulted in some groundbreaking research, most notably, the discovery that some prostitutes are immune to HIV despite having more than 500 partners a year. The two universities have also launched two research and treatment clinics, including SWOP, which recently celebrated its fi rst anniversary.

Over the past year, SWOP has grown from a quiet start-up to a busy clinic that regularly treats 2,600 female and 65 male clients. To Joshua Kimani, the Kenyan-born, U of N-educated doctor who now oversees the clinics run by the two schools, these numbers are a sign of success.

Kimani is particularly excited to see the growing presence of male sex workers. “It takes a long time to win the confidence of men,” explains Kimani. “There is a double stigma, adding insult to injury, of men who have sex with men and who are also sex workers.” In Kenya, both homosexuality and prostitution are illegal.

Together, the University of Manitoba and the University of Nairobi have made a significant dent in the HIV rate among Nairobi’s sex workers. Majengo, one of their other clinics, saw the HIV rate drop from 10 percent to 1.5 percent over the past two decades. With research and technical support from the University of Manitoba, SWOP expects similar results in the coming years.

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