HOMA BAY, Kenya – The Kenyan government has been stepping up its efforts to eradicate HIV/AIDS by 2030.
It has done this by introducing long-acting treatments (such as injectable Lenacapavir), integrating services, strengthening domestic funding, launching a five-year strategic framework (2025–2030), partnering with international organisations to address funding gaps, and concentrating on paediatric care, prevention, and treatment access.
In Homa Bay, the county most hit by HIV/AIDS in Kenya, residents are complementing the government efforts in various ways, making the situation different.
Although it is still one of the high-burden areas, Homa Bay County has historically had a very high HIV prevalence.
The significance of community leadership in the HIV response, just as the case in Homa Bay County, is acknowledged by the United Nations Member States’ 2016 and 2021 pledges to eradicate AIDS by 2030.
Decision-making, planning, execution, and monitoring of the HIV response must include networks of people living with HIV and impacted communities in a meaningful way, according to the Greater Involvement of People Living with HIV/AIDS (GIPA) principles.
Recent estimates show a significant decline to about 15.2% (2023) from over 23% a decade prior, making Homa Bay County a success story in Kenya’s HIV response. Ongoing efforts are concentrated on lowering new infections and improving treatment adherence.
Homa Bay adolescents empowered on sexuality and reproductive health issues
Here, teachers, parents, healthcare providers, Community-Based Organisations (CBOs), and government officials are collaborating diligently to empower youth regarding sexuality and reproductive health issues. Communities of people living with or affected by HIV in the Nyanza county have been at the forefront of delivering HIV-related health services and critical social inclusion responses since the start of the HIV pandemic. This is even though creating awareness amongst teenagers remains a contested issue in Kenya.
Former Health Cabinet Secretary Dr. James Macharia launched the National Adolescent Sexual and Reproductive Health Policy 2015 (ASRHP) to guide age-appropriate comprehensive sexuality education among the juveniles.
However, the move appears not have had an impact across the country, forcing the residents of Homa Bay County to take up the matter.
“Since teenagers are also sexually active, we have a high prevalence of HIV in this area. But we’ve united and decided to educate this group to intervene,” explained Millicent Anyango, a Sofia, Homa Bay resident.
One of the peer counsellors in Homa Bay Sub-County is Anyango, better known as Mama Gift, a mother of three.
She notes that infections among teenagers are widespread in the area because of parental carelessness and cultural barriers.
“Most parents cannot talk to their children, especially daughters, about changes that happen during puberty, making adolescents get into experiments that expose them to HIV infections. They are sexually active and need to know rights and wrongs and protect themselves in case of attacks by defilers,” explains Anyango.
Inside the ambitious Homa Bay County’s GATE program
The initiative dubbed Girls Attaining Transformation and Empowerment (GATE) is aimed at increasing access to integrated Sexual Reproductive Health (SRH) and has established social support networks for Adolescent girls and young women at the community level.
“My two daughters are members of one social support group and meet regularly to share experiences in a session where their questions are answered by trained peers. For the last six months, our interaction has improved, and they are free to ask vital questions and develop uprightly,” she added.
Anyango’s sentiments were echoed by Everlyne Odongo, a teacher at Lala Mixed Secondary School, who explained that teens are exposed to greater danger when sexuality is not discussed with them.
“We engage and empower girls through the GATE initiative to better understand themselves and exercise caution because HIV is real. Such education is essential for teenagers. In addition to preventing new HIV infections, teenage pregnancy rates are significantly declining,” explained Odongo.
Teenage pregnancies caused four girls to drop out of school in 2016, but to date, there hasn’t been a single instance, according to Odongo.
“There has been a change even in how the teenagers conduct themselves, with absenteeism also reducing. We noticed teenagers have a lot of questions to ask during our forums, only that they lacked a platform because sexuality issues are perceived to be a preserve of the adults,” added Odongo.
Networking sessions among adolescents and peers are a game-changer in Homa Bay
During a recent visit to the Family Health Options Kenya (FHOK) Health Centre in Sofia, we met a group of girls who were reciting poems, while others played netball in an open field. They had just come out of a networking and learning session.
Cynthia Akinyi, a peer educator in charge of the group, disclosed that the interactions have not only helped reduce new Sexually Transmitted Diseases (STDs) infections but also boosted self-esteem amongst the girls.
“We are surrounded by slums like Shauri Yako, where parents share tiny shacks with their children. there is no privacy, and the young ones witness everything that happens and being children, they would want to experiment,” says Akinyi.
She observed that some teenagers were born with the infection, and if their peers have intercourse with them, they get infected, which is what they want to tame.
“We meet at least every weekend, targeting teenagers in day schools and talk about reproductive health issues, sexuality and family planning in sessions structured to fit different age sets. Parents were adamant at first, but have softened up and allow their children to come here due to notable outcomes,” added Brenda Ogutu, a peer counsellor at the FHOK centre.
*Cecilia Adhiambo’s resilience story amid HIV/Aids infection
According to Ogutu, with the help of chiefs, clergy and faith-based organisations, they conduct regular outreaches through barazas and door-to-door visits to create awareness and support the infected individuals to access medication.
Cecilia Adhiambo (not her real name) realised she was HIV positive when she was about seventeen years old, about 15 years ago, when still in high school, a revelation that demoralised her to the core.
“It was shocking because I was still a young girl, and I refused to accept the outcome. I was depressed. Two years later, I conceived and bore a son. My then-boyfriend was also infected,” she lamented.
The lady who has already sat for her KCSE, however, had to accept her condition following a series of counselling sessions and connection to support groups and is currently championing against reckless sexual behaviour. Her narration is a true reflection of living positively.
She does numerous income-generating activities, including riding a boda boda motorbike and rearing improved Kienyeji chicken, and through these activities creates HIV awareness.
Why are boda boda operators a vulnerable group?
At Sofia’s main boda boda stage, she is a popular figure; she arrives with her bike with a backpack and suddenly, male bodaboda riders jam around her. She unzips the bag and begins dispensing Condoms in red sachets as they chat freely.
“I accepted my status, and I want to help people tread carefully to avoid infections. I don’t feel weird carrying and distributing condoms. Twice a week, I make supplies, or on order. In this area, the prevalence is high,” she stated.
She emphasised that boda boda operators are a vulnerable group by virtue of their job’s nature, and some of them are afraid to get the condoms from health centres, hence her intervention.
“I also engage the teenagers and ask them to be cautious and safely interact, besides supporting those who are infected. There is more life even after infection, provided one accepts their condition, takes drugs and lives positively,” the female boda boda operator further said.
Governor Gladys Wanga weighs in on the HIV status in Homa Bay
Following the launch of the Kenya Plan to End AIDS in Children by 2027 in Homa Bay County, the area Governor, Gladys Wanga, said the plan would help her devolved unit, which has been having a high HIV prevalence, make significant milestones in ending HIV.
The ambitious strategy followed a national dialogue and a 100-day children and adolescents living with HIV (CALHIV) rapid result initiative (RRI) that calls for an urgent response to end the spread of HIV among children and reduce infant mortality in the country.
“We have decided as a County that we are tired of being known for the bad things, and so we are putting our best foot forward to work together with our partners to end this triple threat,” she noted.
The County SGBV policy provides a legal framework to comprehensively protect, prevent, promote and coordinate the numerous phases of Sexual and Gender-Based Violence. The Governor said that for the policy to be effectively implemented, there must be the continous partnership between the government, the local community, the provincial administration, and the security sector to ensure SGBV is dealt with.
She said that punitive action must be taken against the perpetrators, adding, “For us to end the triple threat, we cannot do things the same way this time and expect different results. To deal with this, we must become firm by becoming a bit insane.”
According to a 2020 report, one-third (33%) of adolescent girls between the ages of 15 and 19 in Homa Bay are mothers or are pregnant with their first child. The same report also indicated that youth aged between 15 and 24 contribute 13% of the total number of HIV infections amongst 15- to 49-year-olds in the County.
John Cheboi, Nurse in Charge at Magina Health Centre in Ndhiwa Sub-County, revealed that they hold teenage clinics between 4.00 PM and 6.00 PM and on weekends, saying this has improved the number of new STD infections from 63% to 45% since January, 2025.
Experts and professionals react to the HIV/Aids and STIs issue
James Otiato, County Reproductive Health Officer in Homa Bay, observed that the teenagers’ empowerment project has improved awareness creation, which has gradually translated to reduced teenage pregnancies and infections among the children.
“General prevalence levels in the county were 26% a year ago compared to now, where it is about 15%, the programme has done well in Homa Bay and Ndhiwa Sub Counties, and if sustained, will enable us reduce the new infections greatly,” he said.
According to experts and professionals, the issue of HIV and STIs prevalence in the country and the African continent in general necessitates a fresh national emphasis.
In just one year, the number of new HIV infections among teenagers between the ages of 10 and 19 increased by 34%, from 2,083 in 2023 to 2,799 in 2024. 19,991 new infections were reported nationwide in Kenya, indicating a reversal of decades of arduous progress.
An estimated 1.3 million Kenyans are HIV positive today. Adolescents and young people between the ages of 10 and 24 make up roughly one-third of all infections, with children accounting for 22% of new cases.
Who is the most HIV/Aids affected group on the African continent?
While reacting to the approval of Lenacapavir, as pre-exposure prophylaxis (PrEP) to lower the risk of sexually acquired HIV in adults and adolescents weighing at least 35 kg in June 2025, United Nations Programme on HIV/AIDS (UNAIDS) Executive Director Winnie Byanyima observed that the most infected people across Africa are young girls and young women.
“They are infected because they do not control sex. If they have sex with a man or a boy, they may not be able to insist on protection while having sex. Or they may not even be able to insist on turning the request down. So, they are the most infected,” said Byanyima.
The Ugandan-born academician observed that the injection is the solution for them because they don’t know how best to protect themselves.
“They can get this injection and rest assured that whatever happens will be okay with them. The most affected are the sex workers. A sex worker may sleep with 8 men in a day. So, if she is infected, then it means that she is spreading the disease,” Byanyima added.
How is the Kenyan government addressing the withdrawal of foreign funding?
To keep sex workers safe, Byanyima indicated that the new injection would be the best solution.
“She gets her injection every six months; whatever she is doing, she is not transmitting. So, we need it here. Gilead Sciences is going to sell the drug at USD 28,000 (Sh3.6 million) per person per year, which is out of reach for us,” lamented Byanyima.
National STI Control Programme (NASCOP) Chief Executive Officer Dr. Andrew Mulwa, while addressing journalists at the launch of the Voices of Impact: HIV and STIs Media Awards 2026, said Kenya’s health systems had been tested following the withdrawal of funds by the U.S. government.
“Time is now ripe for the health systems to be integrated. Not because the funds have been withdrawn, but because we need to do it. The U.S. government has changed its strategy on how it conducts its development agenda,” said Dr. Mulwa.
Dr. Mulwa said the government, through its development and implementing partners, is keen to reduce the HIV infections among the younger people.
This comes when Homa Bay County’s success story appears to be a clear indication that achieving universal health coverage can be greatly aided by community responses to HIV.
Community-led organisations have been providing HIV services for over 20 years, shaping the ecological systems of health delivery processes and holding duty-bearers accountable.
A look into the state of HIV/Aids prevalence rate in other notable Kenyan counties
When health systems are people-centred, communities can take full advantage of the crucial choices made within the system by using services as clients, establishing regulations and allocating resources as policymakers, or implementing those regulations as managers, implementers, providers, and service consumers.
Meanwhile, the National Syndemic Disease Control Council (NSDCC), formerly known as NACC, reports that despite Homa Bay’s sharp decline in HIV prevalence, Kisumu remains one of the highest-burden areas with an estimated prevalence of 11% to 17.5% depending on the specific report (2025 datasets).
It is noted as having over 111,000 to 135,000 people living with HIV.
Migori County has been reported as the fourth-highest county nationally for people living with HIV (approximately 99,510 to 106,003). Prevalence estimates for 2025 range from 9.7% to 11.09%.
On the other hand, Busia County reported a drop in prevalence to 5.3% in 2025 from 7.7% in 2024, although it remains higher than the national average of 3.03%.
Additionally, Nairobi has a lower prevalence percentage (approx. 4.3% to 6.1%) compared to the Western/Nyanza counties, which leads in the absolute number of new infections (3,045 in 2024/2025) and total people living with HIV (over 151,000).
These top four counties, along with Siaya, Kakamega, Nakuru, Mombasa, and Bungoma, accounted for 60% of all new cases in 2024, indicating notable regional disparities.
